by Patricia Cleary, Clean Nurse Practitioner
Stomach pain, bloating distension, constipation and or diarrhea for greater than 3 months. The experts say it is irritable bowel syndrome. What? My bowels are irritable? Are they annoyed by what I eat? How can that be? I eat like every other standard American. Hmmm. Maybe it is related to the Standard American Diet. How SAD.
The experts want to give me an antidepressant. Maybe this is to counteract my depressed or SAD diet that could be the cause of my abdominal pain. They also want to treat me with an antispasmodic. They say it will help with the muscle contractions in my stomach. It is the most common drug to treat IBS. I have read it helps in the short term but unsure about long term use. So it may help my gut, but it can cause psychosis, further bloating, loss of taste, neuromuscular weakness, blurred vision, impotence and I think I’ll stop right there.
Irritable Bowel Syndrome (IBS) is the most common gastrointestinal disorder. Typical symptoms that accompany IBS include abdominal pain, bloating, and an altered bowel habit with a relapsing and remitting history. The exact cause of IBS is uncertain. The condition is further sub-classified in to diarrhea-predominant, constipation-predominant, or alternating bowel habit. Traditionally the focus has been on alterations in gastrointestinal motility and visceral hypersensitivity. Today the focus is on inflammation, alteration in gut flora (bacteria) and overgrowth of bacteria. Food sensitivity is also being looked at as a contributive factor as well as genetic predisposition.
So what is causing the inflammation in my gut? Why are there changes in the bacteria of my gut? Are my genes set in stone?
Inflammation that occurs in your digestive tract in IBS is on a cellular level. It can be caused by bacteria and/or virus or another type of insult that triggers an inflammatory response. Initially you may be treated with an antibiotic and your symptoms may go away. However with IBS, the inflammation can be chronic. This can contribute to motility dysfunction (movement of the smooth muscle in the digestive tract) which then attributes to pain.
The changes that occur in gut flora (bacteria) are closely related to diet. Dietary patterns that alter glycemic load, fiber content, essential fatty acid composition, pHbalance, and macronutrient and micronutrient composition, have a tremendous effect on the balance of bacteria within the gastrointestinal tract. The alteration in gut flora can reshape the immune system and therefore can be associated with clinical syndromes outside of the gastrointesinal tract. The relationship between the abnormal gut flora and the cells of the intestine can results in altered permeability and the absorption of harmful substances into the blood stream which can affect other organ systems.
Although our genes play a role in determining many things about us, I think we can affect how we express those genes by how we live our lives. How we react to stress, our food choices, activity level are just some of the factors that may play a role in the expression of our genes.
So what are the treatment choices? Antispasmodics and antidepressants as mentioned to treat symptoms. But what about the cause?
A functional medicine approach for treatment is a comprehensive one compromised of four basic clinical steps: Remove, Replace, Reinoculate and repair. Eliminating pathogenic bacteria, viruses, fungi, parasites, allergens, and toxins from the gastrointestinal tract is the first step. Secondly, replenishing enzymes and other digestive factors lacking or insufficient in the gastrointestinal environment. The third step is to reintroduce desirable bacteria into the intestine to establish microflora balance.
The Clean program uses the principles of a nutritional cleanse that is based on functional medicine. It incorporates essential functions of detoxification such as reducing the workload of digestion, restoring the 12 hour window, rebuilding the inner environment, supporting the liver and enhancing elimination.
Treating IBS involves addressing the cause. Lifestyle changes are necessary. Trust your gut!