Constipation Food
Irritable Bowel Syndrome - One Condition or a Collection of Problems?
IBS or irritable bowel syndrome is a common medical diagnosis made once other more serious conditions such as cancer, inflammatory bowel disease or coeliac disease have been ruled out.The problem with such a diagnosis is that individuals labelled with the condition are sent away with very little explanation as to what is causing the symptoms that they are experiencing. Consequently they may end up (in many cases unsuccessfully) taking anti spasmodics, antidepressants or immodium for years without getting to the route cause of their problems. Diet is rarely discussed, but if advice is given, it is often very general and takes no account of individual symptoms or possible causes.
So what are the causes of IBS?
There are a number of causes for this common problem and it is important that they are identified and satisfactorily dealt with in order for normal digestive function to resume.
Bugs in the System
One of the most common underlying causes for IBS is a condition called dysbiosis in which the different strains of bacteria in the small and large intestine can become unbalanced leading to symptoms such as bloating, flatulence, constipation, diarrhoea and stomach cramps. Dysbiosis often occurs after a course of antibiotics kills off the so called 'friendly' bacteria in the gut allowing some of the less helpful strains to proliferate. Stress has also been shown to negatively impact on bacterial balance and a diet which is too high in refined carbohydrates such as white bread, white rice, pasta, biscuits, cakes and confectionary can cause excessive gut fermentation. If our gut immune system is working below par then it may allow yeast to proliferate or we may be unlucky enough to pick up a parasite, or a bacterial infection such as helicobacter pylori.
Food Intolerances
Food intolerances are another extremely common cause of IBS symptoms and often co-exist alongside dysbiosis. This may in part be because our friendly bacteria play an important role in enabling us to distinguish friend from foe. Once this part of our immune system has been damaged it becomes more difficult for the body to distinguish harmful antigens from benign food particles. Another factor is that some yeasts and bacteria give off harmful toxins which can damage the gut lining (a condition known as leaky gut syndrome) allowing partially digested food through into the blood stream where it causes an immune reaction.
Irritating Foods
Some food reactions are not mediated by the immune system and are caused by foods which are inherently irritating such as citrus fruits, spicy foods, alcohol, coffee, vinegars and acidic tomatoes. These reactions usually happen because there is some damage to the lining of the gut which is experienced as the food is consumed – a bit like squeezing lemon juice on a mouth ulcer! Other foods which can be abrasive include rough, dry, scratchy crackers and foods high in insoluble fibre such as all bran, bran flakes and fruit and vegetable skins. Interestingly although IBS patients are often told to avoid fibre soluble fibre found in porridge oats, peeled apple works in a different way and can be very beneficial in many cases. A final group of foods which tend to be problematic for IBS sufferers is beans and foods high in sulphur. These are difficult to digest and tend to result in a lot of gas (particularly in individuals with unbalanced gut bacteria)
Stomach Acid, Enzymes and Bile
Although it is often individual foods that are to blame in IBS, sometimes the root of the issue lies in faulty digestion. In order to break down our food adequately we need good levels of stomach acid, digestive enzymes and a plentiful supply of bile. Chronic stress can inhibit secretions of these important substances making digestion slower and more difficult, while acute stress increases the speed at which the bowel empties. If your digestive issues are linked to a group of foods such as fatty foods or fruit sugars for example then this might be an area to explore.
Nutrient Deficiencies
Although not commonly thought of as a cause of IBS, nutrient deficiencies can contribute to the condition in a number of ways. Lack of essential fatty acids (omega 6 and omega 3) can cause the lining of the gut to become dry, sore and irritated. Adequate water is also essential for hydration and to achieve bowel regularity. Fibre is needed to provide bulk for the stool and to make it move through the digestive tract. Nutrients such as calcium and magnesium are often deficient and are needed for healthy peristalsis; the process by which food moves through the gut. Finally zinc and B vitamins are needed in the production of the all important stomach acid and to facilitate the nerves that control the digestive process.
The IBS Recovery Plan
1. Identify and treat any underlying dysbiosis using friendly bacteria supplements and herbal agents such as garlic and oregano to kill off bad bacteria and yeast
2. Identify and remove any food intolerances from the diet (I recommend using IgG finger prick testing as there are a number of studies showing benefits for IBS sufferers)
3. Take enzymes and lecithin to improve digestion of food (stomach acid may also be needed but is best taken at a later stage once any inflammation in the gut is improved).
4. Avoid any of the 'irritating' foods from the list above that you know disagree with you
5. Supplement your diet with a quality omega 3 / omega 6 supplement and multivitamin high in magnesium and calcium. A soothing herbal formula such as aloe vera, slippery elm or marshmallow root is also enormously beneficial
6. Reduce sources of harsh fibres from bran and peel vegetables and fruit before eating. Also cut down on beans and sulphur containing foods such as onions, eggs, cabbage, Brussels, broccoli and cauliflower if you know that these are issues for you.
Paula Werrett is an experienced nutritional therapist, specialising in areas such as IBS, candida and food intolerance. Visit http://www.thenutritionlink.co.uk for more information on our consultation services and wide range of food intolerance tests and other health tests|
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