Natural Remedies for Irritable Bowel Syndrome

Have you ever heard of Irritable bowel syndrome? For those who don't know, Irritable Bowel Syndrome, or IBS, is a widespread chronic disorder of the gastrointestinal tract.

The symptoms may vary, but most are uncomfortable, and may feel embarrassing in your daily activities. They include cramping, bloating, gas, diarrhea, constipation, abdominal pain, flatulence, etc.

This condition affects up to 18% of people worldwide and is often lifelong. The good news is that most of the symptoms are manageable.

What are the symptoms of IBS?

Symptoms of IBS vary between patients; most symptoms are present for a long time. They include:

• Gas and bloating: one of the most persistent symptoms of IBS. This is when you feel your stomach swollen and full.
• Pain and cramps: when having IBS, the signals from the brain and gut that work together and control digestion get distorted. This can lead to painful muscle tension and cramping, mainly in the lower abdomen. The pain usually subsides after a bowel movement.
• Constipation: affects about 35% of patients with IBS. Having less than three stools a week means you have constipation. When the gut-brain signals don't work correctly, stool-passing time changes. As a result, the bowel absorbs more water from stool, making it more difficult to pass. When you have constipation in IBS, you may feel incomplete bowel movement, and the pain you experience often goes away as you empty your bowels. 
  

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• Diarrhea: it affects one in three patients with IBS. The urge to empty the bowel can be sudden, and stool is watery and loose and may contain mucus.
• Bowel movement changes: slow-moving stool becomes complicated to pass, which can lead to constipation. A fast-moving stool can result in diarrhea. Sometimes patients may find mucus or blood in their stool. If blood is in your stool, talk to your doctor, as it may indicate potentially serious illness.
• Mixed diarrhea and constipation: affects ¼ of people with IBS. This type of IBS is more severe because of frequent and intense symptoms.
• Fatigue, anxiety, depression, sleeping disorders: more than 50% of patients with IBS suffer from at least one mental condition. IBS can have a continuous cycle of symptoms that affect everyday activities, making it hard to stay positive or have regular social contact, causing round-the-clock stress.

What are IBS risk factors?

The cause of IBS is yet unknown. However, risk factors include:

• Family history of IBS: it may be related to genetics or the same environmental factors
• Age: it can affect people of all ages, but people under 40 are at a greater risk of developing the disorder
• Stress: increased cortisol levels are connected to GI tract problems, including IBS.
• Gender: IBS is more common among women than men, and women experience worse symptoms.
• Alcohol consumption: studies show that people who drink alcohol regularly are more likely to get IBS. Some patients with IBS may have an occasional drink because each person's sensitivity to alcohol varies. So, remember to drink in moderation; a maximum of one drink daily for women and two for men. If you are unsure if alcohol triggers your IBS, cut it out completely, and after reintroducing it, you can see if it worsens your IBS symptoms.
• Stomach infection: disbalance in the gut bacteria may cause infections and increase the risk of developing IBS. Research shows that the number and type of viruses, bacteria, and fungi differ in patients with IBS.

What should you avoid?

IBS symptoms may worsen when eating particular food or drinks or in stressful periods.

Patients with IBS often state that their experienced symptoms get worse during a period of increased stress.

On the other hand, it is significantly helpful to know the food that triggers your symptoms and try to avoid it as much as possible.

Food that may trigger IBS include:

• chocolate,
• spices,
• dairy,
• alcohol,
• carbonated drinks,
• beans,
• cabbage,
• cauliflower,
• broccoli,
• fat,
• fruit high in fructose, like apples and pears.

How to diagnose IBS?

Since the exact cause of IBS is unknown, there is no test to diagnose it definitively. When other conditions are ruled out, IBS is diagnosed through recurring symptoms.

The diagnostic criteria for IBS are called the Rome criteria. They include discomfort and pain at least one day a week for three months, accompanied by at least one of the other symptoms (constipation, diarrhea, discomfort related to stool discharge, etc.). IBS can be divided into four types based on the symptoms: unclassified, diarrhea-predominant, constipation-predominant, and mixed.

Some patients may get better by changing their lifestyle habits. Yet, some severe cases may need medication.

Common medications used to treat IBS symptoms are:

• Psyllium: it is a ground plantain seed. When mixed with fluid, psyllium increases its mass up to ten times, so the bowel empties quickly. It is essential to have enough fluid intake when taking fiber supplements, at least 8-10 glasses daily.
• Laxatives: are often taken when fiber doesn't work. There are four types of laxatives: stimulant, bulk-forming, osmotic, and stool-softener. Laxatives can cause dehydration, so drinking plenty of fluid when taking them is essential. It is also advisable not to take them for an extended period because they can make the bowels lazy and constipation worse. Other side effects include diarrhea, headache, dehydration, essential vitamins and minerals imbalance, bloating, etc.
• Anticholinergics: are used to relieve bowel spasms. They are mainly prescribed for diarrhea. Side effects include decreased sweating, dry mouth, retaining urine, confusion, memory loss, etc. 
• Anti-diarrheal medications: such as loperamide, can be bought over the counter. Please do not use it for more than 48 hours without talking to your doctor. Common side effects are constipation, headache, dizziness, flatulence, etc. Another commonly prescribed medication is a bile acid binder like cholestyramine. They prevent bile absorption from the small intestine. Side effects include bloating, constipation, and nausea, which can mostly be prevented when taking enough fluid.
• Antidepressants: Some antidepressants inhibit the activities of neurons that control the intestines. That way, they might reduce pain.
• Other medications, which require a prescription, are eluxadoline (decreases bowel activity), alosetron (slows the stool movement in the intestines), lubiprostone (relieves stomach pain and bloating), rifaximin (an antibiotic that slows the growth of bacteria that cause diarrhea), etc.

Before taking any medication, talk to your doctor about the possible side effects of these drugs and try to find one that suits you.

How can you naturally manage IBS?

Sometimes simple changes might do a lot. It is like that with IBS. Let's see what you can do to make your symptoms less severe and your life much easier.

Food Alternatives

1. A Low-FODMAP diet

Try a low-FODMAP diet. It is short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are osmotically active low-chain carbs, forcing water into your digestive tract. That way, they worsen IBS symptoms.

FODMAP can be found in almost every food, like rye, nuts, yogurt, apples, mango, cherries, pears, artichoke, garlic, cauliflowers, honey, watermelon, peaches, etc.

You should choose foods low on FODMAP, such as:

• Fruit: berries, kiwi, grape, pineapple, guava, papaya, oranges, etc.
• Vegetables: carrots, tomatoes, spinach, cucumber, zucchini, kale, eggplant, etc.
• Seeds: sunflower, sesame, pumpkin
• Proteins: egg, lamb, pork, chicken, tofu, fish
• Whole grains: rice, quinoa, corn, potatoes, etc
• Coconut and olive oil
• Dairy: mozzarella, parmesan, greek yogurt, lactose-free milk, brie, cheddar, feta cheese, etc.
• Almond milk
• Dark chocolate

This diet may be challenging for the first few weeks since it is an elimination diet. You first have to stop eating all high-FODMAP food and then slowly reintroduce them (every three days, one ingredient) to see what food is causing your symptoms. Once you identify them, avoiding or at least limiting them should be easy.

Follow this diet only under the supervision of a dietician expert since it could do more damage than help. This diet may take up to eight weeks to see the first symptoms improve. Therefore it may only be suitable for some IBS patients. High FODMAP foods are the primary source of vitamins, minerals, and prebiotics, so take supplements to avoid other health problems.

2. Add fiber to your diet.

Adding fiber to your diet might be enough. One teaspoon of psyllium powder daily will improve bowel movement. Prebiotics are the dietary fiber that feeds the good bacteria in your digestive system. People with IBS can take 25-30g of fiber daily to regulate stool. Prebiotics and soluble fiber can be found in:

• Banana
• Cocoa
• Flaxseed
• Asparagus
• Eggplant
• Sweet potatoes
• Soybeans
• Artichoke
• Brussels sprouts
• Barley
• Blueberries

Slowly increase fiber in your diet for several weeks, and observe the symptoms.

Studies show that supplements containing bifidobacterium and lactobacillus help manage IBS symptoms. They can also be found in fermented food:

• Yogurt
• Kimchi
• Kombucha
• Kefir
• Miso soup
• Green olives
• Some cheese- cheddar, gouda, mozzarella
• Sauerkraut
• Tempeh
• Buttermilk

3. Use Herbs

IBS responds great to natural remedies. By adding some herbs to your diet, you might feel symptoms subside.

Peppermint can be taken as an oil capsule or as a tea. Regularly taking peppermint might help with diarrhea, constipation, abdominal pain, and bloating. Just be careful when using it since it can worsen heartburn. Some studies have shown that peppermint oil is more effective than antispasmodic medications.

4. Try ginger

Ginger also has antispasmodic effects, and it may reduce gas and bloating. You can buy prepared tea bags or make the tea by boiling ginger root in milk or water. Ginger tea has a spicy and sharp taste. It is generally safe, but talk to your doctor if you are on blood pressure medications before using it.

5. Get enough Vitamin D

Vitamin D is essential for overall health, but recent studies have shown that over 50% of IBS patients have vitamin D deficiency. Daily vitamin D intake should be 600 IU.

You can ensure daily vitamin D intake by spending 30 minutes in the sun. Plus, you'll find it in egg yolks, shiitake mushrooms, salmon, sardines, etc.

Before taking any supplements, check your vitamin D levels via blood test to optimize your vitamin intake.

Reduce stress

IBS is a disorder much affected by stress.

When you are in a stressful situation, your cortisol (also referred to as your stress hormone) levels rise, which can negatively impact your digestive system. Studies show that stressful events aggravate IBS symptoms in more than 30% of patients with IBS. So it is essential to do as much as you can to reduce your stress levels.

Exercise regularly

Regular exercise helps regulate stress and depression. It also helps bowel movement and contractions, relieving constipation and reducing bloating. Walking is an excellent way to start if you are not used to exercising. Thirty minutes of physical activity daily will make you feel better. Besides walking, you can slowly try jogging, swimming, bike riding, organized sports, etc. Avoid running and competitive sports since they might aggravate your symptoms.

Try Yoga

Stretching is a great way to help your bowel movements. Since yoga is linked to the body-breath-mind connection, it can help manage IBS symptoms. Always practice yoga under the supervision of a licensed instructor. A few poses that target the lower abdomen are especially recommended, like a supine twist and bridge.

Biofeedback

It is a complementary and alternative medicine for IBS. Biofeedback monitors bodily functions like breathing, muscle contractions, temperature, sweating, heart rate, etc. It is done with a machine connected with sensors to your body.

The machine measures your real-time responses to certain stimuli, which helps you identify changes and your response to them. That way, you can learn how to intervene when symptoms begin. Talk to your doctor if you have other medical conditions before trying biofeedback.

Mindfulness

Breathing exercises and mindfulness may calm down the gut nerves. Positive imagery, abdominal breathing, and progressive muscle relaxation are three relaxation techniques proven to help with IBS. When you imagine yourself in a peaceful place surrounded by beauty, your focus is away from tensions in your body. While focusing on and relaxing one part of the body, your gut signals calm down.

When you breathe deeply and focus, your central nervous system calms down too. More than 70% of patients with IBS who tried these relaxation techniques have reduced the severity of their symptoms.

Acupuncture

Acupuncture is an ancient Chinese technique that involves inserting thin needles under your skin at specific points. Studies show it may help with bloating, diarrhea, constipation, nausea, and other IBS symptoms. It is ideal if used with other treatments as part of integrative medicine.

The Bottom line

IBS is a long-term condition, and there is still no cure for it. However, there are many things you can do to prevent flare-ups and have a calmer life.

It's essential to know your triggers and avoid them as much as possible. Simple changes in your diet and lifestyle are enough in most patients with IBS. Talk to your doctor about your best treatment plan and start making changes.

BM210 may help with gastrointestinal disorders, including constipation, stool in small lumps, flatulent colic, bad digestion, intestinal cramps, spasm and colic, watery stool and nausea, sensitive abdomen, and dysmenorrhea.

Sources: NHS inform, Hopkins medicine, London Gastroenterology centre, Healthline, Everyday Health, Bestmade Natural products, Mindset health, Prime Health