Digestion is a process that should happen automatically and quietly, like a soft humming in the background. Something we should not have to pay much attention to.
This can sound like an alien concept to those that suffer from chronic digestive issues.
When you are dealing with abdominal pain, chronic heartburn, bloating, gas, chronic diarrhoea or constipation or reactions to food, it’s like loud noise; a persistent discomfort that affects your ability to fully be present and feel at ease. In the worst case you may literally be planning your life around your digestion.
IBS or Irritable Bowel Syndrome is one of the common causes of chronic digestive distress. An estimated 7 to 21% of the population suffers from this functional gut disorder that is characterised by many of the symptoms described above, the main ones being chronic diarrhoea or constipation or bowel movements alternating between the two as well as abdominal pain or discomfort (1).
Till date, an IBS diagnosis is arrived at through a tedious and time-consuming process of exclusion of other gastrointestinal diseases, which is not only a frustrating process but costly as well. A colonoscopy is usually part of the investigative process and while it’s a relief when colonoscopy results come back clear you end up walking away from the doctor’ office without a solution to your problem and possibly the suggestion that it may all be in your head.
Some important new areas of research in IBS are starting to throw some light on this common condition and more importantly they are presenting us with exciting new diagnostic tools and treatment strategies (2).
The first area of research is the discovery of post infectious IBS. Based on research it is estimated that approximately 10% of all cases of acute gastroenteritis lead to the development of IBS. It is suspected that in reality these numbers are higher; people tend to forget about episodes of stomach infection. While in many people the acute gut infection is resolved in others it can trigger certain pathophysiological mechanisms that keep symptoms going. These mechanisms include the overgrowth of certain unfavorables gut bacteria, low overall diversity in bacterial species, low grade inflammation, mast cell activation, autoimmune activation, intestinal permeability and small bacterial overgrowth (SIBO)(2).
One of the reasons that I am passionate about this topic is that I can personally trace back the onset of my gut related issues to two pretty severe consecutive gastro- intestinal infections during my first year of living in India. And I have seen this with several of my clients as well. You can read more about that here.
What is exciting about this discovery is that we now have a clear pathway that connects alterations in our gut bacteria through an infection to IBS and an insight into the potential pathophysiological mechanisms involved. Some of these mechanisms can be tested for and this then can provide us targeted treatment strategies for individual IBS cases.
The second exciting area of research is the discovery of a specific diet, called the low FODMAP diet that has been shown to improve symptoms in up to 86% of IBS patients (3, 4, 5). Other interventions that alter the gastrointestinal microbial environment have been shown to be helpful, such as the use of (herbal) anti-microbials, probiotics, and prokinetics (6, 7, 8).
With all these new discoveries and promising new research a few things are becoming clear:
IBS is not a lifelong sentence: there are several promising treatment strategies and nutritional interventions that are proving to be extremely effective.
The underlying mechanisms that play a role in IBS symptoms are varied and possibly unique to each person as is the journey that got them to this point, which makes it important to tailor-make the approach.
If you have been struggling with gut related symptoms and/or an IBS diagnosis I’d be happy to have a chat to discuss if and how I can help you resolve your symptoms. You can set that up here.
Be well.
