Imagine sitting down to a romantic dinner when your stomach suddenly starts to churn. Or picture being stuck in a business meeting when all you can think about is the next bathroom break. Welcome to life with irritable bowel syndrome, or IBS.
IBS affects about 35 million Americans and ranks only second to the common cold for lost productivity at work. Marked by gas, bloating, abdominal pain, mucus in the stool, and bouts of chronic diarrhea and/or constipation, these symptoms can strike without warning. The problem is, diagnosing IBS is highly subjective. There’s no definitive clinical test that can pinpoint the condition so most doctors make a diagnosis based on symptoms and by ruling out other gastrointestinal issues. Unfortunately, some doctors still dismiss a diagnosis entirely, insisting that it’s “all in your head.” If that’s been your experience, get a second opinion from a holistic or integrative health care practitioner versed in digestive conditions.
Spotting the Triggers
While the underlying causes of IBS may seem like a mystery, the most likely culprits are stress and food sensitivities or intolerances. Often called the “second brain,” the gut is home to the enteric nervous system that includes nerves that line the esophagus, stomach, small intestine, and colon. Even though scientists haven’t been able to pinpoint exactly how emotions affect the gut, experience and observational studies show that stress and feelings play a key role in triggering symptoms. In one recent study of 256 people with IBS, researchers from the University of California, Los Angeles, found that patients with a lower resistance to stress had more intense IBS symptoms. They also experienced a lower quality of life than the healthy participants. Plus, they had significantly higher cortisol levels in response to stress. Cortisol is the primary stress hormone produced by the adrenal glands.
People with IBS can also be highly sensitive or intolerant to the foods they eat—especially if they suffer from IBS with diarrhea. According to The IBS Network, food intolerance occurs when your gut is abnormally sensitive and reacts to certain foods that trigger spasms and distend it with gas or fluid. And this reaction can happen within mere minutes of consuming an offending food, finding you frantically searching for the nearest bathroom. Common triggers include grains (not just wheat), sugar, dairy, eggs, and soy—but any food can cause a reaction since everyone is unique in their ability to digest various foods. A little detective work in the form of a food journal can often pinpoint specific reactive foods.
Even though there’s nothing structurally wrong with your gut if you suffer from IBS, it’s a condition that can undermine your quality of life. Fortunately, scientists are getting closer to uncovering at least one of the root causes of this painful, inconvenient, and potentially embarrassing syndrome. New evidence reported in the journal Advances in Medical Science points to a previous gastrointestinal infection like food poisoning or traveler’s diarrhea (e.g. Montezuma’s Revenge) that leaves your immune system on high alert. Other studies also show that chronic stress triggers the pro-inflammatory properties of interlukin-6. Combined, these findings suggest that the hypersensitivity to life’s little stressors and the intolerance to certain foods may actually be secondary to and simply a contributing factor for the activation of immune cells and the ongoing low-grade inflammation that can linger long after a gastrointestinal infection has seemingly passed.
Watching what you eat and adopting stress management techniques like meditation and yoga can help lessen the symptoms of IBS. But the following nutrients have proven useful for managing the physical reactions within the gut that can leave your digestive tract in distress.
Peppermint has a long history as an herbal tummy tamer—with good reason. Peppermint oil contains menthol, which studies show has an antispasmodic effect. Science suggests that this fragrant herb works by blocking the flow of calcium into muscle cells in the intestines, which in turn reduces muscle contractions. It also helps to relieve gas. A few years ago, 110 people with IBS were given either a peppermint oil supplement before each meal or a placebo. Among the peppermint group, 79 percent had less severe abdominal pain compared to just 43 percent of those taking the dummy pill. Plus, 83 percent of those taking the herbal formulation had less frequent bouts of diarrhea and 79 percent experienced less gas. Another clinical trial of 57 IBS patients discovered that a daily dose of supplemental peppermint oil led to a 50 percent reduction in all symptoms, including diarrhea and/or constipation, gas, mucus in the stool, and urgency.
Boswellia is another botanical often recommended for IBS symptoms. A powerful anti-inflammatory, boswellia contains a key compound known as acetyl-11-keto-beta-boswellic acid (AKBA) that inhibits 5-lipoxygenase (5-LOX). 5-LOX is a key inflammatory pathway that increases leukotrienes. This, in turn, triggers chronic gut inflammation. Halting 5-LOX activity results in less inflammation, which leads to less abdominal discomfort. But new evidence suggests that boswellia may provide additional relief to IBS sufferers. Italian researchers from the University of Chieti-Pescara divided 71 IBS patients into three groups. One received a popular antispasmodic drug called hyoscine butylbromide, another group received a combination of the muscle relaxant papaverine hydrochloride and belladonna. The third group was given a boswellia supplement. All three treatments effectively reduced abdominal pain, bowel activity, and cramping. But only those in the boswellia group got relief without side effects. Just be aware that not all boswellia supplements are equally effective. Look for a supplement standardized to contain at least 10 percent AKBA.
Living with IBS is no picnic. But you can significantly reduce symptoms and enhance your quality of life by managing stress, avoiding food triggers, and adding peppermint extract and boswellia to your treatment plan.
You might have IBS if . . .
- You have abdominal pain or cramping
- You feel bloated
- You are gassy
- You experience diarrhea or constipation—or sometimes alternating bouts of both
- You have mucus in your stool
If these symptoms sound all too familiar, see your health care provider for an accurate diagnosis. Since IBS isn’t caused by an anatomical problem, diagnosis is a highly subjective exercise. Most physicians use the ROME IV criteria when evaluating symptoms. Specifically, these criteria state that IBS is a disorder of the gut-brain interaction classified by GI symptoms that occur at least once per week and include “motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system processing.” Armed with a diagnosis and a holistic strategy that addresses your individual symptoms, you can start taking your life back from IBS naturally.