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Irritable Bowel Syndrome (IBS) & Homeopathy

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

As many as 20 percent of the adult population, or one in five Americans, have symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people.

Symptoms of IBS

Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements. Often these people report straining and cramping when trying to have a bowel movement but cannot eliminate any stool, or they are able to eliminate only a small amount. If they are able to have a bowel movement, there may be mucus in it, which is a fluid that moistens and protect passages in the digestive system. Some people with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time.

  • Pain and discomfort may occur in different parts of the abdomen. Pain usually 'comes and goes'. The length of each bout of pain can vary greatly. The pain often eases when you pass stools (motions or faeces) or wind. Many people with IBS describe the pain as a 'spasm' or 'colic'. The severity of the pain can vary from mild to severe, both from person to person, and from time to time in the same person.

  • Bloating and swelling of your abdomen may develop from time to time. You may pass more wind than usual.

  • Stools (sometimes called motions or faeces)

    • Some people have bouts of diarrhoea, and some have bouts of constipation.

    • Some people have bouts of diarrhoea that alternate with bouts of constipation.

    • Sometimes the stools become small and pellet like. Sometimes the stools become watery or ribbony. At times, mucus may be mixed with the stools.

    • You may have a feeling of not emptying your rectum after going to the toilet.

    • Some people have urgency, which means you have to get to the toilet quickly. A 'morning rush' is common. That is, you feel an urgent need to go to the toilet several times shortly after getting up. This is often during and after breakfast.

The following have been associated with a worsening of IBS symptoms

  • large meals

  • bloating from gas in the colon

  • medicines

  • wheat, rye, barley, chocolate, milk products, or alcohol

  • drinks with caffeine, such as coffee, tea, or colas

  • stress, conflict, or emotional upsets

Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems.

In addition, people with IBS frequently suffer from depression and anxiety, which can worsen symptoms. Similarly, the symptoms associated with IBS can cause a person to feel depressed and anxious.

Causes of IBS:

Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved.

·Normal motility, or movement, may not be present in the colon of a person who has IBS. It can be spasmodic or can even stop working temporarily. Spasms are sudden strong muscle contractions that come and go.

·     The lining of the colon called the epithelium, which is affected by the immune and nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the epithelium appears to work properly. However, when the contents inside the colon move too quickly, the colon loses its ability to absorb fluids. The result is too much fluid in the stool. In other people, the movement inside the colon is too slow, which causes extra fluid to be absorbed. As a result, a person develops constipation.

·A person’s colon may respond strongly to stimuli such as certain foods or stress that would not bother most people.

·Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, they experience problems with bowel movement, motility, and sensation—having more sensitive pain receptors in their GI tract.

·Researchers have reported that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS.

Diagnosis of IBS

IBS is generally diagnosed on the basis of a complete medical history that includes a careful description of symptoms and a physical examination.

There is no specific test for IBS, although diagnostic tests may be performed to rule out other problems. These tests may include stool sample testing, blood tests, and x rays. Typically, a doctor will perform a sigmoidoscopy, or colonoscopy, which allows the doctor to look inside the colon. This is done by inserting a small, flexible tube with a camera on the end of it through the anus. The camera then transfers the images of your colon onto a large screen for the doctor to see better.

If your test results are negative, the doctor may diagnose IBS based on your symptoms, including how often you have had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. Many doctors refer to a list of specific symptoms that must be present to make a diagnosis of IBS.

Treatment for IBS

Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many options are available to treat the symptoms. Your doctor will give you the best treatments for your particular symptoms and encourage you to manage stress and make changes to your diet.

Medications are an important part of relieving symptoms. Your doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea, such as Lomotil or loperamide (Imodium). An antispasmodic is commonly prescribed, which helps to control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some symptoms. However, both antispasmodics and antidepressants can worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as Donnapine and Librax. These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician.

With any medication, even over-the-counter medications such as laxatives and fiber supplements, it is important to follow your doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit forming if they are used too frequently.

Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. You will need to work with your doctor to find the best combination of medicine, diet, counseling, and support to control your symptoms.

Does stress affect IBS?

Stress—feeling mentally or emotionally tense, troubled, angry, or overwhelmed—can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.

Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS. Stress management options include

  • stress reduction (relaxation) training and relaxation therapies such as meditation

  • counseling and support

  • regular exercise such as walking or yoga

  • changes to the stressful situations in your life

  • adequate sleep

Can changes in diet help IBS?

For many people, careful eating reduces IBS symptoms. Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your doctor. You may want to consult a registered dietitian who can help you make changes to your diet. For instance, if dairy products cause your symptoms to flare up, you can try eating less of those foods. You might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If you need to avoid dairy products, be sure to get adequate nutrients in the foods you substitute, or take supplements.

In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High-fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. Increasing fiber intake by 2 to 3 grams per day will help reduce the risk of increased gas and bloating.

Drinking six to eight glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals (unless you have celiac disease), fruits, and vegetables may help.

Points to Remember

·         IBS is a disorder that interferes with the normal functions of the colon. The symptoms are crampy abdominal pain, bloating, constipation, and diarrhea.

·         IBS is a common disorder found more often in women than men.

·         People with IBS have colons that are more sensitive and reactive to things that might not bother other people, such as stress, large meals, gas, medicines, certain foods, caffeine, or alcohol.

·         IBS is diagnosed by its signs and symptoms and by the absence of other diseases.

·         Most people can control their symptoms by taking medicines such as laxatives, antidiarrhea medicines, antispasmodics, or antidepressants; reducing stress; and changing their diet.

·         IBS does not harm the intestines and does not lead to cancer. It is not related to Crohn’s disease or ulcerative colitis.

Living with IBS or Living on the Edge

Fortunately the majority of people with Irritable Bowel Syndrome have predominantly mild symptoms with exacerbations, which last a while then settle back to the usual level. There are, however, people who, as a result of their Irritable Bowel Syndrome, live a very restricted life. Things that others do as a regular routine during their day, cause anxiety, and for the Irritable Bowel Syndrome sufferer to do them calls for significant planning.

For an IBS sufferers shopping can be a big problem especially if it is too far from the nearest toilet. If there is a pub nearby, Irritable Bowel Syndrome patients most likely will shop when the pub is open because they know where the nearest toilet is. Simple things such as a car or bus journeys, walks in the park, going out with friends, pose a problem for a person with IBS. It may restrict the IBS patient to a limited choice of jobs. It can also cause insecurity as Irritable Bowel Syndrome sufferers are absent from work very often when their symptoms are really bad. There is always the risk of faecal incontinence with Irritable Bowel Syndrome.

Bloating and abdominal pains also cause problems for Irritable Bowel Syndrome Sufferers. They may suddenly have to stop what they are doing because of the sudden pain. Bloatedness makes sufferers very conscious that people are looking at them. If wind and rumbling tummy from their Irritable Bowel Syndrome is a problem, the IBS patients will avoid meeting people in enclosed areas, and often opt for wide-open spaces.

Irritable Bowel Syndrome, however, creates a big problem in the minds of  patients. Symptoms of Irritable Bowel Syndrome are worrying, yet there is no cause, no treatment that works for everyone, and no cure, and in only a few cases it goes away on its own. If the patients are lucky they will find a caring and understanding GP but as a rule most Doctors see Irritable Bowel Syndrome as a disease that will not cause any long-term harm. They also feel that if Irritable Bowel Syndrome patients have stress and they have a flare up, then it is the stress that is the problem and that the patients should learn to control their stress. Often with patients, it is the symptoms of Irritable Bowel Syndromethat cause the stress.

Doctors are likely to say to a patient, "Sort your stress out and your Irritable Bowel Syndrome will improve".

In addition, friends and family do not really understand Irritable Bowel Syndrome and what the IBS patients are really going through. Often they feel that sufferers  bring on their problem themselves, and that they should do something about it. Irritable Bowel Syndrome sufferers need good support and understanding.

It is not surprising that Irritable Bowel Syndrome patients develop psychological problems as their Illness continues relentlessly.
 The best thing that can happen to an Irritable Bowel Syndrome patient is to stumble on to someone who understands IBS or better still have a special interest. This is why IBS support group are so popular. Individuals know they are in contact with others who have experienced the same or similar problems with their IBS. Irritable Bowel Syndrome sufferers find great comfort in IBS Self Help Groups. In USA, a survey in 1989 found 6.25 million people in Self Help Groups.

However, because of the way Irritable Bowel Syndrome presents itself and is perceived, patients can develop associated problems. For example, if a patient with diarrhoea predominant Irritable Bowel Syndrome is in the town centre, she knows where her old faithful toilet is. Suppose that on that day, the toilet is closed because of flooding caused by vandals. When she arrives at the public convenience and finds out what has happened, what do you think will happen? She will start to become panicky. Her first thought will be about her Irritable Bowel Syndrome. Her biggest fear is that she could soil herself. Her heart will speed up, her breathing will become short and rapid, beads of perspiration will start running down her body, and she will feel sick and faint. She knows there is a real chance that because of her Irritable Bowel Syndrome, she can become incontinent. To her this is perhaps one of the most frightening and embarrassing thing she will ever experience. She will feel helpless. She will rush for the nearest taxi to get home.

This experience will have a psychological effect on her. She could become apprehensive about going back into the town centre. She may even avoid going again. The biggest worry for Irritable Bowel Syndrome patients is faecal incontinence because of the enormous embarrassment. It is socially unacceptable. Patients with Irritable Bowel Syndrome can go to extreme lengths to guard against accidents. They may wear special padded underwear in case of an accident. Irritable Bowel Syndrome can leave a sufferer housebound. Isolation is not an uncommon outcome in IBS.

When Irritable Bowel Syndrome becomes refractory or persistent, patients often develop anxiety and depression. They develop fatigue and tiredness, and disturbed sleep. Most severely affected sufferers do not see a time when their Irritable Bowel Syndrome will be better. The picture in the mind of such a  sufferer is very bleak. This resignation often leads to isolation. On the rare occasionsuicidal ideation can develop in severe or refractory Irritable Bowel Syndrome.

Most patients have mild Irritable Bowel Syndrome. However, when Irritable Bowel Syndrome becomes severe, the burden is great. If a patient has severe diarrhoea predominant Irritable Bowel Syndrome, there is a real risk of faecal incontinence. Up to 16% of Irritable Bowel Syndrome patients have at least one bout of incontinence. 42% of Irritable Bowel Syndrome patients wait ten years before seeing a Doctor. They attend mainly because they worry about serious underlying conditions. It is second to the common cold as the commonest cause of absenteeism from work. Productivity is lower in Irritable Bowel Syndrome group. There is a risk of unemployment.

The burden of Irritable Bowel Syndrome on the Health Service and Health Professional is also great. In UK, 1.1 million Irritable Bowel Syndrome patients see a Gastro-enterologist annually at a cost of £45 Million.

In USA direct cost i.e. physician’s visits, hospital care, tests etc. is $10 billion annually. Indirect cost (Lost Productivity) is $20 billion.

Although IBS is nowhere near as severe as Crohn’s or colitis, it still has the power to completely disrupt and take away your quality of life. Depending on the severity of your IBS, you may:

  1. not be able to sleep well at night
  2. deal with constant pain throughout the day
  3. be unable to engage in social activities due to diarrhea or flatulence (gas)
  4. have ‘brain fog’, poor memory, plugged ear, floaters in your eyes
  5. have trouble eating due to pain and bloating
  6. suffer from mouth ulcers, anal fissures, constipation, spasms, cramping, hemorrhoids, etc.

IBS and Homeopathy

Irritable Bowel Syndrome (IBS) can have significant impact on individual's social, personal, and professional life. Homeopathy offers proven treatment for the IBS which treats the Mind and Body connections.  

IBS calls for the treatment which should address the emotional stress, the stress coping system and the intestinal hypersensitivity. This is what homeopathy attempts to do exactly. Scientific and documented study shows that the homeopathic treatment helps achieve:

1)    Soothing of mind

2)    Slowing down of negative emotions such as anxiety, sadness, frustration, hyperactivity, anger, restlessness, etc.

3)    Helping body's stress coping system

4)    Alleviating the abnormal hypersensitivity of the bowels

5)    Relieving the symptoms of bowel hypermotility

6)    Enhancing level of joyous state of mind

7)    Individualistic approach whereby every patient is treated based on one's case

IBS is a spectrum disorder, which means that there can be a great variety of symptoms and also that their intensity can range from very mild to severe. Primarily, homeopathy is a method where the individual symptoms of patients are given more preference than the labels of the disease and are matched with those of the drug. Thus targeting diseases like IBS with homeopathy becomes much more easy and flexible approach. Disorders like IBS are much effectively treated by it. Although it may take a while before appreciable results are achieved., One must keep in mind that the goal is not to have a temporary relief, but a permanent one.

Homeopathic Drugs used for IBS

Argentum nitricum: Digestive upsets accompanied by nervousness and anxiety suggest the use of this remedy. Bloating, rumbling flatulence, nausea, and greenish diarrhea can be sudden and intense. Diarrhea may come on immediately after drinking water. Eating too much sweet or salty food (which the person often craves) may also lead to problems. A person who needs this remedy tends to be expressive, impulsive, and claustrophobic, and may have blood sugar problems.

Asafoetida: A feeling of constriction all along the digestive tract (especially if muscular contractions in the intestines and esophagus seem to be moving in the wrong direction) strongly indicates this remedy. The person may have a feeling that a bubble is stuck in the throat, or that a lump is moving up from the stomach. The abdomen feels inflated, but the person finds it hard to pass gas in either direction to get relief. Constipation brings on griping pains. Diarrhea can be explosive, and the person may even regurgitate food in small amounts.The person may exhibit a strong emotional or “hysterical” element when this remedy is needed.

Colocynthis: This remedy is indicated when cutting pains and cramping occur, making the person bend double or need to lie down and press on the abdomen. Cramps may be felt in the area of the pubic bone. Pain is likely to be worse just before the diarrhea passes, and after eating fruit or drinking water. Problems tend to be aggravated by emotions, especially if indignation or anger has been felt but not expressed. Back pain, leg pain, and gall bladder problems are sometimes seen when this remedy is needed.

Lilium tigrinum: When this remedy is indicated, the person may make frequent unsuccessful efforts to move the bowels all day and have sudden diarrhea the following morning. A feeling of a lump in the rectum, worse when standing up, is common. Hemorrhoids may develop. Constricting feelings are often felt in the chest. The person is likely to be worse from excitement and strong emotions, and may tend toward irritability or even rage.

Lycopodium: This remedy is often indicated for people with chronic digestive discomforts and bowel problems. Bloating and a feeling of fullness come on early in a meal or shortly after, and a large amount of gas is usually produced. Heartburn and stomach pain are common, and the person may feel better from rubbing the abdomen. Things are typically worse between four and eight p.m. Despite so many digestive troubles, the person can have a ravenous appetite, and may even get up in the middle of the night to eat. Problems with self-confidence, a worried facial expression, a craving for sweets, and a preference for warm drinks are other indications for Lycopodium.

Natrum carbonicum: This remedy is often indicated for mild people who have trouble digesting and assimilating many foods and have to stay on restricted diets. Indigestion, heartburn, and even ulcers may occur if offending foods are eaten. The person often is intolerant of milk, and drinking it or eating dairy products can lead to gas and sputtery diarrhea with an empty feeling in the stomach. The person may have cravings for potatoes and for sweets (and sometimes also milk, but has learned to avoid it). A person who needs this remedy usually makes an effort to be cheerful and considerate, but, when feeling weak and sensitive wants to be alone to rest.

Nux vomica: Abdominal pains and bowel problems accompanied by tension, constricting sensations, chilliness, and irritability can indicate a need for this remedy. Soreness in the muscles of the abdominal wall, as well as painful gas and cramps are common. Firm pressure on the abdomen brings some relief. When constipated, the person has an urge to move the bowels, but only small amounts come out. The person may experience a constant feeling of uneasiness in the rectum. After diarrhea has passed, the pain may be eased for a little while. A person who needs this remedy often craves strong spicy foods, alcohol, tobacco, coffee, and other stimulants—and usually feels worse from having them.

Podophyllum: This remedy is indicated when abdominal pain and cramping with a gurgling, sinking, empty feeling are followed by watery, offensive-smelling diarrhea—alternating with constipation, or pasty yellow bowel movements containing mucus. Things tend to be worse in the very early morning, and the person may feel weak and faint or have a headache afterward. Rubbing the abdomen (especially on the right) may help relieve discomfort. A person who needs this remedy may also experience stiffness in the joints and muscles.

Sulphur: This remedy is often indicated when a sudden urge toward diarrhea wakes the person early in the morning (typically five a.m.) and makes them hurry to the bathroom. Diarrhea can come on several times a day. The person may, at other times, be constipated and have gas with an offensive and pervasive smell. Oozing around the rectum, as well as itching, burning, and red irritation may also be experienced. A person who needs this remedy may tend to have poor posture and back pain, and feel worse from standing up too long.