All of us have ‘good’ and ‘bad’ bacteria in our gut. This is nature’s balancing act. Besides, it’s not just eating, but also what goes on in your mind — for example, emotional stress — that may trigger irritable bowel syndrome [IBS]. That IBS has no known, or established, cause is passé. What characterises the syndrome is abdominal pain, along with cramps, bloating, or gas.
Certain IBS individuals often complain of constipation, or diarrhoea, or both, as outlined earlier too, along with mucous in stools. IBS symptoms tend to worsen in response to certain foods, no less — as also mental distress, or upheavals.
Yet another likely trigger is conventional medical treatment with antibiotics, or their overuse. Antibiotics are evidenced to wipe out the ‘good’ bacteria in the gut. This, in turn, may lead to a whole lot of gut problems, including IBS.
Most people with IBS prefer easy access to the washroom; they also have a certain apprehension, while travelling — especially, when there is no easy access to it. What also marks their day-to-day life is depression with emotional anxiety — that others would get to know about their tummy dilemma.
There is no laboratory, or specific, test for the diagnosis of IBS. However —
- A proper medical history may usually be sufficient to diagnose IBS
- Your doctor may, at times, order certain tests to get a better insight — blood and stool tests, sigmoidoscopy [minimally invasive medical examination of the large intestine], colonoscopy [endoscopic examination of the bowels], CT scan and lactose intolerance tests.
Stress, anxiety or depression, as outlined earlier, can make IBS worse. In arriving at a diagnosis of IBS, your doctor may also ask whether the pain is relieved by defaecation [stools], whether you experience a change in the frequency of passing stools, and whether there is a change in the appearance of the stools. Most doctors may diagnose IBS, if two out of three of such features are present.
IBS is not typically associated with pain, or diarrhoea, that interferes with sleep, blood in the stool [either visible, or in laboratory analyses], weight loss, fever, or any physical abnormality. If any of the symptoms is present, you should see your doctor without delay. Also, any change in bowel habits that happens in middle age should be investigated promptly by a doctor.
While it is agreed that IBS may not be a life-threatening syndrome, its ‘never-let-go’ presentation gives one the feeling that there is something ‘waiting in the gut’ to happen, or explode. This heightens one’s trepidation and emotional distress, while affecting their quality of life [QoL], including domestic harmony, relationships, and workplace performance. When this becomes the song of one’s burden, it can lead to depression and other accompanying mind-body symptoms.
To highlight one example — patients who suffer from morning diarrhoea may not leave their home until the diarrhoea stops. If diarrhoea is constant, they may only go where they know toilet facilities are readily available. Besides, IBS individuals who develop pain after eating may skip breakfast, lunch, or dinner, to avoid symptoms. More importantly, they may associate symptoms with specific, or certain, foods — for example, milk, fat, vegetables and so on. The outcome would be restricted diets and nutritional deficiency. When milk, for instance, is eliminated, it may trigger a calcium deficit. The intrusion, along with the disorder’s unpleasant symptoms, may slowly affect daily activities, leading to heightened interpersonal relationship problems, especially with their spouse.
That most patients with IBS tend to just manage and live with their symptoms and only occasionally visit their doctor for diagnosis and treatment also confounds their problem. Research also suggests that there may possibly be a sense of ‘prediction’ in certain individuals towards IBS. Hence, their strange apprehension, or fear, while travelling. They are free from trepidation only when there is easy access to the washroom.
When IBS — especially, constipation and diarrhoea — is not appropriately treated, it can, as already discussed, affect familial and work relationships, besides triggering, or aggravating piles [haemorrhoids] and diverticulitis — a digestive disorder with abdominal cramping, constipation, or watery stools and rectal bleeding.
Although research evidences that there is a certain ‘bias’ for IBS in some people, it’s not just eating, but also what goes on in our mind — for example, emotional deviations — that ‘triggers’ IBS, a psychosomatic disorder. This relates, no less, to the gut, as already cited, the ‘home’ of ‘good’ and ‘bad’ bacteria.
The inference — IBS individuals should focus on a healthy lifestyle and eat low-glycaemic foods, for example, oats, which convert into glucose, slowly, while preventing the proliferation of ‘bad’ bacteria.
Treatment
Ayurveda
Irritable bowel syndrome [IBS] is one of the clinically challenging disorders. It has a significant effect on health, cost and quality of life. Ayurveda management through whole system approach in IBS is explored in this clinical study.
Objective. To evaluate the efficacy of whole system Ayurveda approach in IBS.
Methods. The present trial is a randomised controlled parallel group study. 48 patients diagnosed as IBS [Rome IV Criteria] between the age group of 20 and 60 years were recruited in the study. Patients were randomly divided into two groups. KC group intervened with Kalingadi churna 3gm twice a day, before food with buttermilk. WS group intervened with whole system Ayurveda protocol [WSAP]. Duration of intervention was 60 days with follow-up on every 15th day. Assessments were through various clinical measures, like IBS Symptom Severity Score [IBS-SSS], IBS Adequate Relief [IBS-AR], Gastrointestinal symptom rating scale [GSRS], IBS-VAS, Complete Spontaneous Bowel Movements [CSBMs], Bristol Stool Form [BSF], Hamilton Anxiety Rating Scale [HARS], Hamilton Depression Rating Scale [HDRS], IBS quality of life [IBS-QoL] at every follow-up. Haemoglobin, Erythrocyte sedimentation rate [ESR] and stool examination was conducted at pre- and post-study.
Results. The study showed that WS group had significant improvement compared to KC group in IBS-SSS, IBS-AR, IBS-VAS, CSBM, BSF-Diarrhoea and BSF-Constipation. Both groups were comparable in GSRS, HARS, HDRS and IBS-QOL. Blood and stool parameters assessments showed comparable improvements in both the groups. Within group significant improvements in all the clinical assessment scales were observed in both the groups.
Conclusion. WSAP was effective in the management of IBS [IBS constipation and IBS diarrhoea]. Improvements were observed in abdominal pain, stool frequency, consistency and adequate relief.
- Teja D Naik, et al, “Efficacy of Whole System Ayurveda Protocol in Irritable Bowel Syndrome — A Randomised Controlled Clinical Trial,” J Ayurveda Integr Med 2023; Jan-Feb; 14[1]: 100592.
Homeopathy
IBS is one of the most common functional conditions treated by professional homeopaths worldwide. It is also a growing area of homeopathic clinical research — to establishing more effective, evidence-based treatment protocols, for the disorder.
In a study conducted, at a large group of homeopathic clinics, on a group of IBS patients, treatment results showed an impressive ‘feeling better’ in 89 per cent of patients. It also highlighted the fact why more and more patients are opting for homeopathic treatment as the most ‘preferred’ and ‘proven’ alternative option in holistic healthcare.
Homeopathy addresses and treats the individual with IBS. Not just one’s bowel, or gut symptoms, as they appear on the surface — all the more reason why clinical studies substantiate the therapeutic value and safety of homeopathic protocols in the treatment of IBS.
That IBS also accounts for more referrals to gastroenterologists than any other digestive disorder, with treatment outcomes being anything but spectacular, or long-lasting is a significant detail. It is classed as a ‘functional disorder,’ which means that the intestines appear normal, but do not function normally — this is obviously a key therapeutic area where homeopathy works best.
Homeopathic treatment has been clinically proven to ease tummy distress, pain and other annoying symptoms, associated with IBS. Your homeopathic doctor can help you manage, control, stall and correct the deterioration of the condition. This will also help prevent its recurrence, as homeopathic treatment for IBS can be more than useful, because it reduces stress — a major trigger for gastric, or other functional disorders — and, also abnormal hypersensitivity of the bowels, aside from bowel hypermotility.
This is simply because homeopathy gets to the ‘root-cause’ of the IBS distress and brings balance and harmony back to your mind-body system. This may often lead to bowel normalcy, good health and a state of inner emotional accord for the long-term.
The evidence for the effectiveness of homeopathy in treating IBS is unmistakable — two controlled studies in Germany showed positive results. This has been followed by clinical studies in different settings and evidence-based patient outcomes.
Most homeopaths prescribe, or recommend, the use of a single homeopathic remedy and, as with homeopathic treatment for other conditions, over 10-15 remedies may be appropriate, subject to the individual’s unique temperament, or personality, and presenting symptoms.
Things To Do
- Consult your homeopathic doctor if your IBS symptoms are severe, persistent, or recurrent, or if you have rectal bleeding, blood in the stool, pain that interferes with sleep, or have unexpectedly lost weight
- Consult your doctor if you are over 40 when symptoms first appear, as some gastro-intestinal disorders have similar symptoms, but need prompt investigation and treatment.
Useful Homeopathic Remedies
- Argentum nitricum is indicated when anxiety is associated with IBS. The affected person has a lot of bloating and a craving for sweet food
- Phosphoric acid is indicated, particularly when IBS symptoms have been triggered by emotional stresses, such as relationship difficulties, or bereavement, and when associated with a weak memory. Diarrhoea is usually a prominent symptom.
- Nux vomica may be given when there is a frequent urge to pass faeces, often without a ‘satisfying’ result, or when irritability and poor sleep are present.
It’s imperative that one consults a professional homeopathic physician for the appropriate remedy, also lifestyle guidance, among more than a handful of closely-corresponding remedies — which is what homeopathy is all about, more so, because it treats the individual with IBS, and not just the disorder in isolation.
Self-Help
- Research suggests that IBS individuals often benefit from eating low-glycaemic foods —because they convert into sugar slowly in the bloodstream and prevent the expansion of ‘bad’ bacteria in the gut
- Opt for low-fat foods. Low-fat foods are evidenced to be better, because they reduce inflammation, unlike fat-rich, or junk-foods, which increase the chemical load in our body and heighten inflammatory responses in the gut
- Increase your fluid intake — drink plenty of water, fruit, or vegetable juice, derived from carrot, spinach, beet and cucumber
- Drink two cups of green tea [without milk and sugar], 20 minutes before meal-time to improve digestion
- Avoid, or limit eating cabbage and broccoli; they may trigger gas [flatus] issues.
