Natural Remedies for IBS

This common and uncomfortable condition is felt in the gut but often starts in the mind

Stress, including the stress from past trauma, has been more clearly linked to IBS, providing additional avenues for treatment.PeopleImages.com - Yuri A/Shutterstock

Irritable bowel syndrome (IBS) may not crop up much in day-to-day conversation, but for the millions who suffer from it, the condition is impossible to ignore. Not only can it be uncomfortable or painful, but IBS symptoms can seriously impinge on ordinary social interactions and lifestyle, as well.

Fortunately, there are treatments for the condition and a dietary investigation that can help sufferers figure out what foods may be triggering their symptoms.

Common and Uncomfortable

IBS is very common. According to Cleveland Clinic, between 10 and 15 percent of the adult U.S. population has IBS, but only about half are actually diagnosed. IBS is a gastrointestinal (GI) disorder that affects the stomach and intestines and manifests itself through a variety of symptoms that can include abdominal pain or cramping, excess gas or bloating, and changes in bowel movements resulting in either diarrhea or constipation.

For those who suffer from it, IBS is usually a chronic problem that doesn’t have a cure but must be managed long-term.

Unfortunately, medical experts aren’t clear on what exactly causes IBS. The Mayo Clinic reports that early life stress, severe infection, or bacterial changes or overgrowth in the intestines are all likely contributors to the development of IBS symptoms. Also, people with IBS often have unusual activity in the muscles that line the walls of the intestines, resulting in irregular contractions that are either too strong or too weak. Because of this, there’s speculation that IBS could also be caused by problems within the nervous system, a result of poor signaling between the brain and the muscles of the intestinal walls.

Certain groups of people are more prone to developing IBS than others. Women are almost twice as likely as men to develop IBS, and those under age 50 are more likely to develop it than older adults. It’s also possible that anxiety, depression, or other mental health issues, and even genetics, play a role.

Treatments and Triggers

For severe cases of IBS, your doctor may prescribe medications, such as laxatives or antidiarrheal drugs, to help manage symptoms, and may even recommend mental health counseling. Prescription IBS medications may help reduce uncomfortable symptoms, but they can carry unwanted side effects and normally do nothing to identify or address the underlying causes of the problem.

Since the precise causes of IBS can be varied and are unclear, and no test exists that can accurately diagnose IBS, treatment in most cases comes down to trying to identify factors that could trigger symptoms, and addressing those directly. For most, the first line of treatment will be diet and lifestyle modifications.

What triggers IBS flare-ups can vary from person to person, so it’s important for each individual to closely monitor symptoms and anything that seems to worsen them.

A study in the June 7, 2017, issue of the World Journal of Gastroenterology reported that at least two-thirds of patients with IBS associated their symptoms with the consumption of specific foods. Being aware of what you’re eating and which foods may trigger uncomfortable symptoms is a very important step toward managing IBS.

While there’s no one-size-fits-all nutritional strategy for managing IBS, there are some common offenders among the food groups that offer a starting place for dietary recommendations. Many IBS patients have reported that foods high in fat and caffeine, spicy foods, gluten, and dairy products tend to exacerbate symptoms. Through observation and a process of trial and error, identifying and avoiding what triggers symptoms is the first step toward relief.

A Dietary Investigation

Another dietary approach to IBS that has been growing in acceptance in recent years is the low-FODMAP diet. This diet was developed based on the understanding that certain non-digestible short-chain carbohydrates actually ferment in the gut and tend to trigger or exacerbate IBS symptoms. FODMAP stands for “fermentable oligo-, di-, and monosaccharides and polyols.”

These carbohydrates are found in different combinations in a wide variety of foods but, according to an article in the journal Nutrients, are largely found in wheat, legumes, nuts, onions, dairy products, fructose-containing food like fruits and sweeteners, as well as cauliflower, mushrooms and low-calorie sweeteners like xylitol. Functional Dietitian Nutritionist Adair M. Anderson, MS, RDN, LDN, explains “FODMAPs are sugars that not only pull water into your gut causing diarrhea, but are also rapidly fermented by your gut bacteria, resulting in gas and bloating.”

A growing body of studies, including a meta-analysis published in the journal Nutrients in September 2017, have found that following a low-FODMAP diet is an effective way to manage IBS symptoms in a majority of patients. As the Cleveland Clinic explains, a low-FODMAP diet is more than just a simple dietary plan, it’s actually an elimination diet with a phased approach.

During the first phase, all FODMAP foods are eliminated from the diet temporarily, usually for two to four weeks. This gives symptoms a chance to subside (if they have a dietary basis), and gives the gastrointestinal tract a chance to rest.

Phase two includes a systematic reintroduction of one FODMAP food at a time, and observing carefully to see if there is an uncomfortable GI reaction to that particular food. Phase three is the maintenance phase.

Hopefully phases one and two identified a specific food or foods that are problematic; phase three is about avoiding just those foods, and keeping everything else.

Because the low-FODMAP diet involves eliminating a large number of healthy foods at first, in order to find out which ones are causing GI distress, this isn’t a lifestyle diet that should be kept up long-term.

The Stress Factor

Another major factor that may trigger IBS symptoms or make them worse is stress. Medical experts have known for years that psychological stress can result in physical symptoms, but recent research published by researchers from the Tokyo University of Science in the journal Frontiers in Neuroscience added another layer of confirmation to this finding. They showed that exposing mice to repeated psychological stress over 10 consecutive days resulted in gastrointestinal symptoms similar to those typical of IBS.

Dr. Gary Spink, a New York-based psychologist focusing on chronic pain and illness, including IBS, points to research that finds IBS is linked to stress and the traumatic stress caused by childhood trauma and maltreatment.

“Essentially, the more severe your trauma, the more severe IBS symptoms you experience. This association, as well as the association of stress with IBS symptoms, is believed to be the result of the gut-brain axis.”

That axis is made up of the many neurological connections between your gut and brain, which are in close and constant communication with each other.

“Your gut provides information to your brain necessary for energy regulation, and your brain regulates your gut,” Spink explains.

“When people experience stress, they can have a range of symptoms such as diarrhea, nausea, stomach pain, constipation, etc. An additional layer of complexity for people with IBS, their symptoms are a source of their stress, which leads to an endless cycle of stress-symptoms-stress and so on.”

Managing Stress to Treat IBS

For those experiencing IBS symptoms, managing stress can play a significant role in alleviating symptoms. One of the most effective ways to do this is through regular exercise.

Physical exercise is good for both mind and body, reducing stress and anxiety, as well as stimulating regular bowel movements. Multiple studies have shown a positive association between moderate, regular exercise and a decrease in IBS symptoms.

Other stress-reducing practices, like enjoying time outdoors in nature or participating in an engaging hobby, can help. Spending time in prayer, deep breathing, or meditation, can also be calming. Anything that helps a person relax and de-stress is beneficial for a gut suffering from IBS. Some health practitioners prescribe counseling as an important part of IBS treatment because of this.

Other Treatments

Aside from dietary changes, exercise, and stress reduction, there are also several other treatment options that have shown promise for some patients. Supplementation with probiotics, soluble fiber, or peppermint oil, intermittent fasting, and acupuncture have also each been used effectively to improve IBS symptoms in many patients.

IBS is a complex disorder that can have as many different causes and symptom combinations as there are individuals. Doing some investigative work into possible food triggers, managing stress, and working with a knowledgeable health care provider if needed can be important first steps in managing this condition.