The treatment for irritable bowel syndrome

In previous blogs I have covered specific foods to avoid in the treatment of Irritable Bowel Syndrome. An overall bad diet of white sugar, white flour and white fat found in many packaged and highly processed foods can disrupt the ecology of the gut by turning non-harmful bacteria into harmful bacteria. We all carry about 3-4 pounds of bacteria in our intestine and colon that contain greater than 100,000 billion bacteria of about 500 different types–many more cells than our whole body. These bacteria can work for us or against us depending upon our diet and usage of antibiotics. The total of these bacteria is called our microbiome which also includes bacteria on our skin surfaces. If there is an overgrowth of the wrong kind of bacteria they can change the molecular structure of the food we eat causing reactions to that food. This is called an acquired food sensitivity i.e. you weren’t born with it. This imbalance can result in diarrhea, constipation, skin problems, headaches, joint and muscle pains, bloating and even heart disease.

So an important treatment for irritable bowel syndrome is to keep your gut bacteria happy and healthy but not through the highly advertised yogurts on TV. I recommend plain yogurt since the flavored kinds have very little of the beneficial bacteria. I may recommend a special stool test not performed by local laboratories to get levels of good and potentially bad bacteria. Then I will know which specific types of good bacteria to recommend. Many times a person will say “I have been taking this kind, is it good?”. When the test will come back and shows very low levels of the good bacteria I will recommend highly researched probiotics available only through health care professionals for them. They will need to take it for six months or longer. People with IBS seldom have just that as a health problem, and tend to have other conditions that are in some way related to disrupted bacteria in their gut. Helping your gut bacteria is essential for treating irritable bowel syndrome.

Some commonly prescribed medications for irritable bowel syndrome or IBS are dicyclomine (Bentyl) for muscle spasms, hyoscyamine (Levsin , Levbid) anti-spasmodic. Nexium, Prevacid, Prilosec, omeprazole (Zegrid), pantoprazole (Protonix) and Aciphex all acid blockers. A wide variety of laxatives, stool softeners and constipation agents are also prescribed. These are considered standard treatments by GI and primary care doctors for either diarrhea or constipation predominant IBS.

An expensive antibiotic (up to $1100 per month) called rifixamin (Xifaxan) is starting to be used for some cases of IBS in the research, however it is only approved by the FDA at this time for travelers diarrhea. Other than eat more fiber there is usually very little dietary advice. These medications may provide some temporary relief from the symptoms but do very little to address the underlying causes of irritable bowel syndrome.

From a Functional Medicine perspective, the first treatments should be dietary changes. I give a long list of foods to avoid such as all dairy, wheat, corn, white sugar, white flour, all fast foods, microwave foods and more. We also give a longer list of good foods, and easy to fix meals so no one goes hungry. Many people will have amazing improvement in their symptoms after just four weeks on a “clean” diet. Gradually we will add back some foods, one at a time, and monitor for reactions. Then people know what really bothers them.

These simple dietary changes can begin to change the composition and quality of the bacteria in the gut in a more “friendly” direction. I may also recommend a strong probiotic or specialized fiber supplement containing a pre-biotic or what I call “fertilizer” because it helps good bacteria to grow. Quoting Hippocrates: ” Let food be thy medicine and medicine be thy food”. These are the “medicines” that get to the causes of irritable bowel syndrome.

Natural remedies for irritable bowel syndrome

From a Functional Medicine perspective all treatment for Irritable Bowel Syndrome should be natural remedies. Medications purporting to treat IBS address only symptoms. This type of medical treatment ignores diet and food sensitivities which is the first place to start. Eliminating the most common food offenders like dairy, eggs, wheat, corn and fructose, especially high fructose corn syrup in soda and flavored yogurts can significantly decrease gas and bloating in just a few days. Also to be eliminated immediately are soy foods, peanuts, all process meats and red meats, chocolate, ketchup, mustard, relish, chutney, soy sauce, barbecue sauce, mayonnaise, margarine, butter, shortening, processed and hydrogenated oils, mayonnaise, spreads. We give an extensive list of acceptable food substitutes, menus and recipes so no one goes hungry.

What could be a more natural remedies for Irritable Bowel Syndrome than eating good foods? The only side effects are good ones because frequently the IBS symptoms go away. After people learn the connection between what they eat and how it affects their bowels it becomes a much easier choice as to what to eat or “it’s eat now pay later.” Sometimes a blood test may be helpful in identifying unsuspected food sensitivities. I order the IgG test for the delayed reactions to foods occurring 24-48 hours after the food is eaten in contrast to the IgE test for an immediate reaction. The skin tests are IgE. The higher reactive foods are eliminated for three or six months, not for life. The only exception may be wheat due to the gluten protein which could be a genetic issue and would need to be eliminated permanently.

After foods have been taken care of, it may important for people to have digestive enzymes or betaine HCL (stomach acid) to properly digest foods. Replacing the good bacteria is almost always necessary and a specialized stool test can identify deficiencies. With all these proven natural remedies for irritable bowel syndrome there would be very little need for prescription medications.

One of the most important treatments for Irritable Bowel Syndrome or IBS is good probiotics. Without sufficient amounts of beneficial bacteria in the gut there can be diarrhea, bloating and gas, intestinal pains, and constipation. We are all supposed to have about 3-4 pounds of gut bacteria to keep us healthy. The growing of the bacteria begins at birth. There are more bacteria cells in out gut than in the rest of our body. This bacteria performs necessary functions of making B-vitamins, vitamin K and breaking down toxins in the gut. Without them this does not happen. The good bacteria can be destroyed by antibiotics, poor diet and intestinal infections and needs to be replaced. Probiotics are essential for Irritable Bowel Syndrome.

However all probiotics are not created equal. You can’t just eat yogurt or take any acidophilus product from the health food store to get the full benefits of probiotics. Why? Because efficacy is dependent on the viability and type of probiotic used. For instance, by the time the yogurt or supplement is manufactured, shipped, and finally consumed there may be very little probiotic activity. Second, there are many different species and strains of probiotic bacteria, most of which have very little research, if any, to prove that they actually have beneficial effects on human health. It’s no wonder that many people who use these “unknown” probiotics don’t get the results they’re after! To get the benefits you are looking for, you must use organisms that have proven stability, are safe for human consumption, and produce beneficial effects in humans. That leaves only a few to choose from, such as Lactobacillus acidophilus NCFM & Bifidobacteria.

There are billions of reasons to take high potency probiotics for Irritable Bowel Syndrome. The potency and viability of probiotics are a critical determinant of their efficacy. First, a supplement must supply billions of organisms per serving. The typical dosage in human studies is approximately 5 to 10 billion or more per day! Second, the manufacturer must ensure that these organisms will be viable (alive

and active) when you consume them. Without these factors, it is unlikely you will get the results you expect. So taking the right probiotic is critical for Irritable Bowel Syndrome.

There is an old expression in Functional Medicine; ” If you are sitting on a nail, it takes a lot of aspirin to make it feel better.” The follow up to that is ” If you are sitting on two nails, taking out one nail does not make you feel 50% better”. And so it goes with Irritable bowel syndrome.

To feel better we first have to eliminate everything that may be disturbing your intestines, such as NSAIDS or non-steroidal anti-inflammatory drugs: aspirin, ibuprophen (Motrin), Naprosyn (Naproxen or Aleve), all over the counter and prescription Mobic, indomethacin and others. This class of drugs can produce significant damage to the lining of the intestine that can look like a colitis or inflammatory bowel disease. They can also produce intestinal permeability or “leaky gut” allowing partially digested food and bacteria to leak into the blood producing immune reactions. We will find other safer pain relievers that don’t cause these effects. Antibiotics can disrupt the balance between the good and bad bacteria in the GI tract. They are not natural remedies for Irritable Bowel syndrome.

We must also eliminate the foods that are the most common offenders causing intestinal problems such as gluten grains, (wheat, barley, rye, spelt, Kamut, triticale), eggs, corn, milk products including cheese, oranges, soy, peanuts, corn fed red meat, soda, alcohol, caffeine, white and brown sugar, honey, corn syrup sweeteners and candy. A long list of food substitutions menus and recipes is given so no one goes hungry. Often by eliminating these foods people will experience a significant decrease in gas and bloating. Of this list the only food that may be a permanent elimination is gluten since there may be a genetic component. The other foods can be added in one at a time after there is good resolution of symptoms.

So taking out all the “nails” is first step of natural remedies for Irritable bowel Syndrome.

Studies show a large overlap between Irritable Bowel Syndrome (IBS) and Fibromyalgia. A major finding is a connection involving overgrowth of bacteria in the small intestine producing gases like hydrogen and methane. These gasses cause intestinal bloating and widespread pain in the body by lowering the pain threshold. A simple breath test is used to diagnose this problem by drinking a solution of lactulose (a non-digestible sugar). The treatment involves a course of a special non-absorbable antibiotic for severe cases and always dietary changes to eliminate starches and sugars. Small intestinal bacteria ferment carbohydrates into gas. Functional Medicine Pain Mangement Clinic in Tucson Arizona. Hunter Yost M.D.