Prescriptions
Symptoms of irritable bowel syndrome can be relieved

By Laurie Steelsmith

"Everything I eat makes my stomach feel gassy, bloated and very uncomfortable!" complained Jane, my 34-year-old patient from Kailua. She was also experiencing a skin rash and joint pain. I explained to Jane that she has a condition called irritable bowel syndrome (IBS) with increased intestinal permeability, sometimes called "leaky gut syndrome." I told her that she needed to take a lab test, called a comprehensive stool culture, to analyze the flora — bacteria and yeast — living in her intestinal tract and that she would need to make significant dietary changes and begin a stress management program to alleviate her symptoms.

What is IBS? IBS has been called nervous digestion, spastic colitis and even intestinal neurosis. It can vary in degree from mild to severe. The most common causes are imbalanced intestinal flora, food allergies, the standard American diet, stress and anxiety.

The symptoms of IBS include abdominal pain, distention, gas, bloating and changes in bowel habits that can worsen with stress, prolonged antibiotic use or a dramatic change in diet. A diagnosis of IBS is made only after more serious gastrointestinal disorders and parasites have been ruled out.

Lactose intolerance, a condition wherein a person lacks the enzyme lactase necessary for digestion of milk sugar, should be ruled out first. Lactose intolerance is common among Asian, black, Mediterranean and American Indian people. The IBS-like symptoms can be eradicated simply by eliminating dairy products from the diet.

How can you relieve the symptoms of IBS?

• Identify what type of abnormal flora is growing in your gut. According to Dr. Leo Galland, author of "The Four Pillars of Healing," imbalanced flora can cause IBS and intestinal permeability, which can lead to food allergies and illness. A lab test, called a comprehensive stool culture, analyzes the specific flora — both normal and abnormal bacteria and yeast — growing in the intestines. This test is performed at specialized labs on the Mainland. Treatment involves rebalancing the intestinal flora.
• Identify and eliminate food allergies. Many studies have documented the role of food allergies in IBS. An article called "Gut Reactions" in the Nov. 17, 1997, issue of Newsweek, describes how food allergies can result from abnormal intestinal flora and "leaky gut syndrome" (intestinal permeability). This means that abnormal flora causes the intestinal wall to become more permeable to larger proteins and bacteria. The body reacts by creating antibodies, or immune cells, to the larger proteins found in the blood stream and a food allergy results. Besides aggravating IBS, food allergens can cause a myriad of symptoms including headaches, skin rashes, asthma, fatigue and joint pain.
• Avoid sugar. The standard American diet is very high in refined sugars. When blood sugar levels rise too rapidly, small intestine motility decreases significantly causing constipation. In "The Encyclopedia of Natural Medicine," naturopathic physicians Mike Murray and Joe Pizzorno state that "A diet high in refined sugar may be the most important contributing factor to IBS being such a common condition in the U.S." Sugar not only decreases intestinal motility, it can also feed bacteria and yeast in the large intestine, contributing to abnormal flora. This overgrowth of abnormal flora leads to gas, bloating and the discomfort associated with IBS.
• Add fiber to your diet. Galland recommends a combination of soluble and insoluble fibers found in a diet high in fruits, vegetables and whole grains. He also recommends the addition of friendly bacteria, called Lactobacillus acidophilus, found in yogurt, sauerkraut or as a supplement in the refrigerated section of the health food store. Friendly bacteria help to prevent intestinal infection from bacteria, viruses and yeasts.
• Manage your stress. Stress management is important to a healthy body and particularly important in relieving the symptoms of IBS. Don't forget, the condition has also been called intestinal neurosis. Give your intestines a chance to do their job: Take time to eat your food and relax afterward.

Jane is no longer plagued with gas, bloating or joint pains and her rash is gone. She has rebalanced her gut flora and made significant changes in her lifestyle. Jane is eating a new standard healthy diet and better managing her stress. She said at her last visit, "If I had known that I wouldn't have to live with this condition, I would have made these changes a lot sooner!"

Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu.

Hawai'i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send your questions to: Prescriptions, 'Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.