Irritable bowel syndrome

Irritable bowel syndrome (IBS) causes a great deal of discomfort and distress, it does not permanently harm the intestines and does not lead to intestinal bleeding or any serious disease, such as cancer. Most people can control their symptoms with dietary adjustment and stress management.

Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved.

Normal motility or movement may not be present in the colon of a person who has IBS. It can be spasmodic or can even stop working temporarily. Spasms are sudden strong muscle contractions that come and go.

The lining of the colon called the epithelium, which is affected by the immune and nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the epithelium appears to work properly. However, when the contents inside the colon move too quickly, the colon loses its ability to absorb fluids. The result is too much fluid in the stool.

In other people, the movement inside the colon is too slow, which causes extra fluid to be absorbed. As a result, a person develops constipation.

A person’s colon may respond strongly to stimuli such as certain foods or stress that would not bother most people.

Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain.

Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, they experience problems with bowel movement, motility, and sensation,having more sensitive pain receptors in their GI tract.

Researchers have reported that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS.

Researchers have also found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. People with celiac disease cannot eat these foods without becoming very sick because their immune system responds by damaging the small intestine. A blood test can determine whether celiac disease may be present.

Crohn’s disease: is among the most common, non-infectious inflammatory condition that may affect any part of the gut from the mouth to the anus. It is believed to be due to an autoimmune mechanism.

Ulcerative colitis: only affects the colon and rectum. As its name indicates, IBS is a syndrome: a combination of signs and symptoms. IBS has not been shown to lead to a serious disease, including cancer. Through the years, IBS has been called by many names, among them colitis, mucous colitis, spastic colon or spastic bowel. However, no link has been established between IBS and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.

Inflammatory bowel disease (IBD): should not be confused with irritable bowel syndrome (IBS) which is a functional disorder of the bowels, meaning that it is in a state of dysfunction although there is not evident pathology of the bowels.

The alimentary tract extends from the mouth to the anus. Most of the length of this tract is made up on the bowels, namely the small intestine and large intestine. The small intestine is divided into three parts:

1. Duodenum (leading from the stomach)
2. Jejunum and ileum (leading to the large intestine).
3. The large intestine is composed of the cecum, colon and rectum.

Most of the digestion, absorption and stool formation occurs within the bowels.

Inflammatory bowel disease is a chronic disease characterized by varying degrees of inflammation of mainly the bowel but may extend to other parts of the gastrointestinal tract. There are two main types;

1. Crohn’s disease
2. Ulcerative colitis

Although there are several key differences between the two conditions, the symptoms are largely the same and it may be difficult to differentiate. Crohn’s disease more frequently affects the ileum and colon but can occur in any part of the alimentary tract. Ulcerative colitis is only seen in the colon and rectum.

Both Crohn’s disease and ulcerative colitis appear to be due to the same mechanism, the cause of which is largely unknown. (idiopathic). Most cases of Crohn’s disease appear in early adulthood, although it may be very infrequently seen in children. Ulcerative colitis is more common and women are more prone than men to developing IBD.

The cause of inflammatory bowel disease appears to be due to a defective mucosal immune mechanism, but it is not considered as an autoimmune disease. It is believed that a combination of the following mechanisms may be responsible for the chronic inflammation.  These defects are largely due to genetics and may therefore be seen in families although this is not always the case.

Intestinal flora

The bowels contain trillions of bacterial cells which play an important role in digestion and the absorption and manufacture of various nutrients. These naturally occurring bacteria, known as the normal intestinal flora, also help to prevent the invasion of the bowel by foreign pathogens.

However, the population of these bacteria needs to be closely controlled by various mechanisms within its microenvironment to prevent it from becoming harmful to the bowels.

There is some evidence to suggest that in inflammatory bowel disease, the body forms antibodies against these bacteria which then leads to inflammation that is ongoing as the bacteria are constantly replenished. The bacterial population may also, for some reason or the other, pass beyond its normal acceptable limits in inflammatory bowel disease.

What is the epithelial tight junction barrier?

The neighbouring cells that make up the mucosal epithelium lie closely together and practically join together to form an impermeable membrane. This close association is known as a tight junction and the effect of the epithelial barrier is to ensure that substances within the epithelial tissue does not leak out into the gut and at the same time substances do not enter the tissue spaces without being absorbed, either passively or actively, as required. One of the hypotheses around the pathogenesis of inflammatory bowel disease suggests that this epithelial tight junction barrier function is compromised to some degree and this may allow for unregulated transport of substances across the mucosal epithelium.

Ultimately this triggers inflammation of the bowel wall. A defective transport of substances across the epithelial lining may also be another factor in inflammatory bowel disease, irrespective of the integrity of the tight junction barrier.

What is the mucosal immune response?

Mucosal epithelium lines the gastrointestinal tract from the mouth to the anus. Although there may be differences in the lining of the various portions of the gut, it is largely the same structure. The mucosa is not a tight impermeable barrier like the skin but is often just as exposed to the environment, air, foods and drinks.

It has its own immune response known as the mucosal immune system which is geared to protect it from any invading pathogens. In this manner it also prevents infiltration into deeper tissue and infection from spreading to the rest of the body. In inflammatory bowel disease this mucosal immune response appears to be defective. I

Inflammatory mediators are abnormally activated and inflammation therefore sets in despite the obvious absence of any threat to the mucosal epithelium.

What causes irritable bowel syndrome?

Although the exact cause has not as yet been identified despite a better understanding of the mechanism in recent years, it is believed that some external factor triggers the process in a person who is genetically susceptible.

What are possible trigger factors for irritable bowel syndrome?

• A previous infection (possibly infectious gastroenteritis)
• Exposure to cow’s milk or other animal protein
• Und underlying autoimmune diseases like autoimmune thyroiditis and systemic lupus erythematosus.
• Tobacco smoking appears to play some role in inflammatory bowel disease, but the exact interaction is not clear as yet.
• Appendectomy, removal of the appendix. It appears that the appendix does play a protective role which is also not clearly understood as yet.

Irritable bowel syndrome can be caused by the Bifido bacteria

Natural antibiotic remedies for a Bifido infection

• Angelica root (Angelica archangelica)
• Psyllium husks (Plantago ovata)
• Okra (Abelmoschus esculentus)
• Oregano (Origanum compactum)

What are Crohn’s disease and ulcerative colitis?

The main differences between Crohn’s disease and ulcerative colitis are listed below. Other differences and similarities relate to ethnicity, recurrence after surgery, cancer potential and nutrient malabsorption. Ulcers occur in both conditions but may vary in size and depth.

Crohn’s disease: Skip lesions with inflammation extending through the entire wall of the bowel. Fibrosis is significant. Deep narrow ulcers, fissures and fistulas.

Ulcerative colitis: Inflammation isolated to the mucosa and submucosa. Little or no fibrosis is seen. Large, shallow ulcers.

What are the symptoms of irritable bowel syndrome?

Recurrent or persistent diarrhoea is the main feature of both Crohn’s disease and ulcerative colitis.

In Crohn’s disease this is watery, large volume diarrhoea with no blood or mucus.

In ulcerative colitis, bloody diarrhoea is a cardinal sign, along with mucus in patients with proctitis. Some ulcerative colitis patients may experience frequent bowel movements with small-volume loose stools and rarely may even experience constipation with hard stools between acute attacks.

Abdominal pain is significant in Crohn’s disease which intensifies with eating and passing stool.

In ulcerative colitis, abdominal pain is not as prominent although there is some abdominal discomfort and cramping which is often temporarily relieved by defecation. In severe cases of ulcerative colitis, however, the pain is intense and not eased by bowel movements.

Weight loss is prominent in most patients with Crohn’s disease partly due to pain associated with eating and malabsorption.

Ulcerative colitis patients are largely unaffected with regards to weight loss except in very severe cases although there may be some temporary loss of weight during acute attacks.

What are other symptoms of irritable bowel syndrome?

• Anaemia
• Anorexia
• Arthralgia (joint pains)
• Black tarry stools
• Bleeding from the anus.
• Bowel movement, inability to have one.
• Depression or anxiety.
• Eye inflammation (uveitis).
• Fever.
• Flatulence and bloating.
• Headache.
• Lethargy and fatigue.
• Malaise.
• Mouth sores.
• Mucus covered stools.
• Nausea, especially after eating.
• Sharp pain in the lower abdomen or groin areas before and during bowel movement.
• Skin disorders.
• The urge to have another bowel movement after you’ve just had one.

Feelings of nervousness, anxiety, guilt, depression, frustration or anger may bring on or aggravate this very common disorder. Coffee, raw fruits and vegetables, hormones, certain medications and overuse of laxatives can promote it, as can an inability of the body to digest the natural sugar found in milk.

Symptoms of ulcerative colitis may also occur outside the gut and include joint pain, eye inflammation, skin rashes and lesions and mouth ulcers.

What should be avoided for IBS, IBD, Crohn’s disease and ulcerative colitis?

A basic diet avoiding items, which have been associated with IBS, IBD, Crohn’s disease and ulcerative colitis may result in marked improvement.

Such items to avoid include sugar, sweets, bleached white flour, insoluble fibre, carbohydrates, processed meat and alcohol as well as allergenic foods such as wheat, dairy products and corn.

Alcohol can cause diarrhoea and nausea and interfere with digestion. See Alcohol dangers

Caffeine found in coffee, chocolate, cola and even some medications can stimulate the intestines and cause heartburn and cramping. Coffee is especially aggravating as it reacts with the stomach’s normal acids. See Coffee dangers

Chocolate not only contains caffeine but high amounts of sugar and fat all of which can worsen IBS symptoms.

Citrus fruits: Of all the types of fruit, citrus varieties, such as oranges, grapefruit, lemons, limes and tangerines, seem to be the most common offenders.

Dairy products: Some sufferers are lactose intolerant, which means they can’t digest lactose, the sugar found naturally in milk and other dairy products. Live probiotic yogurt and hard cheeses don’t seem to cause any symptoms because their bacterial content converts much of the lactose to lactic acid before they’re consumed.

Whole-milk dairy products also contain fat, which may be an irritant. Goat’s milk can be better tolerated than cow’s milk. Yoghurt can actually benefit the digestive system and ease symptoms.

Animal fat: Fatty meats like duck, goose, lamb and pork, butter and oils are more difficult for the body to digest and can cause problems in the intestines.

Gas producers: Onions, legumes, pulses, beans, broccoli, Brussels’ sprouts, cabbage, red and green peppers and carbonated beverages can increase wind. Many of these offenders are rich in nutrients, however, so experiment with smaller amounts or different cooking methods or try a Sprouting greens regime.

Lectins are a type of glycoprotein found in many plant foods. Seeds of the grasses such as rice, rye, spelt and wheat have exceptionally high levels of this defensive glycoprotein. Whole wheat sprouted grains and wheat germ enriched products, all have considerably higher levels of lectins than their processed, refined and non-germinated equivalents and may be ironically contributing to making people significantly less healthy.

This may be why the ‘Paleo diet’, which eliminates grains entirely from the diet, may be effective in improving the health and reducing pain and inflammation in some individuals.

Food sources of lectins include most fruits, grains, legumes, herbs, nuts, seeds, spices and vegetables and grain-fed animals. Some types of lectins are destroyed during processing and digestion however others are not and can cause the pain and inflammation and health problems mentioned above. The most common potentially ‘toxic’ lectin containing food groups are:

• Grains: (Especially wheat and wheat germ but also barley, buckwheat, corn, millet, oats, quinoa, rice, rye and spelt).
• Legumes: (all dried beans, including navy beans, soya beans and peanuts).
• Dairy: (when cows are fed grains instead of grass).
• Nightshades: (aubergines, peppers, potatoes and tomatoes).

NOTE: Dairy products may be potentially more harmful when pasteurised and processed because of the reduction of SIgA, an immunoglobulin that binds to and eliminates dangerous lectins.

Nightshades: Aubergine, peppers, potatoes and tomatoes belong to the nightshade (Solanaceae) family that contain inflammation inducing alkaloids and, although not truly nightshades, ashwaganda, blueberries, goji berries and huckleberries also share the same alkaloids.

Glycoalkaloids and steroid alkaloids:The Solanaceae family contains cholinesterase inhibiting glycoalkaloids and steroid alkaloids including, among others, capsaicin in peppers, nicotine in tobacco, solanine in aubergines and potatoes and tomatine in tomatoes. The glycoalkaloids in potatoes are known to contribute to irritable bowel syndrome and negatively affect intestinal permeability.

Spicy foods: Hot spices can be a cause of IBS. Try eliminating them and see if that makes a difference.

Sugar: Some IBS sufferers have what’s known as fructose intolerance and have difficulty digesting fructose (fruit sugar). Sucrose or white sugar can also trigger IBS and are especially detrimental to the digestive tract. See Sugar Dangers

Tobacco: Smoking may have an effect on the motility, or movement, of the digestive system but it has been found to lower the risk of ulcerative colitis and some people have been treated with nicotine.

Sugar free products especially chewing gum: Specifically, those made with sorbitol or aspartame can aggravate IBS symptoms because the artificial sweetener is not digestible. See Aspartame Dangers.

Wheat can irritate the lining of the intestines and should be avoided when suffering from IBS or any other colon and intestinal disorders. Many processed products contain wheat so labels should be checked carefully. Amaranth, coconut flour, millet, quinoa and rice flours are good alternatives to use in place of wheat.

Visit the Food allergies page to learn more about foods that cause inflammation and contribute to immune system disorders, IBS and other intestinal disorders including leaky gut.

What natural remedies are there for irritable bowel syndrome?

Mainstream medicine usually treats ulcerative colitis as an immune disorder and often prescribe the dangerous steroids and other drugs to control symptoms. Natural remedies, on the other hand, often control symptoms and lead to prolonged remission without drugs, side effects or surgery. Some of the best are:

Black seed oil is a natural immune modulator that can help prevent immune dysfunction which may cause ulcerative colitis.

Cabbage: Juice of the cabbage soothes the symptoms of irritable bowel syndrome. To turn it into juice, wash and put through a juicer or blender. If these are not available, cook the cabbage in a very small amount of water, just enough to keep it from scorching or burning, until very mushy. Then mash with a fork or mixer.

NOTE: Avoid cabbage if suffering with thyroid problems, kidney stones, gallstones, joint problems or osteoporosis

Carrots: Help to prevent the symptoms of IBS as well as regulate diarrhoea and constipation. Eat them raw with avocado or in salads or steamed. They can be juiced too but they’re not a juicy vegetable so add a little pure apricot nectar when making carrot juice. Don’t overcook them to avoid loss of nutrients. In order to absorb the carotenoids in carrots they must be consumed with oily foods such as cold-pressed avocado, nuts or coconut, rapeseed or olive oil.

Curcumin is a natural immune modulator that can help prevent immune dysfunction which may cause ulcerative colitis.

Fennel seeds can relieve the intestinal spasms associated with IBS. They may also aid in the elimination of fats from the digestive system, inhibiting the over production of mucus in the intestine, which is a symptom of the ailment.

 Make a tea with the seeds by adding 1/2 teaspoon fennel to 1 cup boiling water, steep for 15 minutes then strain and drink after meals. Add them to vegetables such as carrots that also soothe IBS symptoms.

They can be sprinkled on salads or roasted and consumed as a snack after a meal to reduce the symptoms of IBS (they also freshen the breath). To roast, sprinkle a baking sheet with olive oil, then cover with fennel seeds. Bake at 325F for 10 to 15 minutes. NOTE: avoid seeds and nuts if suffering from diverticulitis.

Flaxseed: Make a tea using one teaspoon flaxseed per cup of water, steep for 15 minutes then strain and drink at bedtime for relief of symptoms.

Frankincense has been found to block chemical reactions involved in inflammation.

NOTE: Rare side effects of frankincense include diarrhoea, heart burn, nausea and skin rash.

Lettuce: Consumed raw it can relieve symptoms of IBS, but it’s especially helpful if lightly steamed. Go for the darker varieties, the darker the colour, the more nutrients it contains.

Maqui berry is a Chilean ‘super fruit’ which contains the highest amount of antioxidants and anti-inflammatory compounds than any other known natural food. Regular consumption can relieve the symptoms of colitis.

Marshmallow is a useful herb for the treatment of diarrhoea and indigestion; along with chronic diseases that cause these symptoms such as Crohn’s disease, irritable bowel syndrome (IBS) and gastroesophageal reflux disease. Its anti-inflammatory properties are also useful for treating peptic ulcers, hiatus hernias, mouth ulcers, enteritis and colitis.

Oat bran: Increasing fibre is a cure for almost every intestinal ill and oat bran is especially good for IBS because it is mild and colon friendly. Consume some every day: a bowl of oatmeal or oat bran bread. It may take up to a month to get any IBS relief. There are other whole grains that are equal to oat bran in nutritional value and cause no irritation of the stomach lining see >> Whole grains.

Oleander leaf is a natural immune modulator that can help prevent immune dysfunction which may cause ulcerative colitis.

Passion fruit contains components which have the ability to relax the nerves and relieve constipation, colitis and diarrhoea.

Pears may help to relieve IBS symptoms. Purchase when they’re still hard and let them ripen at room temperature for a few days. Pure unsweetened additive free pear juice and dried pears are also helpful in treating intestinal problems.

Peppermint: Several studies have shown that peppermint can reduce IBS symptoms, particularly when cramping and diarrhoea are major problems.  Steeped into a nice, relaxing tea, dried peppermint can relieve intestinal spasms. Use 1 heaping teaspoon dried peppermint and steep in 1 cup boiling water for ten minutes. Peppermint can exacerbate heartburn, but there are no other side effects.

Pineapple can prevent dehydration when severe diarrhoea is present.

Psyllium husks: Are invaluable in the treatment of bowel problems as they help with digestion and provide lots of fibre making the stool soft and easily passed. Try mixing a small carton of live probiotic yogurt with 1/2 teaspoon psyllium husks and eating the mixture one hour after meals. Or mix one teaspoon with a large glass of water and consume daily upon waking. Always drink plenty of water with psyllium husks.

Which nutrients that can help protect against and treat irritable bowel syndrome?

Bromelain, a digestive enzyme from pineapple, reduces inflammation and aids healing and can decrease the incidence and severity of colitis. Pineapples can also prevent dehydration which can be the result of constant diarrhoea.

Omega-3 fatty acids can reduce inflammation in people with ulcerative colitis.

Magnesium is a natural immune modulator that can help prevent immune dysfunction which may cause ulcerative colitis. has been leeched from the soil with modern day intensive farming techniques and is not replaced, which may explain the lack of it in the diet leading to the increase of immune dysfunctions in humans.

There are many varied combinations of magnesium available as supplements but natural foods rich in magnesium are far better to consume.

WARNING: People with liver, kidney or heart diseases, alcohol dependence, phenylketonuria (increased phenylalanine levels in the blood), and diabetes should not take magnesium supplements.

Magnesium supplement drug interactions

Magnesium can lower the absorption of bisphosphonates, some antibiotics and antiviral medications, and gabapentin (Neurontin) if they’re taken together.

Magnesium overdose

Magnesium is poisonous for people with kidney problems or disturbances in the heartbeat. High doses can cause hot flushes, thirst, low blood pressure and sometimes loss of reflexes and therefore supplements are not advised. Natural foods containing magnesium will not cause severe overdose as they also contain the other minerals required for a natural balance.

Highest natural sources of magnesium in milligrams per 100 grams

Inulin and magnesium

Inulin is a form of starch which enhances magnesium absorption in the intestines.

Natural sources of inulin in alphabetical order

Vitamin B9 (folic acid): People with chronic ulcerative colitis are at greater risk of colon cancer. Four times the recommended daily amount of vitamin B9 significantly suppresses ulcerative colitis-associated colon cancer.

Vitamin C helps protect and heal the mucosa.

Vitamin D helps with digestion and absorption of calcium and phosphate, regulates the amount of phosphorus in the body and can reduce chronic inflammatory conditions. 10-15 minutes of midday sunshine on the skin can provide all the vitamin D the body needs. It is not the same as sunbathing; the skin simply needs to be exposed to sunlight.

Through a window does not work. Over exposure of the sun’s rays can be dangerous for the skin but no exposure at all can be equally detrimental. Ultraviolet B (UVB) rays in sunlight convert cholesterol in the skin into vitamin D.

During the winter months (October-April) when it is too cold to expose the skin to the sun and in the northern hemisphere there is not enough UVB rays from the sun anyway, it is advisable to raise the weekly intake of oily fish and cod liver or krill oil. Other sources of vitamin D are goat’s milk, wild mushrooms and eggs.

Other natural remedies include:

• Aloe vera gel
• Calendula
• Fenugreek
• Devil’s claw
• Ginkgo biloba

Raw juice therapy can successfully treat colitis and bowel problems. The best organic natural foods to blend and juice are:

• Apple
• Apricot
• Beetroot
• Carrot
• Cucumber
• Papaya
• Pear
• Peach
• Pineapple
• Spinach

How can symptoms be eased?

• Eating small amounts of food throughout the day.
• Avoiding fatty, greasy or fried foods and sauces (butter, margarine and heavy cream).
• Limiting dairy products. Try low-lactose cheeses, such as Swiss and cheddar and goat’s milk instead of cow’s.
• Fasting and drinking lots of water (drink small amounts often throughout the day) helps eliminate toxins and restores natural balance.
• Stress should be avoided as it may cause the onset of ulcerative colitis symptoms.
• Mind/body therapies such as breathing exercises and meditation can help.
• Gentle stretching exercises can also help the digestive system. Too much sitting can exasperate symptoms.

Related subjects

• A-Z of ailments
• Anal fissures
• Anti-microbial healing plants and foods
• Bacterial infections and natural antibiotics
• Constipation and diarrhoea
• Diverticular disease
• Excretory system disorders
• Feed your friendly bacteria
• Flatulence
• Haemorrhoids
• Intestinal system disorders
• Parasites
• Sclerosing mesenteritis