IBS or Irritable Bowel Syndrome, is the chronic condition of the GI tract, with abdominal pain and altered bowel habits with unidentifiable cause.
It is second to common cold to cause absence from work.
10-20% of general public get it.
15% of people with IBS seek help.
Causes of IBS:
1-Abnormal colonic contractions, some doctors prescribe anti-spasmodic drugs or fiber due to this theory.
2-Following severe GI infections, i.e. Salmonella or Campylobacter
3-Anxiety & stress, and a history of physical, verbal or sexual abuse
4-Food intolerance, allergies i.e. dairy, lactose containing food, legumes, cruciferous vegetables, like broccoli, cauliflower, brussels sprouts & cabbage, some medications
5-Intestinal nervous over-sensitivity (visceral hyperalgesia). This group of patients respond well to low doses of drugs like imipramine or nortriptyline that decrease the sensations coming from the intestines.
IBS usually begins in young adulthood. Women are twice likely to get it.
Abdominal pain with altered bowel habits are IBS's hallmark.
IBS Symptoms:
1-Abdominal pain (cramps mostly in lower left abdomen)
2-Altered bowel habits (diarrhea, constipation, or alternating diarrhea constipation)
3-Diarrhea (frequent loose stools of small to moderate volume, mostly in am or during day with urgency following by
feeling of incomplete evacuation, some with mucous discharge, diarrhea during sleep is uncommon with IBS)
4-Constipation (Lasting from days to months, stools are hard and pellet-shaped ,some have incomplete evacuation sensation)
5-Other GI symptoms (Bloating, gas, belching, heartburn, reflux, difficulty swallowing, early feeling of fullness with eating, nausea)
6-Outside GI symptoms (frequent and urgent urination, painful menstruation, sexual problems)
Diagnosis of IBS:
Several other bowel related diseases like CD, UC, malabsorption, microscopic eosinophilic colitis, have similar symptoms.
Diagnosis steps:
1-Medical history
2-Physical examination
3-Tests (to rule out other diseases)
Treatment of IBS:
1-Reduce pain
2-Control bowel movement
3-Monitoring
4-Dietary modification (avoid legumes, beans, cabbage, brussels sprout, cauliflower, broccoli, onions, celery, carrots, raisins, bananas, apricot, prunes, sprouts, wheat)
5-Increase dietary fiber
How can Acupuncture and Chinese Herbal Medicine help IBS?
The root cause of IBS according to TCM, is Spleen Qi deficiency and Liver disharmony with Spleen or Stomach. Another major reason would be the anxiety which mainly affects Spleen.
Acupuncture and Chinese herbal medicine can improve the Spleen function and regulate the Liver function.
In addition probiotics and some minerals can be prescribed to replenish the intestinal flora, and help resolve IBS faster.
Research on IBS & Chinese Herbs:
An Australian study published in 1998 in the Journal of the American Medical Association lends strong scientific support to treating IBS with Chinese herbs. In this double-blind study, 116 patients with Irritable Bowel Syndrome were divided into three groups. One group was given a standard Chinese herbal preparation, a second group was given customized herbal formulas (individually written for each patient), and a third group was given a placebo. Each patient had regular consultations with both a Chinese herbal-medicine practitioner and a gastroenterologist. Both groups taking the Chinese herbs showed significant improvement over the patients taking the placebo. Positive results were reported by both the patients themselves and the gastroenterologists. Although there was improvement in both groups of patients taking herbs, it is important to note that the positive effects were shown to last longer in the group that was given individualized formulas. Only these patients had maintained improvement on a follow-up consultation 14 weeks after completing the treatment.
This study clearly shows that Chinese herbalism is most effective when each patient is treated not only for their condition, but also for their bodily constitution and other presenting symptoms. According to the principles of Chinese medicine, each patient must be treated as an individual. Optimal results will be obtained with both herbs and acupuncture when specific treatments are customized for each patient.
[Journal of the American Medical Association 1998; 280(18): 1585-1589.]