Get a good gut feeling about digestive health – Irritable Bowel Syndrome (IBS) Part III

On the 16th July I wrote about artichoke leaf extract (ALE) supplements for cholesterol lowering.  Evidence is also mounting for the usefulness of this plant supplement in the reduction of IBS symptoms (1,2).  In one study (2) 208 adults with IBS were given ALE for a two month period.  The individuals had a significant improvement whilst taking the supplement with a normalising of bowel pattern away from alternating constipation/diarrhoea toward normal.  The IBS sufferers also had a significant improvement in their total health-related quality of life scores.  The trials were small and provide preliminary evidence but it certainly seems that artichoke leaf extract is useful for an array of digestive complaints.  If you decide to try ALE supplements for the management of your IBS symptoms please follow the manufacturers dosage advice, taken in excess it may cause digestive upset.

When discussing IBS it is difficult not to mention the issue of food sensitivities or intolerances.  Some studies indicate that a large proportion of people afflicted with IBS have food sensitivities, very few have true food allergies, and that gas production and other IBS symptoms diminish when the sensitivities are discovered and the offending food(s) eliminated (3,4,5,6).  Assessing sensitivities can be quite subjective and therefore difficult to assess properly in a clinical-trial setting. 

Research suggests that some people with IBS may malabsorb the sugars lactose (found in milk), fructose (found in high concentrations in fruit juice and dried fruit) and sorbitol (found in diabetic and sugar-free products) (7).   Research shows that in a large majority of IBS patients with lactose malabsorption, a lactose-restricted diet can improve symptoms markedly both in the short term and the long term (8).  Fructose- and sorbitol-reduced diets in subjects with fructose malabsorption reduce gastrointestinal symptoms such as bloating, cramps, osmotic diarrhoea and other IBS symptoms (9).  Hence, individuals with IBS attempting to uncover food sensitivities should consider the possibility that milk, fruit juice, dried fruit and products containing sorbitol might cause worsening of their symptoms.

A note of caution – please do not attempt elimination diets without supervision from your GP or a fully qualified professional.  Many ‘food sensitivity tests’ are advertised at very high cost and, in my opinion, can often be unhelpful.  Working with a professional and keeping food diaries and symptom scores may uncover specific triggers for your personal symptoms.  Stress, emotions and psychology may also be playing a major role in your IBS symptoms so assessing how you feel could also prove helpful.  Foods may be triggering symptoms in conjunction with stressful/emotional periods but less-so at other times.

Finally I would like to briefly mention aloe vera juice.  Many individuals with digestive complaints report that their symptoms diminish greatly with the regular ingestion of an aloe vera juice drink or supplemental aloe capsules.  Most of the evidence so far is anecdotal (but that does not lessen personal experiences).  A few animal studies have started to provide weight to the evidence but very few human studies have occurred to date.  A test tube study(10) using human colon cells has shown that aloe vera did appear to work as a potent anti-inflammatory.  You may find it useful to try the juice yourself to see if it is helpful in reducing your personal symptoms.  Remember to follow the dosage guidance and try and keep note of your symptoms for about a week.  If the juice works for you then it is worth continuing with. 

That ends my posts on IBS, I do hope that the information presented over the last few days has been of help?!

(1)Walker AF et al.  2001.  Artichoke leaf extract reduces symptoms of irritable bowel syndrome in post-marketing surveillance study.  Phytotherapy Research.  15:58-61
(2)Bundy R et al.  Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis.  J Altern Complement Med.  10:667-669
(3) King TS et al.  1998.  Abnormal colonic fermentation in irritable bowel syndrome.  Lancet.  352:1187-1189
(4) Jones AV et al.  1982.  Food intolerance: a major factor in the pathogenesis of irritable bowel syndrome.  Lancet.  ii:1115-1117
(5) Smith MA et al.  1985.  Food intolerance, atopy, and irritable bowel syndrome.  Lancet.  ii:1064
(6) Parker TJ et al.  1995.  Management of patients with food intolerance in irritable bowel syndrome: the development and use of an exclusion diet.  J Human Nutr Diet.  8:159-166
(7) Fernandez-Banares F et al.  1993.  Sugar malabsorption in functional bowel disease: clinical implications.  Am J Gastroenterol.  88:2044-2050.
(8) Bohmer CJ, Tuynman HA.  2001.  The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year follow-up study.  Eur J Gastroenterol Hepatol.  13(8):941-944
(9)Ledochowski M et al.  2000.  Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers.  Scand J Gastroenterol.  35(10):1048-52
(10)Langmead L et al.  2004.  Anti-inflammatory effects of aloe vera gel in human colorectal mucosa in vitro.  Aliment Pharmacol Ther.  19:521-527

Written by Ani Kowal