Tag Archives: Irritable Bowel Syndrome

April is IBS Awareness Month

IBS Awareness Month, observed every April, is an annual campaign aimed at increasing awareness and understanding of irritable bowel syndrome.

IBS is a functional gut disorder, which means that the bowel simply does not work as it should. Around 10% of the population suffers with this disorder, and sufferers can experience a number of intermittent symptoms including diarrhoea, constipation, gas, bloating and lower abdominal pain. While the condition is not thought to damage the bowel, it has a significant impact on quality of life (1).

Before IBS is diagnosed by your doctor it is important that he or she rules out other digestive conditions such as Crohn’s or Ulcerative Colitis which are inflammatory bowel diseases.

For many, treatments such as anti-spasmodics offered by the GP have limited success. Sufferers can be left feeling helpless, and do not always have the information they need to manage the condition.

IBS: Four Steps to Digestive Health

1. Optimise digestion

Chewing food thoroughly and eating in a slow and relaxed manner can help improve the first stage of digestion by increasing levels of digestive enzymes and helping them to work more effectively. Plant enzyme formulas, such as papaya enzymes in Caricol, may also be helpful in optimising digestion, and have been found to improve symptoms of IBS (2).

2. Restore gut bacteria

Many studies have drawn attention to a link between IBS and overgrowth of pathogenic bacteria in the gut. Probiotic formulas can help to crowd out these problem bacteria, improving digestion, decreasing inflammatory response and restoring proper balance in the digestive tract. Strains of Lactobacillus and Bifidobacter look particularly promising as natural agents aimed at improving symptoms of IBS (3,4).

Prebiotic foods, such as asparagus, garlic, leeks and bananas can also be helpful as a regular addition to the diet. Prebiotics feed the friendly bacteria in your gut helping it to proliferate.

3. Repair and protect

April is IBS awareness month
April is IBS Awareness Month

While IBS is not classed as an inflammatory condition. However, recent research published in the journal Gastroenterology has actually found ‘mini-inflammations’ in the gut mucosa of IBS patients. This inflammation is thought to upset the sensitive balance of the bowel and cause hypersensitity of the enteric nervous system leading to IBS symptoms. Lead researcher Prof. Schemann explains: “The irritated mucosa releases increased amounts of neuroactive substances such as serotonin, histamine and protease. This cocktail produced by the body could be the real cause of the unpleasant IBS complaints.”

Natural measures to help repair and protect the gut lining, such as supplementing glutamine or omega-3 oils could help reduce this localised inflammation, improving IBS symptoms.

4. Identify trigger foods

While food choices are not the cause of IBS, they can certainly trigger symptoms. Trigger foods can vary from person to person, but common culprits include wheat, fatty of fried foods, milk and coffee. Keeping a diary of your diet and symptoms can help to identify trigger foods. Eliminating possible trigger foods from your diet should be done in a safe and healthy way, and guidance from a nutritional therapist can be helpful for those who need support with this.

The management of IBS requires a personalised approach, as what works for your neighbour may not be the best option for you. It is important to persevere in order to find the right approach. Hopefully international campaigns such as IBS Awareness Month should encourage sufferers to find the information and help they need to manage the condition effectively.

References

1. Amouretti M et al (2006)  Impact of irritable bowel syndrome (IBS) on health-related quality of life (HRQOL). Gastroenterol Clin Biol.  Feb;30(2):241-6.

2. Muss et al (2012) Papaya preparation (Caricol®) in digestive disorders. Biogenic Amines Vol. 26, issue 1 (2012), pp. 1–17.

3. Clarke G et al (2012) Review article: probiotics for the treatment of irritable bowel syndrome – focus on lactic acid bacteria. Alimentary Pharmacology & Therapeutics 35:4. pp. 403–413.

4. Technische Universitaet Muenchen (2010, August 20). Proof that a gut-wrenching complaint — irritable bowel syndrome — is not in your head. ScienceDaily. Retrieved March 29, 2013, from http://www.sciencedaily.com­/releases/2010/08/100819141950.htm.

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IBS Awareness

April is IBS Awareness Month. This calendar event is aimed at heightening awareness of the causes and symptoms of IBS, and the treatment options available. It also encourages sufferers to talk about their condition and take positive steps to manage their symptoms.

Painful tummy
IBS can cause symptoms such as gas, bloating, constipation and / or diarrhoea

The exact cause is unknown, but attacks can be triggered by stress and dietary factors. Typical symptoms of IBS or Irritable Bowel Syndrome include abdominal pain, a sense of urgency (having to rush to the toilet), bloating and gas, and diarrhoea or constipation.

Might you have IBS?

Learn your ABC for IBS! The National Institute for Clinical Excellence (NICE) advises that anyone experiencing the following symptoms for 6 months or longer should be assessed for IBS:

  • Abdominal pain or discomfort
  • Bloating
  • Change in bowel habit

Common myths and misconceptions

There are many misconceptions about IBS, perhaps because many people find IBS difficult or embarrassing to talk about. A clear understanding of IBS can help sufferers to manage the condition more effectively.

1. MYTH: IBS is “all in the head”

FACT: For many years, doctors believed IBS was a psychological condition, only existing in the patient’s head. This misconception is damaging for patients who require practical help to manage IBS. Fortunately physicians now have a better understanding of the condition and can offer practical approaches to relieve symptoms.

2. MYTH: IBS is not a serious condition

FACT: IBS is not life-threatening, and it is not an inflammatory disease like Crohn’s or Ulcerative Colitis. However, IBS can significantly impact a person’s quality of life and ability to function on a day-to-day basis. These are serious concerns and should be treated as such by your GP.

3. MYTH: IBS is related to lactose intolerance

FACT: IBS and lactose intolerance are not linked, although their symptoms are very similar. Some people suffer with both IBS and lactose intolerance. If your symptoms are relieved by cutting out lactose, or by taking lactase supplements, then it is possible you have lactose intolerance rather than IBS.

4. MYTH: Increasing your fibre intake will help IBS

FACT: Although fibre is an important part of a healthy diet, certain types of fibre can actually trigger IBS symptoms. In IBS, the rough edges of insoluble fibre can irritate the digestive tract, causing abdominal pain and cramps. Swapping foods high in insoluble fibre, such as bran flakes, for foods high in soothing soluble fibre, such as oats, can help to manage painful symptoms.

5. MYTH: IBS cannot be diagnosed

FACT: There is an established protocol that GPs can use to diagnose IBS. By assessing symptoms and ruling out other digestive disorders such as inflammatory bowel disease and celiac disease, your doctor can accurately diagnose IBS.

6. MYTH: There are no good treatment options for IBS

FACT: There are several prescription drugs, over-the-counter medications and nutritional supplements that can relieve symptoms for sufferers. Different approaches can work for different people, and it is sometimes necessary to experiment to find what works best for you. Some over the counter medications can actually make symptoms worse if they are used excessively. Dietary and lifestyle changes can make a world of difference. For example, the FODMAP diet has proved helpful to many. Probiotics (especially strains such as Bifidobacterium Infantis), peppermint oil, and soluble fibre supplements such as psyllium husk all represent effective natural approaches to troublesome symptoms.

If you have been diagnosed with IBS then a nutritional therapist can advise you on dietary management and helpful supplements. If you suspect you may have IBS then you should initially speak to your GP. After all, one of the most important messages of IBS Awareness Month is that nobody should have to suffer in silence.

Written by Nadia Mason, BSc MBANT NTCC CNHC

References

National Institute for Health and Clinical Excellence (NICE) Irritable Bowel Syndrome in Adults: Diagnosis and Management of Irritable Bowel Syndrome in Primary Care. Feb 2008.

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An introduction to Coeliac Disease

Coeliac disease (CD) is a common autoimmune disorder where the body attacks itself.  It occurs as a consequence of gluten intolerance and affects approximately 1% of the population. Gluten is found in all food and non-food products that are made from wheat, barley and rye. Oats contain some lower levels of gluten but the levels are not always problematic for Coeliac sufferers, however as oats are often processed in the same factories as wheat, barley and rye they should be eaten with caution.

When these products are consumed, the disease activates chronic small intestine inflammation and erosion of the intestinal villi which can lead to nutrient malabsorption and potentially deficiencies, with iron and folic acid deficiency being the more common deficiencies. Although it is usually thought to be solely a gastrointestinal disorder, many will be surprised to know it is in fact a systemic disorder affecting the whole body. Gluten ingestion can trigger inflammation in several other areas of the body, manifesting itself in many ways and consequently it can be extremely distressing for the individual, severely affecting quality of life. For example it can cause skin disorders such as psoriasis and eczema, fatigue, and also more serious conditions such as type I diabetes, heart and/or liver disease, anaemia, epilepsy, osteoporosis amongst others. Sufferers may feel like their symptoms are unrelated to those typically associated with an intolerance such as abdominal pain, bloating, diarrhoea etc which means that Coeliac disease often goes undiagnosed for years. It is however becoming more widely recognised and acknowledged by the Medical Profession and diagnosis is improving.

Bread and Wheat are foods that Coeliac Disease sufferers should avoid
Bread and Wheat are some foods that Coeliac Disease sufferers should avoid due to their gluten content (3.)

A gluten free diet is currently the only method of treatment as there is no approved medication, however gluten is extremely difficult to avoid completely as cereal use in food products is widespread and it is often hidden in many products unexpectedly e.g. in cosmetics. It is now possible to get gluten free oats along with better and more tasty gluten free breads and other grains, so CD sufferers should look out for these options.

Prolonged exposure to gluten in Coeliac sufferers can result in mortality, therefore in addition to attempting to remove gluten, other therapeutic methods should be considered. It has been acknowledged that the gut balance (microbiota) is vital for keeping a healthy state and reductions in beneficial bacteria can cause imbalances and potentially contribute to diseases such as Coeliac disease. One study published in 2010 by Journal of Leukocyte Biology investigated the effects of the probiotic Bifidobacteria on the immune triggers of Coeliac disease. They found that the inclusion of this beneficial probiotic improved the gut state, immune reaction and disease outcome for those with CD. In addition to probiotics and a gluten free diet, anti-inflammatory nutrients such as fatty acids will also help to reduce the inflammation across the body. Taking supplements such as glutamine and arginine can help to repair the intestinal damage to allow the villi in the small intestine to grow back and begin to absorb the nutrients again (2).

These nutrients are not only beneficial for those suffering with Coeliac disease and can benefit everyone, as they allow the body to be in a balanced state and reduce inflammation which can also be a cause of many conditions including IBS. If you think you may have Coeliac Disease or would like to be tested for it, you should contact your Health Practitioner or a local BANT or Nutrition Society registered Nutritionist.

Written by Lauren Foster

(1) G. De Palma,* J. Cinova,† R. Stepankova,† L. Tuckova,† and Y. Sanz Pivotal Advance: Bifidobacteria and Gram-negative bacteria differentially influence immune responses in the proinflammatory milieu of celiac disease. Journal of Leukocyte Biology, vol. 87 no. 5 765-778.

(2) Sukhotnik, I., Slijper, N., Pollak, Y., Chemodanov, E., Shaoul, R., Coran, A.G., Mogilner, J.G. (2011) Parenteral omega-3 fatty acids (Omegaven) modulate intestinal recovery after intestinal ischemia-reperfusion in a rat model. Journal of Pediatric Surgery, Vol. 46, Issue 7, Pg. 1353-1360.

(3.) Image courtesy of Grant Cochrane

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A new way to manage Irritable Bowel Syndrome (IBS)?

A new way to manage Irritable Bowel Syndrome (IBS) is quickly gaining support amongst the medical community, and many IBS sufferers are seeing positive results.

Dr Susan Shepherd, an Australian dietician and researcher, led a presentation on the low-FODMAPs diet last month at the American College of Gastroenterology conference in Washington.

A low FODMAPs diet has been shown to help those with IBS
A low FODMAPs diet has been shown to help those with Irritable Bowel Syndrome (IBS)

The theory is that people with IBS have difficulty digesting certain types of carbohydrate, leading to symptoms such as gas, bloating, abdominal pain, constipation or diarrhoea.

Small studies in the UK and Australia have shown that the diet reduced symptoms in around 75% of IBS sufferers, which makes it a more successful approach than many other dietary or medical interventions. In a controlled study published some weeks ago in the Journal of Human Nutrition and Dietetics, the low-FODMAP diet improved IBS symptoms in more than 80% of the adults tested (1).

FODMAP stands for Fermentable Oligo-, Di- and Mono-saccharides and Polyols. These are a group of short-chain carbohydrates and sugar alcohols present in food. They comprise fructose, lactose, fructans, galactans and polyols.

Certain foods are particularly high in FODMAPs. These include milk and unripened cheeses, which are rich sources of lactose, and wheat and rye which are high in fructans. Sources of galactans and polyols include legumes, some fruits, and sweeteners such as sorbitol and xylitol.

FODMAPS have a number of characteristics which can make them troublesome for those with IBS and other digestive problems.

  • They are poorly absorbed in the small intestine.
  • They tend to draw liquid into the gut, affecting movement in the gut.
  • They are quickly fermented by bacteria in the gut, producing gas and bloating.

The low-FODMAPs diet recommends eliminating all suspect foods for 6-8 weeks, and then gradually reintroducing these foods in order to identify which ones are causing digestive problems.

As the low-FODMAPs diet is rather restrictive, it is advised that those with IBS should only follow the diet under the guidance of a qualified health practitioner.

There are some potential drawbacks to the low-FODMAPs diet, which can be overcome with a little careful planning. For example, those restricting FODMAP foods should be sure to include other sources of fibre in their diet. Fibre is an important nutrient for bowel health, and this can be provided by grains such as quinoa and rice, as well as well-tolerated fruits and vegetables.

The FODMAP diet also excludes many ‘prebiotic’ foods, which help to feed good bacteria in the gut. Good bacteria help to produce vitamins, support the immune system and prevent the growth of harmful bacteria. It may therefore be helpful to include probiotic supplements or probiotic foods in order to help boost levels of good bacteria in the gut.

Written by Nadia Mason, BSc MBANT NTCC CNHC

References

1. Staudacher HM et al. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. Journal of Human Nutrition and Dietetics. October 2011. 24(5):487-495

2. Image courtesy of Ambro

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