Don’t be ruled by your IBS!
As many as 1 in 5 Australians will at one stage in their life suffer from IBS and did you know it is more prevalent in women?
IBS used to be a poorly understood gastrointestinal disorder until a few years back when it was found to be a microbiome-gut-brain axis disorder. This multifactorial disorder can involve gut integrity, changes to motility, post-infections reactivity, stress and anxiety, dysbiosis, SIBO (small intestinal bacterial overgrowth), dyspepsia, food sensitivity and inflammation and immune activation.
There can be many symptoms from abdominal pain, bloating, flatulence, urgency and changed bowel habits. You can have IBC-C (constipation), IBS-D (diarrhoea) and IBS-M (both constipation and diarrhoea).
What are some key drivers of IBS?
Stress – have you ever felt ‘butterflies in your stomach’ or felt nervous before speaking in public or worried there are no toilets close by and that it has sent you for a trip to the loo? That is due to your mind-gut connection or gut-brain axis. This bidirectional link is between your central nervous system (CNS), your enteric nervous system (ENS), hypothalamo-pituitary-adrenal (HPA) axis and let’s not forget your gut microbiome. Your gut microbiome sends signals through your vagus nerve (the longest nerve in the body connecting your brain to your gut) to your brain and vice versa. It has been shown that individuals with higher stress are more likely to experience IBS from a dysregulated gut-brain axis.
Gut bacteria disruption – dysbiosis (an imbalance in the types and levels of gut bacteria) as well as small intestinal bacteria overgrowth (SIBO) are very in IBS patients. Alteration in your microbiome can be caused by environmental factors like poor diet, toxins, medications and pathogens. These can lead to systemic inflammation, immune activation, altering the intestinal barrier function, changing your gut bacteria and impacting your gut-brain axis. These bad bugs can over-ferment fibre resulting in pain and excessive gas, as there is a reduction of bacteria that ferments fibre and short-chain fatty acids (SCFAs).
Gut Inflammation – inflammation of the gut barrier can increase intestinal permeability (leaky gut) and lead to immune activation. This increases our pro-inflammatory cytokines and mast cells that sit close to your ENS to cause visceral pain sensitivity (abdominal pain) and altered gut motility.
Post-Infection –a previous gastric infection can increase the risk IBS. Infections such as Salmonella may increase intestinal inflammation, leading to an increase in leaky gut and changing the gut bacteria.
Intolerance to FODMAP’s – FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are types of fibre that gut bacteria ferment naturally and help to support a healthy gut environment by feeding beneficial bacteria. What happens to people with IBS is the overgrowth of bad bacteria over-ferment the FODMAP containing foods leading to pain and flatulence. Limiting high FODMAP foods, doing the re-introduction stage and identifying your food triggers with the support of a naturopath or nutritionist can help alleviate IBS symptoms. This does not work for all IBS patients and is only a short-term strategy while your practitioner works with you to holistically tret the underlying causes of your IBS.
What actions can you take to help your IBS symptoms?
Reduce stress - by trying to identify triggers and make sure you are getting quality sleep. Keep a journal to note how your feelings may trigger you to run to the toilet or give you that butterfly feeling. Look at toning your vagus nerve, some strategies include - having cold showers, humming or chanting, gargling, yoga, and meditation.
Low FODMAP diet – work with a health care practitioner to see if a low FODMAP diet will help you and your IBS symptoms.
Reduce Inflammation – Through diet and lifestyle, herbs and nutrients. Many practitioners use herbs like turmeric and Boswellia for gut pain and spasms. Some other favourites are glutamine, zinc, vitamin D, vitamin A and omega 3’s.
Is dysbiosis (overgrowth of bad bugs) an issue for you? – your practitioner can do a comprehensive microbiome stool analysis to see if you have opportunistic bacteria or parasites that could be making your symptoms worse.
Repopulate your gut with good bacteria and then feed them – By introducing specific strain probiotics that are targeted for you and your symptoms your practitioner can help your IBS symptoms. These probiotics can improve your immune system, reduce gut inflammation and pain and restore balance by crowding out dysbiosis in your gut.
You then need to feed your gut bugs and microbiome with fibre-rich foods as well as fermented foods and prebiotics like oats, kiwifruit, green banana flour, lentils, kimchi and cooked and cooled potatoes. Your practitioner will work with you to introduce these foods when your gut is ready!
By working with a natural healthcare practitioner, you can start to take action, so you don’t feel trapped by your IBS!
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