The 5 element theory is the basis of Chinese medical theory. The elements include water, fire, wood metal and earth and correspond to particular organs. The Kidneys, associated with water, include also the brain. In the 5 element theory the stomach and the spleen, the earth element, control the kidneys and the brain. When there is a dysfunction the digestive system could overact on the kidney’s/brain or in reverse the kidneys/brain could ‘attack’ the digestive system. This reiterates this direct connection between the brain and the digestive system.
This connection between the gut and the brain is now also widely accepted in Western medicine. The vagus nerve directly connects the intestine with the lower part of the brain. It was first thought that the brain simply sent signals to the intestine, but now it is understood that signals are sent both ways and a disturbance in the intestine can in fact affect the brain. It is therefore fair to say that a variety of illnesses that were once believed to be mental disturbances, have in fact originated in the gut.
Causes and Treatment of Irritable Bowel Syndrome
20 years ago Irritable Bowel Syndrome was said to be rooted in stress although even today the real cause is unknown. Theories propose that if the muscles that line the walls of the intestine contract stronger or contract for extended period of time, this can then cause gas, bloating and diarrhea, or on the other hand if they move too slowly this will cause hard, dry stools.
The nervous system is most likely also involved in this process. This complex interaction between the brain and the intestine may be the root cause. The signals that are sent back and forth are essential reactions during times of stress. Thoughts and feelings can cause an exaggerated response in the gut. If the signals that are sent between the brain and the intestine malfunction this causes the intestine to overact, resulting in pain, diarrhea or constipation.8.
Communication made between nerves is conducted along the pathways by neurotransmitters. An important transmitter in this case is serotonin. About 90% of serotonin is produced in the gut. Serotonin plays a major role in motility and appetite in the gut while in the brain it is responsible for mood, social behavior, sleep and memory. Studies have found that elevated or reduced levels of serotonin are found in the blood of IBS sufferers.5.
A final known factor that plays a role in IBS is the amount of good bacteria found in the gut. Decreased levels will cause an imbalance in the microflora of the gut and be a cause of diarrhea dominant IBS.6.
Stress and Other Triggers
The overuse of the word stress in a way has minimalized its significance as it is the root cause of many diseases today. IBS is a disease where stress is often imbedded in its origin. When I talk to people with IBS I normally find some psychological issue that accompanies it. In most cases anxiety prevails, while bouts of depression are also associated. In an eternal vicious cycle the IBS symptoms themselves can lead to depression or anxiety, further reiterating the bond between the gut and brain.7.
Other known culprits that aggravate IBS symptoms include long gaps between meals leading to excessive acid build up, as well as thirst and alcohol or coffee on an empty stomach. It may also be the food itself that causes an irritation such as with an intolerance to a specific food. Known triggers include wheat, dairy, eggs, cruciferous vegetables and carbonated drinks.
Interestingly women are twice as likely to develop IBS. It has therefore been suggested that hormones may play a role, particularly around menstruation. I believe this could be prostaglandins that cause the muscles in the wall of the intestine to spasm.
Exercise and Meditation
Exercise such as running and aerobics is a great reducer of stress, plus keeps you fit, and frees your mind of clutter. For those with constipation dominant IBS, it will also help kick start the system. You could also try Yoga or Tai Chi if you are looking for more meditative methods of exercise. Which brings me to meditation. Meditation plays a significant role in reducing inflammation and symptoms of IBS such as gas, bloating and diarrhea. I also encourage my patients to breathe into the belly. Deep meditative breathing helps to relax the muscles in the gut.
In TCM, Irritable Bowel Syndrome can be divided into a number of patterns. It is often characterized with dysfunctions between a variety of organs making it a very complex syndrome 1. and once your therapist has diagnosed you then specific acupuncture points and herbal formulas can be created. From my experience acupuncture and herbs are very successful treatment methods for dealing with IBS.
Digestive Enzyme’s & Pre/Probiotics
Digestive enzymes help to take stress off the GI tract. There are 7 main enzymes that should be found in a good supplement, lactase, invertase, amylase, protease, lipase, cellulose, malt diatase. Lactase, for example helps to breakdown lactose, amylase to help breakdown carbs and lipase to breakdown fats. If you are deficient in any of these enzymes you will trigger symptoms such as gas, bloating and diarrhea. 2.3.
Together with enzymes I also use probiotics. It is important to have enough good bacteria in the gut and as previously mentioned a lack of them may be a cause for IBS. Studies suggest that supplements, especially with an increased amount of Bifidobacterium infantis, will help to alleviate symptoms. Choose a probiotic that also contains prebiotics, as prebiotics are a source of food for the good bacteria in your gut.4. Apple Cider Vinegar could also be considered as it is a prebiotic and may help improve the balance of good bacteria to bad bacteria and aid in digestion.
IBS, while not life threatening, can cause you discomfort on a daily basis. It affects you not only physically but also mentally, being caused by or causing depression and/or anxiety. Treatment will be a journey but essential to controlling symptoms.
- Halland M, Talley NJ. New treatments for IBS. Nature reviews. Gastroenterology & hepatology. 2013;2012;10(1):13.