An estimated 40 million Americans suffer with
irritable bowel syndrome (IBS).
Some experts, recognizing that many go undiagnosed, suggest that irritable bowel syndrome (IBS) affects approximately 10–20% of the general population. Irritable bowel
syndrome is characterized by a group of symptoms in which abdominal
pain or discomfort is associated with a change in bowel pattern, such
as loose or more frequent bowel movements or diarrhea, and/or hard or
less frequent bowel movements or constipation.
We know that gender plays a clear role, as more than 80 percent of IBS patients are
women between 20 and 55 years old.
The criteria for diagnosing IBS is based on the newly modified Rome
criteria (Rome II criteria) as the presence for at least 12 weeks (not
necessarily consecutive) in the preceding 12 months of abdominal
discomfort or pain that cannot be explained by a structural or
biochemical abnormality and that has at least two of following three
features:
(1) pain is relieved with defecation, and its onset is associated (2)
with a change in the frequency of bowel movements (diarrhea or
constipation) or (3) with a change in the form of the stool (loose,
watery, or pellet-like).
Some people with the disorder have constipation (IBS-C). Some have
diarrhea (IBS-D). And some alternate back and forth between
constipation and diarrhea (IBS-A).
IBS symptoms result from what appears to be a disturbance in the
interaction between the gut or intestines, the brain, and the
autonomic nervous system that alters regulation of bowel motility
(motor function) or sensory function.
Research has shown that the cause of IBS is related to neuroendocrine-
immune system dysfunction (brain and stomach hormones). This
connection is largely mediated by the neurotransmitter or brain hormone known as serotonin. The
brain and gut are connected through the neuroreceptors (hormone docking stations)
for serotonin, 5-hydroxytriptamine-3 (5-HT3) and 5-hydroxytriptamine-4 (5-HT4).
These serotonin receptors regulate the perception of intestinal pain
and the GI motility (contractions that move food through the
intestinal tract). Therefore serotonin controls how fast or how slow
food moves through the intestinal tract. In fact, there are more
serotonin receptors in the intestinal tract than there are in the
brain. Ninety percent of serotonin receptors are in the intestinal
tract.
Research suggests that IBS patients have extra sensitive pain
receptors in the gastrointestinal tract, which may be related to low
levels of serotonin. Decreased levels of serotonin may help explain
why people with IBS are likely to be anxious or depressed. Studies
show that 54–94% of IBS patients meet the diagnostic criteria for
depression, anxiety, or panic disorder.
Restoring optimal levels of serotonin has been the focus of
traditional drug therapy. Zelnorm, a 5-HT4 receptor agonist, was once
hailed as “the drug” for IBS-c (IBS with frequent constipation), has
recently pulled from the market for its association with heart attacks
and stroke. The percentage of patients taking Zelnorm that had serious
and life-threatening side effects was 10 times higher than the
percentage of patients taking a placebo.
Even before this drug was recalled cardiovascular risks, many experts
warned that this drug was dangerous for its other potential side
effects including severe liver impairment, severe kidney impairment,
bowel obstruction, diarrhea, constipation, abdominal pain, headaches,
abdominal adhesions, gallbladder disease, and back pain.
Lotrinex (Alosetron), a 5-HT3 agonist, is prescribed for IBS-d. Within
8 months of being on the market, reports of ischemic colitis (a life
endangering situation in which the blood supply to the intestines is
blocked) began to grow each day. Lotrinex was responsible for at least
four deaths, probably many more. Many who took the drug reported
severe abdominal pain from constipation.
The drug was taken off the market. It is now back and available with
strict prescribing guidelines. An editorial in The British Medical
Journal suggests that as many as 2 million Americans will be eligible
for the drug under the new guidelines. According to previous reported
side effects, this would result in 2,000 cases of severe constipation,
almost 6,000 cases of ischemic colitis, 11,000 surgical interventions,
and at least 324 deaths.
Antispasmodics (Levsin, Levsinex, Bentyl, Donnatal, etc.) are
routinely prescribed for the treatment of IBS symptoms. Potential side
effects include bloating; blurred vision; clumsiness; constipation;
decreased sweating; dizziness; drowsiness; dry mouth; excessive
daytime drowsiness ("hangover effect"); feeling of a whirling motion;
headache; light-headedness; nausea; nervousness; rash; hives;
difficulty breathing; tightness in the chest; swelling of the mouth,
face, lips, or tongue agitation; confusion; diarrhea; difficulty
focusing eyes; disorientation; exaggerated feeling of well-being;
excitement; fainting; fast or irregular heartbeat; hallucinations;
loss of coordination; loss of taste; memory loss; muscle pain;
pounding in the chest; severe or persistent trouble sleeping; trouble
urinating; unusual weakness; very slow breathing; vision changes;
vomiting.
Using potentially dangerous drugs to reduce
symptoms, while ignoring natural and often more effective approaches
is typical of what is wrong with “cookbook” (symptom-focused)
medicine.
Reversing IBS With Nutritional Therapy
I find that IBS usually disappears rather quickly once my patient’s
correct their poor eating habits (increase fiber, reduce simple
sugars, caffeine and junk foods), uncover any hidden allergies when
present, including gluten intolerance (Celiac disease), boost optimal
stress coping chemicals (serotonin, magnesium, B-vitamins, etc.),
restore bowel ecology (probiotics), and take the right digestive enzymes with
their meals.
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5HTP
To boost serotonin levels I recommend patients take, the amino acid
responsible for making serotonin, known as 5-hydroxytryptophan (5HTP).
5HTP along with the right vitamins and minerals, is responsible for making serotonin.
Patients should take 300-400mg a day with food.
Digestive enzymes
Most digestion and absorption takes place in the small intestine and
is regulated by pancreatic enzymes (digestive) and bile. The pancreas
aids in digestion by releasing proteolytic enzymes, which help break
down proteins into amino acids. Natural digestive enzymes are found in
raw fruits and vegetables. Processed foods are usually devoid of
digestive enzymes.
Over consumption of these processed foods can lead to digestive enzyme
deficiencies. This may then lead to malabsorption and or intestinal
permeability syndrome (bloating, gas, indigestion, diarrhea,
constipation, and intestinal inflammation). To ensure proper digestion
and absorption, I recommend taking pancreatic enzymes with each meal.
For stubborn IBS symptoms, I recommend using a high dose, pharmaceutical grade, pure 8X (100% stronger than most over the counter digestive enzymes).
Magnesium
I always recommend people take a good optimal daily allowance
multivitamin/mineral formula. Patients with IBS have depleted their
stress-coping chemicals (serotonin, magnesium, and vitamins) and this not only leads to IBS but also
prevents them from overcoming IBS.
It is a vicious cycle that can only be
broken by taking adequate amounts of essential vitamins, minerals and other nutrients I’ve already mentioned above.
The mineral magnesium, which is involved in over 300 bodily processes,
is particularly important for reversing the symptoms of IBS-c and IBS-A.
Magnesium helps relax the smooth muscle of the colon (natural
laxative) allowing normal bowel movements. While a diet high in
nutritious fiber is important, magnesium is even more important. A
magnesium deficiency not only causes constipation but can also lead to
heart disease, mitral valve prolapse (MVP), depression, anxiety,
chronic muscle pain, headaches, migraines, fatigue, and many other
unwanted health conditions. Those with IBS-c may need up to 1,000mg of
magnesium each day. While those with IBS-d, may need less than 500mg.
I recommend patients begin with 500mg of magnesium a day, preferably taken in a multivitamin formula.
Probiotics
The human intestines are inhabited by billions of beneficial bacteria.
These bacteria, which are mostly located in the colon, aid in
digestion by fermenting substances that were not digested in the small
intestine and by breaking down any remaining nutrients.A healthy
intestinal tract contains some 2-3 lb. of bacteria and other
microorganisms, such as yeast, that normally don’t cause ay health
problems.
However, when the intestinal tract is repetitively exposed to toxic
substances (antibiotics, steroids, NSAIDs, etc.), these microorganisms
begin to proliferate and create an imbalance in the bowel flora.
Harmful organisms like yeast and some normally dormant bacteria, begin
to overtake the good bacteria. This is known as intestinal dysbiosis.
IBS and small-intestinal bacterial overgrowth may share similar
symptoms. One study showed that 78% IBS participants had
small-intestinal bacterial overgrowth. To aid in digestion and prevent
intestinal dysbiosis, patients with IBS should take probiotics
(Lactobacillus and Biidobacterium) on a daily basis.
I recommend taking a high dose (9 billion strong), pure, enteric coated probiotic formula once a day on an empty stomach for 2-3 months.
This approach isn’t guaranteed to solve every case of IBS. However, in
the majority of my patients, their IBS symptoms are usually gone within two weeks.
I've developed a IBS Formula, called The Healthy Bowel Formula. You can read more about this formula in my online store or call the clinic 205-879-2383.
