Irritable Bowel Syndrome and Homeopathy

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of detectable structural abnormalities. No clear diagnostic markers exist for IBS, thus the diagnosis of the disorder is based on clinical presentation.

About 10–20% of adults and adolescents have symptoms consistent with IBS, and most studies show a female predominance. IBS symptoms tend to come and go over time and often overlap with other functional disorders such as fibromyalgia, headache, backache, and genitourinary symptoms.

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Diagnostic Criteria for Irritable Bowel Syndrome

Recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months associated with two or more of the following:

  1. Improvement with defecation
  2. Onset associated with a change in frequency of stool
  3. Onset associated with a change in form (appearance) of stool

Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.

 

Clinical Features

Symptoms range from mild to severe.

Most people have mild symptoms.

Symptoms are different from person to person.

IBS is a disorder that affects all ages, although most patients have their first symptoms before age 45.

Older individuals have a lower reporting frequency.

Abdominal Pain – Abdominal pain in IBS is highly variable in intensity and location. Pain in IBS is localized to the hypogastrium in 25%, the right side in 20%, to the left side in 20%, and the epigastrium in 10% of patients. It is frequently episodic and crampy, but it may be superimposed on a background of constant ache. Pain may be mild enough to be ignored or it may interfere with daily activities.

People with IBS may also lose their appetite.

Sleep deprivation is also unusual because abdominal pain is almost uniformly present only during waking hours.

Pain is often exacerbated by eating or emotional stress and improved by passage of flatus or stools.

Female patients with IBS commonly report worsening symptoms during the premenstrual and menstrual phases.

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Altered Bowel Habits

Alteration in bowel habits is the most consistent clinical feature in IBS. The most common pattern is constipation alternating with diarrhea, usually with one of these symptoms predominating. At first, constipation may be episodic, but eventually it becomes continuous and increasingly intractable to treatment with laxatives.

Most patients also experience a sense of incomplete evacuation, thus leading to repeated attempts at defecation in a short time span. Patients whose predominant symptom is constipation may have weeks or months of constipation interrupted with brief periods of diarrhea. In other patients, diarrhea may be the predominant symptom. Diarrhea resulting from IBS usually consists of small volumes of loose stools.

Diarrhea may be aggravated by emotional stress or eating. Stool may be accompanied by passage of large amounts of mucus

Bleeding is not a feature of IBS unless hemorrhoids are present, and malabsorption or weight loss does not occur.

Gas and Flatulence – Patients with IBS frequently complain of abdominal distention and increased belching or flatulence.

Upper Gastrointestinal Symptoms – Many patients with IBS complain of dyspepsia, heartburn, nausea, and vomiting.

 

Patient Counseling and Dietary Alterations

Reassurance and careful explanation of the functional nature of the disorder and of how to avoid obvious food precipitants are important first steps in patient counseling and dietary change. Occasionally, a meticulous dietary history may reveal substances (such as coffee, disaccharides, legumes, and cabbage) that aggravate symptoms. Excessive fructose and artificial sweeteners, such as sorbitol or mannitol, may cause diarrhea, bloating, cramping or flatulence. As a therapeutic trial, patients should be encouraged to eliminate any foodstuffs that appear to produce symptoms. However patients should avoid nutritionally depleted diets.

Stool-Bulking Agents

High-fiber diets and bulking agents, such as bran or hydrophilic colloid, are frequently used in treating IBS.

The water-holding action of fibers may contribute to increased stool bulk because of the ability of fiber to increase fecal output of bacteria.

Furthermore psyllium preparations tend to produce less bloating and distention.

Avoid large meals

Have regular meals and take time to eat at a leisurely pace.

Avoid missing meals or leaving long gaps between eating.

Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas. This helps to keep the faeces (stools) soft and easy to pass along the gut.

Restrict tea and coffee to three cups per day (as caffeine may be a factor in some people).

Restrict the amount of fizzy drinks that you have to a minimum.

Don’t drink too much alcohol. (Some people report an improvement in symptoms when they cut down from drinking a lot of alcohol, or stop smoking if they smoke.)

Limit fresh fruit to three portions (of 80 g each) per day.

If you have diarrhoea, avoid sorbitol, an artificial sweetener found in sugar-free sweets (including chewing gum) and in drinks, and in some diabetic and slimming products.

If you have a lot of wind and bloating, consider increasing your intake of oats (for example, oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon per day). You can buy linseeds from health food shops.

Individual food intolerance -some people with IBS find that one or more individual foods can trigger symptoms, or make symptoms worse (food intolerance or sensitivity). If you are not sure if a food is causing symptoms, it may be worth discussing this with a doctor who may refer you to a dietician. A dietician may be able to advise on an exclusion diet. For example, one meat, one fruit, and one vegetable. Then, advise on adding in different foods gradually to your diet to see if any cause the symptoms. It may be possible to identify one or more foods that cause symptoms. This can be a tedious process, and often no problem food is found. However, some people say that they have identified one or more foods that cause symptoms, and then can control symptoms by not eating them.

Probiotics- Probiotics are nutritional supplements that contain good bacteria. That is, bacteria that normally live in the gut and seem to be beneficial. Taking probiotics may increase the good bacteria in the gut which may help to ward off bad bacteria that may have some effect on causing IBS symptoms. You can buy probiotic capsules (various brands) from pharmacies. The dose is on the product label. You can also buy foods that contain probiotic bacteria. These include certain milk drinks, yoghurts, cheeses, frozen yoghurts, and ice creams.

Other lifestyle factors Regular exercise may also help to ease symptoms. Stress and other emotional factors may trigger symptoms in some people. So, anything that can reduce your level of stress or emotional upset may help.

 

Psychological treatments (talking treatments) –

Situations such as family problems, work stress, examinations, recurring thoughts of previous abuse, etc, may trigger symptoms of IBS in some people. People with anxious personalities may find symptoms difficult to control.

The relationship between the mind, brain, nervous impulses, and over activity of internal organs such as the gut is complex. Some people have found hypnotherapy, cognitive-behavioral therapy, relaxation techniques, stress counseling, psychotherapy and similar therapies useful in controlling symptoms of IBS. However, the evidence of benefit from research trials for some of these treatments is mixed (see the references cited at the end).

Psychological treatments are generally mainly considered in people with moderate-to-severe IBS, when other treatments have failed. Or, when it seems that stress or psychological factors are contributing to causing symptoms.

 

Homoeopathic Treatment:

Homeopathy is probably the mildest and safest form of treatment available.

A holistic or constitutional approach, in our opinion, is the only choice of treatment capable of helping this ailment truly. Thus, unlike conventional IBS treatment, homeopathic treatment is a ‘Personalized Approach’.

By  Homoeopathic Treatment initially, acute symptoms of diarrhea or constipations can be relieved immediately .

Relapses during the course of treatment are common and subside gradually.

As treatment progresses you can expect the relapses and intensity of symptoms to reduce.

Relapses due to diet and environmental factors can be better handled.

Significant improvement can be expected on completion of 4-6 months of treatment.