What Is Irritable Bowel Syndrome (IBS)?
The word ‘Syndrome’ means a group of symptoms. Irritable Bowel Syndrome is a group of symptoms that includes abdominal pain, changed pattern or regularity of bowel movements, and many other symptoms, such as cramps, bloating of the abdomen, urge to pass the stools, unsatisfactory stools, etc.
Changes in the pattern of Bowel movements can be variable and, based on that, IBS can be classified into 4 types:
- Diarrhea Predominant IBS: This is a type of IBS where symptoms of diarrhea are common.
- Constipation Predominant IBS: It is a type of IBS where symptoms of constipation are common.
- IBS causing both diarrhea and constipation or causing diarrhea and constipation alternately.
- IBS causing neither diarrhea nor constipation.
Sometimes, the patient can suffer from IBS after having an infection and that causes symptoms, such as fever, diarrhea, vomiting, and positive stool culture. This type of IBS is called ‘Postinfectious IBS’.
IBS is a functional disorder which means that the abnormality lies at a functional level, the movements of the intestine are neither regular nor normal. However, if we examine the intestinal tract, there is no structural change or pathology observed. The peristaltic movements of the intestines (regular contractions and dilatations) are disturbed, they either contract too hard or are dilated too long.
IBS is known by many different names like colitis, mucous colitis, spastic bowel, functional bowel disease, nervous colon, etc. However, many of these terms are not doesn’t provide a proper understanding of the disease. Colitis stands for the inflammation of the colon whereas in IBS there is no inflammation.
Homeopathy For IBS:
IBS is known to be a functional disorder of the gastrointestinal system. As we know, emotional stress, disturbances in the stress system i.e. HPA axis, the sensitivity of the intestines to different foods, etc. are the various causes that can trigger and aggravate IBS. Thus, this condition requires a system of medicine that addresses these causes. Homeopathic treatment treats the disturbances in the stress system, makes an individual capable of dealing with various psychological problems, and maintains an equilibrium between the mind and body. Thus, the root cause of IBS is taken care of and this is evident with the improvement in the relief from the symptoms at the physical level.
How Does Homeopathic Treatment Help?
Homeopathic treatment for IBS is beneficial in the following ways:
- Homeopathy helps to keep our mind calm.
- It helps us to deal with our negative emotions, such as anxiety, anger, guilt, worries, hatred, etc.
- Homeopathy helps to improve our stress-coping system
- It reduces or treats the hypersensitivity of the gut towards certain foodstuffs.
- As we adopt an individualistic approach in Homeopathic treatment, the minor issues or problems specific to a particular patient are also taken into consideration during the treatment.
How Does Homeopathy Work In Treating IBS?
Homeopathy addresses the root cause of the disease, in the case of IBS, it is psychological factors, such as emotional stress, anger, etc., and abnormal sensitivity towards certain foodstuffs.
Homeopathy treats the disturbance at the level of the stress-coping system. Homeopathy very well addresses the relationship between the psyche and the physique of the patient. Homeopathic medicines help in imparting positive emotions and feelings so that the patient can handle stress effectively and does not let himself get affected negatively by the stressors.
Homeopathy studies every individual patient of IBS in detail by considering the minute details of the person and not just by concentrating on the gastrointestinal affections. Homeopathy treats every patient as a whole entity by taking into considerations all the general symptoms as well as symptoms particular to specific organ systems, such as gastrointestinal symptoms.
Duration Of Homeopathic treatment:
IBS is a functional disorder that can be triggered by several factors, and it can present with slow or fast progress. Since many factors contribute towards its development, along with homeopathic medicines, diet, lifestyle and stress factors also play an important role in its treatment.
The duration of homeopathic treatment in IBS also depends on the following factors:
- The duration of the disease
- The previous use of conventional medicines
- The general condition of the patient
- Age of the patient
- Any associated diseases along with IBS
We can expect an initial improvement within 8 to 12 weeks of homeopathic treatment. However, a treatment of 12 to 16 months is recommended for a significant recovery.
Homeopathic Case Analysis:
During the case taking of a patient as per the homeopathic protocol, all his/her IBS related symptoms are noted in detail by considering their severity, frequency, nature, modalities, and other associated symptoms. For instance, the severity, frequency of diarrhea, whether the patient experiences constipation anytime, when is diarrhea aggravated or better, whether any other associated symptoms like nausea, vomiting, heartburn, etc. are present or not, etc. are considered.
Along with these disease-specific symptoms, the general symptoms of the patient, such as the food habits, sleeping habits, preference to the cold and hot climate, natural secretions like urination, stools, perspiration, etc. are also taken into consideration while prescribing the medicines. The family medical history and the past medical history of the patient is also given importance, as it helps us to know about the genetic dispositions and miasm of the patient.
There are about 3000 homeopathic medicines available for treating a variety of health conditions. However, more than 20 medicines are commonly used in the treatment of IBS. We would like to list a few homeopathic medicines useful in the treatment of IBS.
1. Nux Vomica 2. Sulfur
3. Pulsatilla 4. Lycopodium Clavatum
5. Argentum Nitricum 6. Podophyllum
7. Silicea 8. Colocynthis
9. Lilium Tigrinum 10. Asafoetida
Our Experience In Treating Irritable Bowel Syndrome At Life Force Homeopathy
At Life Force, we have been treating cases of IBS for over 30 years, under the care of Dr. Rajesh Shah, M.D. We have carefully treated and documented many cases of IBS.
Using homeopathy, we have observed substantial results in most cases of IBS where we were able to provide symptomatic relief and control the further progression of the disease. Also, the future complications, which could have occurred if it was not managed properly, were prevented with homeopathic treatment. Based on our significant experience, we strongly recommend homeopathy for the treatment of IBS.
Pathogenesis Of IBS:
Our intestines are made up of layers of muscles that contract and relax to the move the food through them and to digest it. This is also called Peristalsis.
These contractions and relaxations usually occur smoothly and in a rhythmic manner. Thus, the normal frequency of defecation is maintained, and there is a satisfactory and timely evacuation of the bowels.
In cases of IBS, sometimes strong/violent contraction of intestines occurs for a prolonged time or the intestines may contract and relax very slowly. This results in the entrapment of the stools in the contracted portion of the intestine for a long time causing the stool to become hard. This eventually results in constipation. Also, air may get entrapped in the intestines causing abdominal bloating, swelling, and discomfort.
Sometimes the bowels may contract very rapidly, so much that the intestines will not get time to absorb the water from the stools and may result in watery stools or diarrhea.
Due to the sharp contractions, the patient can experience excruciating pain. Also, in IBS patients, the gut tends to send pain signals with increased intensity, so IBS patients can experience pain even after a normal meal or even when a small amount of gas is present in the bowels.
Mucous is usually secreted in the bowel lumens, this secretion can increase in IBS patients, but it is not a serious problem.
Prevalence of IBS:
It is estimated that about 15% to 20% of the people in the world suffer from IBS at some point during their lifetime. It is more commonly observed in South America and less common in South East Asia. Approximately, one-third population in the UK and 40 million Americans suffer from IBS. It is two times more common in females than in males. It is observed that IBS becomes less common with age, mostly occurs before 45 years of age.
It is not a life-threatening condition. It does not affect life expectancy. However, it is very common and statistics say that IBS is one of the reasons for most people remaining absent at the workplace along with colds and other related disorders.
Causes of IBS:
It is difficult to find out the exact cause of IBS in a given patient, as many different causes are seen to be related to IBS. Different theories include Gut-Brain Axis Problems, Intestinal bacterial overgrowth, Motility (peristaltic movements) abnormalities of Gut, Neurotransmitters, Food sensitivity, genetic factors, psychological factors, Post-infectious condition, etc.
We would like to throw the light on some of the causes of IBS:
Post-Infectious IBS: This can be observed in approximately 10% of IBS cases. This type of IBS usually manifests as Diarrhea Predominant IBS. Anxiety, stress, and genetic defects appear to contribute to postinfectious IBS. An acute attack of gastrointestinal infection can end up causing IBS due to increased gut permeability. IBS is strongly associated with increased gut permeability, regardless of the cause of permeability.
Psychological Factors: STRESS: It is observed that many patients of IBS may experience a trigger or aggravation of their disease by one or the other psychological disturbance. It is during events like the loss of any loved one, school exams, financial stresses, emotional breakdowns, etc. when most people experience IBS symptoms. This shows that any problem in the stress system or incapacity to handle stressors disturbs the HPA axis (Hypothalamus-Pituitary-Adrenal Axis), i.e. disturbs the communication between the brain and intestines and causes altered movements of intestines (IBS).
Overgrowth Of Bacteria: Small Intestinal Bacterial Overgrowth is more commonly observed in people with IBS than in people not having IBS. This may occur due to the altered immune system response against the bacterial overgrowth which causes the release of cytokines (chemical substances) which increase the permeability of the gut and may lead to IBS.
Sensitivity To Certain Foods: In some patients, it is observed that IBS gets triggered after the consumption of certain foodstuffs. Such patients are sensitive to certain foods, such as chocolate, coffee, milk products, etc.
Genetics: According to several different studies, it is found that certain factors or inborn tendencies run in a family which makes a person respond abnormally to stress or certain foods, etc. and result in IBS.
Vitamin D Deficiency: Vitamin D deficiency is seen to be more common in people suffering from IBS.
Conventional Medicines: In many patients, the IBS symptoms may get aggravated after the use of conventional medicines, such as steroids, antibiotics, anti-inflammatory drugs, etc.
Symptoms of IBS:
Most of the symptoms seen in IBS patients are similar, yet every IBS patient presents with a unique set of symptoms unique to himself/herself.
Even the intensity of the symptoms may vary from patient to patient. Where some patients may have one or two mild episodes, others may have a severely debilitating form of IBS which compels them for taking frequent leaves from work.
Some of the common symptoms of IBS are:
- Change In Bowel Habits: Some patients may suffer from constipation, where the patient may experience less bowel movement, hard stools, and unsatisfactory stools. Some may have diarrhea resulting in loose motions and urgency to pass the stools immediately after meals. Some patients may have both, constipation for weeks followed by diarrhea (alternate constipation and diarrhea)
- Abdominal Pain & Discomfort: Abdominal pain may vary from severe cramps to continuous dull aching pain in the abdomen. Pain is aggravated after meals and is better after passing stools. Most commonly, the pain is experienced in the left lower quadrant.
- Urgency & Incomplete Evacuation: Urgency to pass motions after meals may be experienced by the IBS patient. The patient experiences a desire to defecate even when he has already passed the stools. This is termed as incomplete evacuation.
- Gas, Bloating, & Abdominal Distension: Most of the IBS patients complain of abdominal distension due to the gas. The patient feels heaviness and a sense of discomfort due to the rumbling of gas. The person feels better after passing the gas.
Other Symptoms: Apart from the common symptoms mentioned above, other symptoms include Gastroesophageal reflux (nausea with or without vomiting and heartburn), the sensation of fullness after eating a small meal, sensation of something being stuck in the throat, genitourinary symptoms (urinary urgency, feeling of incomplete emptying of the bladder), headache, body ache, and muscular pains (fibromyalgia). Some may also experience sexual dysfunction, reduction on libido, and pain during sexual intercourse.
Diagnosis of IBS:
There is no specific test for investigation for the diagnosis of IBS, however, ruling out other diseases and other serious symptoms like blood in stools, onset after 50 years of the age, weight loss, iron deficiency i.e. anemia, family medical history of colon cancer, etc. can help in diagnosing IBS. It is usually recommended to minimize the use of investigations to diagnose IBS and depend more on symptoms for diagnosis.
The following can be considered for the diagnosis of IBS:
A Good Medical History Of The Patient: Considering a good medical history from the patient with regards to his symptoms will help a lot to arrive at the diagnosis. The presence of symptoms, such as abdominal pain relieved after defecation, abdominal distension, the sensation of incomplete evacuation, and the passage of mucus in the stools, indicate IBS and helps in diagnosing it.
Laboratory Tests: A stool sample examination for the presence of blood in the stool may be recommended. This can help us to differentiate the diagnosis of IBS from other conditions as blood is not present in the stools of IBS patients, however, rarely some IBS patients can have blood in stools. Blood in stools is mostly seen in diseases, such as Ulcerative Colitis, Crohn’s Disease, etc. Also, a stool culture will help us to find out if there are any microorganisms in the stool which are responsible for diarrhea or constipation patterns. Blood tests, such as CBC, ESR, LFT (Liver Function Test), etc. and test for the coeliac disease can help in diagnosis.
X-ray: X-rays of the lower GIT can also be taken for the diagnosis of IBS. This is called Barium Enema, in which an enema of a chalky white substance called Barium sulfate is given to the patient and X-rays are taken. This test helps the doctor to rule out other conditions, such as a tumor, inflammation, obstruction, and Crohn’s Disease.
Colonoscopy: In this method, a special flexible tube (Colonoscope) is inserted into the anus to view the interior of the colon. This can be used to rule out the inflammations, tumors, ulcers, etc. in the colon.
Apart from the medical tests and investigations, certain criteria can also be applied to confirm the diagnosis of IBS.
The patient should have abdominal pain at least 1 day/week for the last 3 months, and the abdominal pain should be associated with 2 or more of the following criteria.
- Related to defecation
- Associated with a change in the frequency of stool
- Associated with a change in the form of stool.
General Management For IBS:
After having gained information about IBS, we all know that our diet, lifestyle, and stressors do affect IBS and its management. Here, we list some general things which we can follow to manage IBS.
- Avoiding Dietary Triggers
Although, different patients have different triggering factors for IBS, most commonly found are as follows:
- Milk and dairy products
- Fatty, spicy foods
- Beverages, such as tea, coffee, and aerated drinks
- Certain vegetables, such as cabbage, cauliflower, and broccoli
- Alcohol and alcoholic beverages
Avoiding these common triggers can help manage IBS effectively.
- Small Meals At Frequent Intervals:
Eating meals in smaller proportions that have low fat, high carbs, whole grains, fruits, & vegetables facilitate easy digestion.
- Increase Your Water Intake:
Increasing your intake of water can help in treating constipation-predominant IBS.
- Eat Fiber-Rich Foods:
Consuming foods that are rich in fiber, such as wholegrain bread & cereals, fruits, & vegetables, keeps the bowel distended, thereby preventing crampy pain and regulate bowel movements.
- Manage Stress:
Stress has been closely related to IBS, and, thus, the role of psychological therapies in the treatment of IBS must be considered in its management. Although, there is no significant evidence that psychological therapies can be effective in the treatment of IBS, however, psychological therapies don’t have any adverse effects as such.
Hypnotherapy can help to achieve mental well-being. Cognitive-Behavioral Therapy (CBT) can help to provide strategies and ways to cope with stress and to reduce the thoughts or behaviors which can aggravate IBS symptoms. According to NICE guidelines for IBS, psychological therapies should be considered for the patients who have not responded to Pharmacological therapy for more than 12 months and the symptoms go on increasing.
Conventional Treatment for IBS:
Conventional medicines for IBS are targeted at treating various symptoms of this disease. Thus, they help to provide temporary relief in the symptoms and so cannot treat the disturbance at the level of the Brain-Gut Axis. Also, conventional medicines have side-effects that cannot be tolerated by every patient. Below are some of the medicines usually given in IBS:
- For Pain: Anti-Cholinergic and Anti-Spasmodic drugs are given to the IBS patients to help relieve them of the discomforting pain.
- For Diarrhea: Anti-diarrheal - Loperamide and other related medicines are given to the patient suffering from diarrhea.
- For Constipation: Laxatives (stool softeners) are given to the IBS patients suffering from the discomforts of constipation.
- For Bloating & Flatulence: Antacids/anti-foaming medicines help to relieve painful pressure caused by the excess of gas in the stomach and intestines. Smooth muscle relaxants may provide temporary relief to the patient.
- For Indigestion: Prokinetic Agents help in increasing the motility of the upper GI tract, thereby helping in treating the indigestion symptoms.
- For IBS Patients With Depression: As depression is closely associated with IBS, Anti-Depressants or Serotonin Reuptake Inhibitors are commonly prescribed to IBS patients with depression.
- Coeliac disease
- Colon cancer