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IRRITABLE BOWEL SYNDROME (IBS)

IBS affects between 3% and 20% of Americans. (Source 1)

IBS is typically diagnosed based on symptoms and by ruling out other conditions. The exact causes of IBS are unknown. Some suggested causes include increased intestinal inflammation, digestive motility, intestinal bacterial overgrowth, food sensitivities, carbohydrate malabsorption and infections. (Source 2)

IBS can present with many different symptoms: abdominal pain/cramping, diarrhea, constipation (or back and forth between the two), gas/bloating, food intolerances, fatigue, difficulty sleeping, anxiety or depression.

Many people have heard of Irritable bowel syndrome (IBS). Perhaps you have been diagnosed with IBS by your doctor, or know someone who suffers from it or maybe you suspect you may have IBS because you have many of the above mentioned symptoms.

BALANCE: MIND, BODY, SPIRIT

Let me begin by stressing that we all need balance in our lives. This may seem like a strange place to start when IBS appears to be solely a physical ailment. However, our bodies, like everything in our lives, need to be in balance. We are holistic beings and it is not possible to compartmentalize without causing an imbalance.

We need to consider our BODY, our MIND and our SPIRIT. Focusing on only one of these will cause issues in one or both of the others. Imbalances may lead to many different issues and result in disease.

A balance of Mind, Body, and Spirit is key – healthy nutrition, adequate movement, mental stimulation, having a grasp on your financial situation, healthy relationships with self and with others, deep breathing, yoga, meditation and self care – like a bath or a massage or some alone time to read a book and sip a cup of tea. These things all contribute to creating balance in our lives. 

ALLOPATHIC TREATMENT

Physical ailments, like IBS, are typically addressed allopathically in our current medical paradigm. Rarely does a person go to their medical doctor and find themselves discussing self care, finances or even exercise or nutrition as it relates to the present diagnosis.

The allopathic method tends to focus on symptoms, potential causes of these symptoms and suppressing symptoms with medication. For example, if you go to your doctor with the primary complaints of gas, bloating and acid reflux, you will typically be asked questions about diet, alcohol consumption, smoking, specific food triggers, current and past infections, medications/supplements you are taking, and family history, Of course, any good doctor will tell you (what you may already suspect) to cut out the alcohol and smoking and any foods that cause these symptoms. He may even recommend that you add a probiotic, especially if you are currently taking an antibiotic or have a long history of antibiotic use. These are all great recommendations by themselves. However, a person typically doesn’t want to go to the doctor only to be told to quit smoking, quit drinking and quit eating foods that trigger our symptoms. We have come to expect the “magic pill” that fixes all of our problems.

ACID REDUCERS

You will often be given a prescription for an acid reducer, either an H2 Blocker like Pepcid (famotidine) or a proton pump inhibitor like Prilosec (omeprazole) or maybe even simply get a recommendation to take Tums (calcium carbonate) after meals to neutralize the stomach acid. 

These treatments may help in the short term, but they are suppressing symptoms and not treating the underlying issue, unless perhaps your issue is truly an overproduction of stomach acid. Often there is not an excess of stomach acid present, on the converse, there is often a lack of stomach acid that is leading to the bloating, gas and reflux because the stomach is not efficient at digesting the food with the low level of digestive acid and enzymes. This may lead to a slower gastric transit time and putrification of the food in the stomach, leading to the excessive gas and bloating and the feeling of acid reflux.

Adding any medication is always a determination of benefit to risk ratio. If the potential benefit is greater than the potential risk then it is a reasonable treatment to try. No medication is without potential risk and these risks should be considered.

In the example of being prescribed a proton pump inhibitor like Prilosec (omeprazole), this medication has few, if any short term side effects, making it a perfect medication to prescribe, initially, to suppress symptoms. However, this medication suppresses stomach acid production which can lead to decreased assimilation of vital nutrients (vitamins, minerals, phytonutrients, amino acids, etc)  from food because of the low stomach acid and enzymes. This can cause a degree of malnutrition and a multitude of other issues. If the body feels it is not getting adequate calcium, for example, it will begin to steal calcium from the bones, potentially leading to osteoporosis. This medication can also prevent the microbiota from functioning properly. Since ⅔ of our immune system resides in our gut, this can lead to decreased immunity, putting every system of the body at risk. As you can see, one medication has the potential to start a whole cascade of damaging effects.

Looking at the “Big Picture” and the “Why” is exceedingly helpful. Physicians are highly trained medical professionals and they are, at times, truly life savers. However, we are the guardians and protectors of our own bodies. If we don’t take a proactive role in accepting responsibility for our own health and wellbeing this can lead to many health issues.

L-GLUTAMINE

One supplement that has potential for healing the intestinal lining and helping to improve overall GI health is L-GLUTAMINE. There are no studies to date showing the specific benefit of L-Glutamine for IBS but improvement has been experienced by many and there are very few risks to taking this amino acid. Side effects may happen if you’re allergic to L-glutamine, or if you’ve taken too much. Some effects include nausea, vomiting, joint pain, or hives. If any of these occur the supplement should be decreased or discontinued.

The recommended dose to start is 5 grams of L-Glutamine Powder mixed in 2 ounces of water (or beverage of choice) and taken in the morning and at bedtime on an empty stomach. Some physicians will increase this to 4-6 doses per day but this should be done under your physician’s supervision. This amino acid has the ability to improve intestinal permeability and this, in turn, protects against unwanted toxins entering the digestive system.

PROBIOTICS

Probiotics can be very helpful in restoring balance to the microbiota in your digestive system. (Source 3) The microbiota is made up of beneficial and pathogenic microorganisms. The beneficial organisms play a critical role in your health, but if they are damaged and not thriving, this gives the pathogenic organisms a chance to overgrow causing an imbalance in the microbiota. (Source 4)

Probiotics are strains of live bacteria or yeast found in food and supplements. They provide health benefits, are safe to take and are similar to the helpful microorganisms in your gut microbiota. (Source 5)

Some common probiotic food include yogurt, sauerkraut, kimchi and other fermented foods. Some people with IBS cannot tolerate fermented foods, dairy or foods high in FODMAPs. This is where adding a probiotic supplement can prove to be very beneficial.

DIGESTIVE ENZYMES

Digestive enzymes support healthy digestion, optimize the breakdown of fats, carbohydrates, and protein, and promote optimal nutrient absorption. For these reasons,  digestive enzymes might help alleviate common IBS symptoms.

Right now, there isn’t enough evidence to support the use of digestive enzyme supplements in treating IBS. Small studies have shown some promise, but more research is needed. There is potential benefit and very little risk to trying digestive enzymes. They may help to alleviate some or all of your IBS symptoms.

The basic digestive enzymes include:

• amylase — breaks apart complex sugars into smaller molecules like maltose
• lipase — breaks down complex fats into smaller fatty acids and glycerol
• protease — breaks down protein, so it can be made into amino acids

Rainbow Light Digestive Enzymes

IBS AFFECTS WOMEN MORE THAN MEN

Research has determined that IBS dis-proportionately affects women more than men. (Source 6) 

This may be related to women being natural nurturers. Not that men can not be nurturers, but women can be more focused on taking care of those around them, children, family, friends, neighbors, etc. Taking care of others and neglecting our own self care can lead to an imbalance in the 3rd Chakra (Solar Plexus). Making self care a priority BEFORE you take care of others, finding your purpose and fully realizing your passionate self are a few ways of rebuilding your self esteem and rebalancing your 3rd Chakra. This rebalancing can be helped with tapping, yoga, meditation, deep breathing and essential oils to name a few. By rebalancing your body, mind and spirit and putting yourself first, you are better equipped to care for others. It is a win-win situation for everyone. 

ESSENTIAL OILS

ESSENTIAL OILS (EOs) like peppermint oil in a product called IBGard, are sometimes recommended for internal use to help acid reflux. You can safely take some EOs internally, however, In this case, topical application will have the biggest impact on healing your energetic body (Chakra System). 

EO’s should be diluted with a carrier oil like almond oil or coconut oil and then applied to the abdomen to get the most powerful results. This will be more effective than diffusing or ingesting the EOs.

These are a few EOs that can help to balance your 3rd Chakra

1. Ylang Ylang 
   1. For Cooling & Clearing Anger/Frustration
   2. Joyful & Peaceful
   3. Promotes confidence, self esteem, self acceptance
2. Juniper
   1. Helps with frustration and annoyance
   2. Strengthens will power
   3. Helps overcome fear of failure, helps you to branch out
   4. Restores self confidence & self worth
3. Roman Chamomile
   1. Helps with excessive ego, ego based drive, paralyzes us into inaction
   2. Cultivates patience and self nurturing
   3. Enables you to own your limitations without self criticism
4. Fennel
   1. Great oil for digestive system
   2. Reduces tendency to over think and over analyze
   3. Activates mind energy centers
   4. Calming
   5. Promotes Self Love & Self Acceptance

YOU ARE WHAT YOU ABSORB & ASSIMILATE

You are what you eat, but more specifically you are what you absorb and assimilate. Things that impede this absorption and assimilation, and lead to GI issues like IBS, are: 

• Stress
• Digestive Stressors
• Lack of mastication because of Dental Issues.
• Lack of Intrinsic Factor (a substance secreted by the stomach which enables the body to absorb vitamin B12)
• Parasites, JUICE FAST GUIDE & PARASITE CLEANSE
• Candida, HEAL CANDIDA NOW
• Anything that is stressing your body can lead to an imbalance which can result in disease.

SYMPATHETIC & PARASYMPATHETIC NERVOUS SYSTEM

Psychological Stress is widely accepted as an important factor contributing to IBS (Source 7). 

The central nervous system (CNS), the brain and the nerves that control your body, operates on internal controls that seem to run on autopilot. The CNS is divided into two parts: the sympathetic and parasympathetic nervous systems. Some classify it as having a third part, the enteric nervous system, which controls most of the activity of the gastrointestinal system.

The sympathetic and parasympathetic systems usually work in tandem. 

The parasympathetic system is known as the “rest and digest” system. It controls body functions like urination, defecation, digestion, tear production, and saliva production.

The sympathetic nervous system is your “fight or flight” side. Stress and anxiety activate this system and they set off a chain reaction of hormone release that increases how fast your heart beats, pumps more blood to your muscles, and slows or even stops your digestive processes.

Stress and anxiety sometimes trigger overactivity of your gut. This causes the diarrhea and stomach churning that those with IBS know well. In others, the brain signals are underactive, and their gut may slow down, resulting in constipation, gas, and abdominal discomfort. (Source 8)

VAGUS NERVE

You can improve IBS symptoms by activating and toning the Vagus Nerve.

The big culprits that cause poor vagal nerve function are stress, fatigue, overwhelm and anxiety.  Activating your vagus nerve has been shown to reduce anxiety and activate the “rest and digest” of the parasympathetic nervous system.

Ways to activate, tone and improve vagal nerve function:

EAT MINDFULLY

• It’s not just WHAT you eat that helps improve digestion but HOW you eat plays a role in vagal nerve health.
• Chew food until it’s liquified before swallowing.  (20 chews)
• Eat meals mindfully and slowly, without rushing.
• Take a Deep Breath, before beginning to eat and between bites

BREATHE

• Slow, deep breathing will activate the vagus nerve and stimulate the relaxation response otherwise known as the “rest and digest” 
• Digestion can only happen in the parasympathetic state
• Slow down and take 6 breaths per minute. (Breathe in for a count of 4, Hold it for a count of 8, Release it for a count of 8 and Repeat)

INVIGORATE WITH COLD

• Take a cold shower, splash your face with cold water or invigorate your body with cold water at the end of your shower. 
• The exposure to colder temperatures improves your stress response and helps reduce anxiety.

MAKE SOME NOISE

• Singing, humming, chanting, and gargling will stimulate the vagus nerve by activating the muscles at the back of the throat and vocal cords connected to the nerve.

MEDITATE & PRACTICE YOGA

• Meditation reduces stress and anxiety and stimulates the vagus nerve.
• Yoga helps to reduce stress and improve mood.  

GET MOVING

• Low to medium impact exercise stimulates the digestive system and therefore the vagus nerve.  It also helps move waste through the body and helps reduce stress. 

ENJOY MASSAGE OR ACUPUNCTURE

• Certain acupuncture points have been known to improve vagal function, especially points in the ear.
• Massaging specific parts of the body, especially feet or carotid sinus (right side of the neck) can help lower heart rate and blood pressure, which can improve vagal function.

INFLAMMATION

Systemic inflammation in the body is typically the underlying issue in all disease and IBS is no exception.

Many things contribute to overall inflammation in the body. Diet is a contributing factor and should be considered when trying to decrease inflammation.

An anti-inflammatory, plant based diet focusing on whole foods, especially fresh fruits and vegetables, legumes, healthy fats and anti inflammatory herbs and spices can be extremely helpful in decreasing inflammation. Organic choices are always best:

• Blueberries
• Blackberries
• Cherries
• Dark red grapes
• Kale
• Spinach
• Cauliflower
• Brussels sprouts
• Cabbage
• Scallions
• Leeks
• Broccoli
• Beans of all types
• Lentils
• Onions
• Garlic
• Green tea
• Avocado & Oil 
• Coconut & Oil
• Olives
• Walnuts
• Pistachios
• Pine nuts
• Almonds
• Turmeric
• Ginger
• Cinnamon
• Dark chocolate

The anti inflammatory diet is a great place to start but sometimes, with IBS, even these healthy organic foods can act as triggers for symptoms.

ELIMINATION DIET: LOW FODMAP 

Low FODMAP Diet

• FODMAP: Fermentable Oligo-Di-Monosaccharides And Polyols
• Eliminates Fermentable Carbs that irritate the gut lining
  • Oligosaccharides
    • Wheat, Rye, Legumes, Various Fruits/Vegetables (garlic & onions)
  • Disaccharides
    • Milk, Yogurt, Soft Cheese
    • Lactose
  • Monosaccharides
    • Various Fruits (figs & mangos), 
    • Sweeteners (honey & agave) 
    • Fructose
  • Polyols
    • Various Fruits & Vegetables (blackberries, lychee)
    • Low Calorie Sweeteners (especially in sugar free gum/mints)
    • Mannitol & Sorbitol

Most FODMAPS are PreBiotics, which are a necessary food for microflora in gut

• Acacia Fiber is well tolerated – Heather’s Tummy Fiber
• This is a great prebiotic to add in Stage 2

FODMAP Diet Stages

• Stage 1: RESTRICTION (3-8 Weeks)
  • Avoid all high FODMAP foods
  • Progress to stage 2 once symptoms are under control
• Stage 2: REINTRODUCTION (Systematically)
  • Test food one at a time for 3 days each
  • Identify which foods you are able to tolerate
  • Identify how much of these foods you can tolerate
• Stage 3: PERSONALIZATION
  • Modified FODMAP Diet
  • Very important to reintroduce foods
  • Increases diet variety, flexibility & long term compliance
  • Improves Gut Health & Quality of Life

As you can see, following a FODMAP Elimination Diet may be a daunting task for some, but with the right mindset and motivation it is doable and can be life changing.

FOOD SENSITIVITY TESTING: IgG

Food Sensitivity Testing could help guide people with IBS towards a diet that could reduce or eliminate symptoms. These tests can be pricey but are a helpful guide if the anti inflammatory diet and/or the FODMAP Diet is not providing a reduction in or complete elimination of IBS symptoms

• Everlywell (IgG reactivity to 96 Foods or 204 Foods)
• US BioTek Labs FoodStats Antibody Assessment (96 Foods or 208 Foods)

ACTION STEPS

12 ACTION STEPS TO TAKE WITH OR WITHOUT AN IBS DIAGNOSIS

1. Quit Smoking
2. Eliminate or Decrease Alcohol
3. Eliminate Trigger Foods
4. Decrease Coffee/Caffeine as it relates to symptoms
5. Add Stress Management
6. Add Self Care
7. Add Vagus Nerve Stimulation
8. Add L-Glutamine
9. Add Probiotics
10. Add Digestive Enzymes
11. Add Essential Oils
12. Consider Food Sensitivity Testing

DISCLAIMER 

Any statements expressed in these recommendations are for informational purposes and self-help only and are not intended to be a substitute for professional medical prevention, diagnosis or treatment. Please consult with your health care provider before embarking on any cleansing, detoxing, or juicing program, or before beginning any new diet or nutritional program. Always consult with your personal health care physician regarding taking any supplements, as only your health care provider can provide you with advice on what is safe and effective for your unique needs or diagnose your particular medical history. Pregnant and breastfeeding women should never undertake a cleanse, a fast, a detox or a parasite cleanse of any kind. Also, those on medication should always have their medical doctor’s approval before making any dietary changes.

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