A Gut-Wrenching Problem

By David Blyweiss, M.D.

If the slightest upset or worry sends your digestive tract on a roller coaster ride, you may be one of the 60 million Americans with irritable bowel syndrome. Eating certain foods, known as “trigger” foods, can just make mattes worse. But getting a diagnosis of IBS can be tricky. Symptoms vary from person to person. And, while sometimes you can link a flare-up to a certain event, other times IBS symptoms can strike out of the blue.

It’s important to recognize that IBS is not an inflammatory disease like Crohn’s or celiac. It also doesn’t lead to other life-threatening illnesses. But it is a complex functional disorder that many doctors don’t consider a “real” disease. Even those who do have a tough time making a cast-iron diagnosis since IBS merely relates to a set of symptoms that fail to indicate disease in diagnostic tests.

But, just because this condition isn’t easy to spot, it doesn’t mean the disorder is all in your head. According to the International Foundation for Functional Gastro­intestinal Disorders (IFFGD), clinical IBS is characterized by at least 12 weeks out of a 12-month period of abdominal pain or discomfort and recurrent diarrhea and/or constipation. Other symptoms include gas, bloating, nausea, vomiting, mucus in the stool and a full sensation after even a small meal.

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There is not one specific cause of IBS nor one sure cure. However, there are some factors that may trigger bouts of IBS, such as food allergies, enzyme deficiency, disordered overgrowth of intestinal flora and stress. Stress and anxiety influence our biochemistry, which in turn affects what goes on in our bowels by killing off our beneficial bacteria. If you are a “gut responder” and tend to internalize tension, exercise or self-affirming meditations may help reduce your stress level. In fact, meditation or simple “mindful breathing” exercises have proven to be a non-pharmacological method of decreasing stress cortisol levels.

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Diet is also vital in managing IBS. Processed foods can trigger IBS, and caffeine and alcohol must be consumed in moderation. If you suspect a food allergy, an elimination diet can determine the cause. In some cases, an inability to metabolize carbohydrates (including gluten) or fruit and/or milk sugars can be a major trigger for IBS.

Although IBS isn’t an inflammatory disease, inflamed tissue may occur nonetheless. When the tissue in your bowels becomes chronically inflamed, you may develop leaky gut syndrome (conventional physicians refer to it as “abnormally increased intestinal permeability”). When this happens, your intestinal lining becomes permeable and allows undigested foods and bacterial enzymes to leak into the blood stream. Since the body is not designed to process this material, it calls forth an immune response and appears to be the initiating or core cause of the autoimmune disease spectrum.

Inflammation may also be attributed to an over-production of an omega-6 fat called arachidonic acid, which is made by the body but also found in dairy fat and red meat. To counter this imbalance, try supplementation with specific omega-3 fatty acids called eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Start by taking 1,000 mg. of omega-3’s with meals. It you don’t experience any discomfort, you can take up to four capsules [or 4,000 mg.] daily.

Probiotics are another great addition to your supplement regime if you suffer from IBS. Besides their immune boosting and anti-inflammatory properties, beneficial bacteria like Lactobacillus acidophilus and Bifidobacterium help increase the production of digestive enzymes such as lactase to help digest dairy products. One specific strain of bacteria may be particularly useful. Mayo Clinic researchers found that B. infantis 35624 helped relieve bloating, while British studies have found that the strain significantly normalized bowel habits among IBS patients. What’s more, lab tests have reported that probiotic supplementation improves colonic motility and enhances the barrier function of the cells that line the intestines. Look for shelf stable probiotics designed to boost gut health and take as directed on the label.

Finally, consider taking L-glutamine, the major fuel of the intestines. This amino acid heals intestinal cells and maintains the villi (the absorption surfaces of the gut). While conventional science hasn’t really looked at L-glutamine’s beneficial role in IBS, I’ve found that it offers significant help to my patients suffering from the condition. Take 500-1,000 mg. of L-glutamine twice a day on an empty stomach. For better absorption, take it with 50 mg. of vitamin B-6 and 100 mg. of vitamin C.

Many people who have IBS become frustrated with the inability of their doctors to properly diagnose the problem. But you can help relieve your symptoms by watching what you eat and taking this trio of gut-friendly supplements. This balanced approach just might help make that gas, pain and strain a distant memory.


References:

Aragon G. Probiotic therapy for irritable bowel syndrome. Gastroenterology & Hepatology (N Y). 2010;6:39-44.

Fasano A. Celiac Disease Insights: Clues to Solving Autoimmunity. Scientific American Magazine. July 27, 2009.

Kilkens TO. Fatty acid profile and affective dysregulation in irritable bowel syndrome. Lipids. 2004;39:425-431

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