Good gut feeling

IBS affects a surprising amount of adults in the UK. If you’re among them, follow our plan to easing symptoms in just one month…

The symptoms of irritable bowel syndrome (IBS) are certainly distressing, but IBS is probably the most common health issue I deal with at my clinic. It can vary from mild to utterly debilitating, and symptoms can include bloating, wind, heartburn, and abdominal pain, with bowel movements that alternate from loose and watery to small and hard. It’s also associated with general symptoms like muscle and joint pain, fatigue and headaches.

If you have these symptoms occasionally, don’t assume you must have IBS – we all experience the odd bout of bloating from time to time. With IBS, however, symptoms are severe or frequent. It’s estimated that 13 per cent of women are affected, compared with five per cent of men – high levels of progesterone during menstruation are thought to contribute to spasms, as changing hormone levels vary the rate of movement of waste matter through the intestines. Although IBS has no link with more serious illnesses such as bowel cancer, you should always see your GP if you have symptoms, as, very rarely, they can be signs of something more sinister, particularly if you’re over 50. Your doctor will ask questions about your symptoms, feel your abdomen, and may take blood and stool samples.

The exact cause of IBS is unknown, but research has thrown up a few theories. One is that the nerves or muscles in the gut could be overactive, so that eating causes them to contract, leading to cramping and diarrhoea. Stress is strongly linked, with many reporting that their symptoms started after a traumatic time. Researchers at St George’s Hospital, London, have suggested a link with food intolerances, although these can be a result of IBS rather than the cause.

This year, a study at Rush University Medical Center in Chicago found IBS was significantly higher in those with allergic conditions such as eczema and asthma. Around one in six people develop IBS after a bout of gastroenteritis or food poisoning, and long-term use of steroids or antibiotics can also irritate the digestive system and upset the natural balance of bacteria. Another interesting development is research from the Mayo Clinic in the USA, which shows there may be a genetic link to IBS.

12 ways to beat IBS
Although it’s a long-term condition, IBS often responds well to lifestyle changes and natural remedies so try the following tips and you could see a change in as little as a month. What works for one person may not work for another, so persevere:

1 Keep a diary
This will help identify both triggers and factors that improve symptoms, so note down the following: food eaten; tea, coffee and other liquids drunk; exercise taken, alcohol and cigarette intake, plus any events that were stressful, upsetting, pleasurable or relaxing. Record whether you had symptoms each day. You should soon start to see patterns developing.

2 Reduce stress
This could cut the frequency of attacks rapidly. Note down any stressful experiences – are they linked to work, exams, family issues or relationship problems? Once you’ve identified them, think of how you could ease the related tension. Simple things like going for a long walk or taking your full lunch hour during the working day give your mind and body a chance to refresh.

3 Manage your personality
Some people are naturally anxious and experience a constant, low-lying level of stress. If this applies to you, adopt a long-term strategy of relaxation using meditation (see page 87), tai chi or yoga, or try something physical like kick-boxing – the aim is to expend nervous energy and reduce anxiety.

4 Try complementary therapies.
One of the most successful proven treatments is hypnotherapy. Recent research at Manchester University reported a 70 per cent success rate in 250 patients who had 12 one-hour sessions of gut-centred hypnotherapy, during which they were taught to influence and control their own gut function. Acupuncture and Traditional Chinese Medicine (TCM) can also help treat symptoms and root causes.

5 Pinpoint food triggers
For some, one or more foods trigger symptoms, especially when diarrhoea is a principal symptom. A nutritional therapist can help identify and eliminate possible trigger foods from the diet. If you want to try to establish a pattern on your own, foods thought to be most commonly associated are alcohol, caffeine, wheat, dairy, beef, pork, lamb, eggs and onions. Eliminate all of these, then reintroduce them one by one to see if you can discover a connection.

6 Control symptoms with diet
If diarrhoea is a problem, cut out alcohol, coffee, tea and the artificial sweetener sorbitol. To ease constipation, introduce more fibre-rich foods, such as vegetables (softer green vegetables like spinach, lettuce, kale and mange tout are best), bran and fruit. To ease bloating or wind, avoid foods which encourage gas, such as cabbage, beans and broccoli. Build up slowly, or your bowels might react adversely to the change.

7 Get active
Not only can exercise help ease stress and feelings of depression, it can also help improve the general motility of the gut. Try to be more active in your daily life as well. Walk and take the stairs whenever possible, and try to stick to a routine of more vigorous exercise, too.

8 Beat bloating
Oil of peppermint has been proven to reduce bloating and pain and help eliminate excess gas. Take one or two drops in a small amount of warm water three times daily.* Research has also found that activated charcoal tablets may help ease bloating and other symptoms of IBS. If you’re receiving treatment for any other condition, seek advice from your doctor first however, as charcoal can reduce the effectiveness of other medications.

9 Balance bacteria
Probiotics, or good bacteria, are thought to help inhibit the growth of the potentially harmful bacteria often present in IBS. They are also believed to improve immunity and enhance the digestive system’s natural defences. As good bacteria are easily destroyed by stress and antibiotics – both linked to IBS – it makes sense to replenish them, either with live yogurt or a supplement. Take one probiotic capsule, such as acidophilus, daily for at least a month to see a difference in your symptoms.

10 Soothe with aloe vera
Aloe vera juice helps soothe and heal an irritated digestive tract. It has natural detoxifying abilities and it can help improve bowel regularity in some people. It also helps inhibit unfriendly bacteria and yeast in the gut.

11 Adopt good eating habits
Rather than eating three main meals a day, reduce the stress on your system by eating little and often. Chew your food thoroughly and opt for lean protein such as chicken, turkey and fish, rather than fatty red meats that are harder for the body to digest.

12 Up your (good) fluid intake
Drink two litres of water daily in between meals to keep your body hydrated. Peppermint and chamomile teas can have a soothing, calming effect on the digestive tract, but avoid caffeine, alcohol, sugary carbonated drinks and milk, all of which can aggravate symptoms.

Expert: Ian Marber
Ian Marber is a nutrition consultant, health journalist and author. His latest book is The Food Doctor Ultimate Diet (Dorling Kindersley, £14.99).