Irritable Bowel Syndrome

We're eating ever more fibre yet IBS similarly increases.

For many years, the medical opinion has attributed irritable bowel (IBS) to a lack of fibre or to stress; yet, since the sixties, the amount of fibre in our diet, i.e. bread, cereals and pasta, has steadily increased; the incidence of IBS has seen a parallel increase in many western countries. While stress is very common today, a large proportion of patients strongly deny stressful circumstances in their lives to explain their digestive symptoms which raises some interesting questions about other possible causative factors.

Many patients are perplexed with their condition. It does not often follow a pattern, some feel worse after meals, others experience some good spells when their symptoms unexpectedly clear only to recur a few days later; others suffer with additional problems seemingly unrelated to the intestine, i.e. feeling tired, with low concentration or mood and aching limbs or back ache. In spite of being so common, irritable bowel remains a phantom condition in medicine. The variety of symptoms people experience can sometimes point to the upper part of the digestive system or to the lower, colon, or both.

Investigations of the digestive system available in hospitals such as endoscopy, colonoscopy, ultrasound scans or barium studies, are often normal, thereby reinforcing the other popular belief that IBS is a stress-related condition. But is it really in the mind, just a simple psychological response?

Food allergies & allergy tests

A number of sufferers, mostly young or middle aged women, find that avoiding certain common foods clearly gives them relief of their symptoms. The reason for this is that they have simple food reactivities, this is different from the serious allergy to egg or peanut, these are lesser allergies or intolerances. It is possible to identify the triggers of one's symptoms with a number of different methods.

Abnormal intestinal fermentation

Another problem is abnormal gut fermentation, which can be the result of bacterial or yeast activity. Some blame Candida Albicans for this, the cause of vaginal thrush and the commonest gynaecological infection in the West. In reality the issue is more complex, but easy to diagnose and treat. Specific tests can detect the presence of raised levels of different alcohols, which are specific to bacterial or fungal activity in the intestine.

Parasites

As many as 30% of people with an unhappy gut may have simple parasites. While most laboratories can identify common infections like Campylobacter, Giardia or Salmonella, some single cell parasites including Blastocystis Hominis or Dientamoeba Fragilis, require a fixative to prevent their disintegration outside the human body. Once identified, these too can be eradicated with appropriate treatment. See section on parasites.

Other factors

Low production of hydrochloric acid and or pancreatic enzymes may be important factors in understanding some types of irritable bowel. The presence of some chemicals added in food has also been associated with chronic digestive problems.

Is irritable bowel just a nuisance?

Whilst the majority of people with IBS seem to have a few symptoms which cause them inconvenience rather than constant ill health, a minority suffer with symptoms severe enough to count as a disability. Nutritional deficiencies are more common in irritable bowel than the healthy population. It is recognised that cancer of the colon is sometimes preceded by years of intestinal symptoms with inflammatory changes of the sub-mucosa tissue, which can only be detected microscopically in biopsies but remain elusive in specialist investigations.