Irritable bowel

Irritable bowel syndrome (IBS) is a disorder of the gastrointestinal tract characterised by recurrent symptoms such as abdominal pain, diarrhoea, constipation and flatulence. Doctors use the following three points to make a diagnosis:

1. There are chronic (lasting longer than three months) or recurrent complaints that are referred to the bowel by the patient and doctor and are usually accompanied by changes in bowel movements such as constipation or diarrhoea.
2. The discomfort is so severe and the quality of life so impaired that patients seek help because of it.
3. Other characteristically similar disorders of the gastrointestinal tract must be excluded.

The last point in this list in particular can mean a minor odyssey for patients. This is because there are some disorders that have similar symptoms to those of irritable bowel syndrome. Chronic inflammatory bowel diseases such as ulcerative colitis and Crohn's disease, for example, must be excluded. The clarification of food allergies and intolerances or a possible histamine intolerance is also part of the medical history. For this reason, examinations such as blood and stool tests, gastroscopy and colonoscopy, ultrasound and breathing tests are sometimes carried out to support the diagnosis.

Irritable bowel syndrome can be caused by different triggers and various medical-scientific theories are discussed. Since it is a functional (and not organic) disorder of the bowel, the following causes are considered:

• Impaired intestinal motility (motility disorder)
• Disturbance of the immune function in the area of the digestive system
• Bacterial infection of the gastrointestinal tract
• Genetic susceptibility to disease
• Stress and other psycho-physical factors
• Increased permeability of the intestinal mucosa (leaky gut), e.g. due to a bacterial overgrowth in the intestine

Among other things, stress can change the intestinal microbiome (intestinal flora) unfavourably and promote colonisation with pathogenic bacteria. This bacterial overgrowth can impair the barrier function of the intestinal mucosa – an important component of our immune system. In addition, irritable bowel patients often have an increased number of mast cells in their intestines, which can trigger symptoms such as abdominal pain and diarrhoea.

Characteristic of irritable bowel syndrome are chronic (longer than three months) or recurring complaints such as:

• Abdominal pain
• Diarrhoea
• Constipation
• Flatulence
• Feeling of fullness
• Heartburn, belching
• Bowel sounds
• Feeling of incomplete bowel emptying

Diarrhoea and constipation often occur in alternation, which together with abdominal pain and flatulence are among the leading symptoms of an irritable bowel. Stress further aggravates these symptoms. Especially before and during going to the toilet, there can be excruciating flatulence and cramping abdominal pain. Symptoms sometimes disappear after a bowel movement or occur more frequently when too much has been eaten.

Although symptoms can severely affect the well-being of those affected, irritable bowel syndrome is generally not dangerous. If symptoms persist and worsen, a doctor should be consulted to rule out other causes of the condition.

Conventional medical treatment is usually symptom-oriented. Thus laxatives are used for constipation and antispasmodic medicines for flatulence. Below we present some treatment options.

Nutrition

Often, a change in diet as part of a therapy already provides relief. So avoid foods that are flatulent or difficult to digest, such as fried foods, fatty foods and foods that are too sweet. Take your time with meals. Eat smaller portions throughout the day instead of three large portions. Drink still water or unsweetened tea. Make sure you eat high-quality food.

If you have constipation, you will benefit from a high-fibre diet with whole grain products, vegetables and fruit or the intake of dietary fibre, which can be found in psyllium husks, for example. For these dietary fibres to develop their full effect, the simultaneous consumption of one or two glasses of water is recommended. Dietary fibres stimulate the intestinal activity. If you have flatulence, you should instead avoid such a diet. For acute constipation, synthetic laxatives or herbal medicines containing, for example, linseed, psyllium and psyllium husks, alder bark or senna as active ingredients are suitable. Laxatives should generally only be taken occasionally and for no longer than one to two weeks.

For diarrhoea, swelling agents that can bind the water in the intestine are suitable. Psyllium seeds are also suitable here. In addition, medicinal plants such as bloodroot, lady's mantle, goose cinquefoil, dried blueberries or long black and green tea are suitable. The tannins it contains have a dehydrating effect in the intestine and are therefore constipating because they "tan" the intestinal mucosa. As a result, fewer pathogenic germs enter the intestinal mucosa and less fluid leaks into the intestinal lumen (the cavity of the intestine). In acute cases, synthetic preparations with the active ingredient loperamide are tried and tested.

For flatulence, you can try a FODMAP diet. This involves reducing foods that are high in sugar and alcohol compounds, as these are fermented by the intestinal bacteria and thus produce gases, which can lead to flatulence in particular. Peppermint and caraway oil also help here.

For acute abdominal pain, peppermint oil, berberine from barberry plants or caraway oil can be taken, as these relax the gastrointestinal muscles and thus relieve the abdominal pain.

Relaxation and balance

With the help of yoga, autogenic training, exercise and walks in nature, sauna or water treatments, you will regain your inner balance. This is because stress usually intensifies the symptoms and puts the gut and its bacteria in turmoil. Give up smoking. Alcohol should only be consumed in moderation.

Herbs and spices

Peppermint, caraway, coriander, camomile, lavender, lemon balm and butterbur are known to have a relaxing, soothing and partly anti-inflammatory effect on the stomach and intestines.

Probiotics

Probiotic bacterial products can have a positive influence on irritable bowel syndrome. Special probiotic intestinal bacteria are known to eliminate not only the symptoms but also the causes of irritable bowel syndrome. They also support the balance of the microbiome in the intestine and help strengthen the intestinal mucosa and its barrier function. In many cases, different strains of bacteria are combined for a balanced intestinal flora, which is an important part of intestinal health.