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What is IBS?

IBS
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According to the Mayo Clinic, “Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.” This was posted on Mar 17, 2018 online. There was no information about how to get rid of IBS, only how to manage the condition with pharmaceutical medications.

To read more about the conventional standard-of-care definition of IBS and how to treat it, click here.[i] One clinical trial using Pregabalin[ii] found no change in adequate relief (which they defined as less severe symptoms) between the two groups – particularly for the constipation arm of the study, and no change in quality of life post treatment scores.

IBS according to the Mayo Clinic:

  • Abdominal pain, cramping or bloating that is typically relieved or partially relieved by passing a bowel movement
  • Excess gas
  • Diarrhea or constipation — sometimes alternating bouts of diarrhea and constipation
  • Mucus in the stool

The precise cause of IBS isn't known. Factors that appear to play a role include:

  • Muscle contractions in the intestine. The walls of the intestines are lined with layers of muscle that contract as they move food through your digestive tract. Contractions that are stronger and last longer than normal can cause gas, bloating and diarrhea. Weak intestinal contractions can slow food passage and lead to hard, dry stools.
  • Nervous system. Abnormalities in the nerves in your digestive system may cause you to experience greater than normal discomfort when your abdomen stretches from gas or stool. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that normally occur in the digestive process, resulting in pain, diarrhea or constipation.
  • Inflammation in the intestines. Some people with IBS have an increased number of immune-system cells in their intestines. This immune-system response is associated with pain and diarrhea.
  • Severe infection. IBS can develop after a severe bout of diarrhea (gastroenteritis) caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth).
  • Changes in bacteria in the gut (microflora). Microflora are the "good" bacteria that reside in the intestines and play a key role in health. Research indicates that microflora in people with IBS might differ from microflora in healthy people.

Symptoms of IBS can be triggered by:

  • Food. The role of food allergy or intolerance in IBS isn't fully understood. A true food allergy rarely causes IBS. But many people have worse IBS symptoms when they eat or drink certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk and carbonated drinks.
  • Stress. Most people with IBS experience worse or more frequent signs and symptoms during periods of increased stress. But while stress may aggravate symptoms, it doesn't cause them.
  • Hormones. Women are twice as likely to have IBS, which might indicate that hormonal changes play a role. Many women find that signs and symptoms are worse during or around their menstrual periods.

The Mayo Clinic offers diagnostic tests to tell you exactly which part of your gut is irritated, in case you hadn’t figured it out already:

  • Gastrointestinal transit study (scintigraphy), to assess the movement of food through your digestive tract
  • Anorectal function testing, to measure the coordination of the muscles you use to move your bowels
  • Defecography, to obtain images of muscles you use when passing stool
  • Dynamic pelvic floor MRI, to identify any abnormalities in your pelvic floor muscles
  • Screening for celiac disease, gluten sensitivity without celiac disease, bacterial overgrowth, lactose and sugar intolerance, and bile acid malabsorption

Certain carbohydrates known as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) can lead to abdominal pain, bloating and gas in people with irritable bowel syndrome. These are found in certain fruits and vegetables; wheat; rye; legumes; foods that contain lactose, such as milk, cheese and yogurt; and artificial sweeteners.

Following a diet low in FODMAPs can ease symptoms of irritable bowel syndrome.

Stress also affects irritable bowel syndrome, with episodes of higher stress associated with an increase in symptoms.

Daily physical activity relieves stress, stimulates normal contractions of the intestines and promotes overall wellness.

There may be another way to figure this out.

Keep reading here, to learn more about what factors may create a climate of irritability for your GI tract, and what you can do to create a different climate.

Is it possible that we have been barking up the wrong tree? Is it possible that by attempting to suppress the symptoms we have simply driven them deeper, and into different organ systems? Could it be that if we were to work WITH our GI tracts, rather than AGAINST them, we might learn something about ourselves and at the same time relieve our symptoms of IBS?

First, let us examine what our gut is trying to tell us.

In Chinese medicine, where every organ system is named for an official of the government, the GI tract – “stomach” and “spleen” – acts as officials for food storage and assimilation. The “small intestine” is the receiving official (assimilates, distributes and separates the useful from the not useful). The “large intestine” directs the processing of nutrients and the passage of waste.

So, there are three major areas which could give rise of symptoms of IBS.

The Stomach – in charge of “rotting and ripening” – preparing food for assimilation – preparing ideas and experiences for assimilation into the mind. If we cannot prepare things for assimilation, we may be voraciously hungry, always seeking experiences or food which does not nourish us. The stomach is about understanding our experiences so that we make absorb them and make use of them.

On the purely physical level, many things can be amiss:

  • there may be insufficient production of hydrochloric acid to digest foods, or too much production of hydrochloric acid. Both of these conditions may cause the sensation of “heartburn”.
  • There may be an anatomic defect of the muscle ring between the esophagus and the stomach, resulting in reflux of acidic stomach contents into the esophagus.
  • There may be insufficient motility to move the food along into the small intestine, resulting in sensation of prolonged fullness.
  • There may also be infection in the stomach – as with Helicobacter pylori – which may be sufficient to cause an ulceration in the stomach lining, and pain due to anatomic disturbance.
  • We may see horrific “bad breath” due to fermentation of food in the stomach, rather than digestion.

On the emotional level, we may see people who are doomed to repeat the same experiences, the same relationships, because they simply are unable to see or discern what is going on in the experience, and then move on to the next phase of life.

The Small Intestine – is the official in charge of separating the pure from the impure. All food, and all ideas, first must be received by this official, who decides whether the substances or emotions or ideas are healthy or not.

We are exposed to so many toxins – in our foods, in our “junk” mail, in our television broadcasts, in our air – that it is easy for our “official in charge of discernment” to become overwhelmed, like an overworked clerk at the Department of Motor Vehicles.

  • When we are inundated by an overload of “fast food” laden with carbohydrate and chemicals – or by an overload of “fast ideas” through Twitter or watching the news on television – we become less able to discern the healthy from the unhealthy, the moral from the immoral, the right from the wrong.
  • Even if the food choices are healthy, if the Small Intestine official is overloaded on the emotional or the mental levels, we may still be malnourished and in pain.
  • If the food choices are healthy as a general rule, but we personally happen to have a problem digesting them – for example dairy products, or gluten-containing grains – then we may be just as miserable as if we were eating chemicals.
  • If the food choices are largely of the sugar and carbohydrate variety, we are liable to encourage the growth of yeasts in our intestines, resulting in significant bloating and production of intestinal gas – either painful or socially unacceptable, or both simultaneously.

On the purely physical level, we may see an overgrowth of bacteria in the small intestine – the so-called SIBO phenomenon. We may see uncontrolled diarrhea, cramping pain, sometimes even bleeding or mucus in the stool.

On the emotional level, we may retreat into depression or irritability or obsessive compulsions. On the moral level, we may lose our ability to distinguish useful from not useful, right from wrong, truth from falsehood.

The Large Intestine separates and stores the wastes of our body, thus maintaining cleanliness and sparkling health in the rest of our system. If we hold on to those wastes – the “constipation” form of IBS – we become polluted in our physical being, as well as in our emotional and mental beings – we may see physical or emotional filth (the expression “full of sh*t” comes to mind) or obsessive cleanliness, which are but two sides of the same unbalanced coin.

When the colon is dysfunctional, we may see either diarrhea or constipation – both of which may be associated with cramping pain typical of IBS. We may be diagnosed with “ulcerative colitis” or just plain “colitis” – meaning inflammation. We may even eventually be diagnosed with cancer – sometimes early in the course of the illness, sometimes late, depending on where in the colon the cancer develops.

On the emotional level, we are unable to get rid of past experiences, and allow them to continue to affect our lives. We persist in requiring that those who have wronged us admit that they are sorry – forgetting that having a bowel movement does not require any action on the part of the digested food. Similarly, forgiveness and letting go does not require that the other person admit fault or apologize for it.

When we are faced with the symptoms of Irritable Bowel Syndrome – the pain, the bloating, the diarrhea, the gas – and are overwhelmed by the potential causes, it is helpful to start with a roadmap of potential causes.

  • What goes into the system on the physical level – food and drink
  • What goes in to the system on the emotional level – relationships, the people with whom we choose to surround ourselves.
  • What goes in to the system of the mental level – newspapers, television, what we choose to watch or to hear in our everyday lives.

If the symptoms are worse than the thought of giving up the offending cause, then problem is solved.

If the symptoms are less terrible than the thought of giving up the offending cause, then we will continue to suffer – or take drugs to suppress the symptoms.

It is pretty simple, in the end…

 

[i] Camilleri, Michael, and Guy Boeckxstaens. "Dietary and pharmacological treatment of abdominal pain in IBS." Gut 66.5 (2017): 966-974.

[ii] Saito, Yuri A., et al. "Randomised clinical trial: pregabalin vs placebo for irritable bowel syndrome." Alimentary pharmacology & therapeutics 49.4 (2019): 389-397.

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