By DR. VICTOR S. SIERPINA
This month’s theme will be our gastrointestinal tract, our gut. This organ is truly amazing in structure and function. It processes about 30 tons of food during our lifetimes, usually with little or no complaint. Yet, if something goes wrong with the gut, you get an immediate pain in the you-know-where.
The gut is not something that is talked about much in polite company. It is kind of like that crazy old uncle Harry who isn’t mentioned at family gatherings. Why is this? Well the gut does have a reputation for embarrassing rumblings, burps, belches, flatulence, vomit and olfactorily offensive offal. To remedy this conspiracy of silence against the gut, I wrote
“The Healthy Gut Workbook,” a kind of do-it-yourself home guide to improving gut health. If you decide to acquire a copy from Amazon, I must disclose that I get a royalty check of about $1.
Let’s cover first a common condition called irritable bowel syndrome. This is the unhappy gut with frequent cramps, distention, bloating, diarrhea, constipation or both. If you were a colicky baby, you are more likely to have the syndrome, and if you are a woman, you are more prone to it.
It is unclear exactly what causes the syndrome but evidence suggests an overly reactive autonomic nervous system and hypersensitivity to distention of the gut wall. It is a diagnosis of exclusion, meaning no other identifiable organic cause such as infection, inflammation, tumor, mechanical obstruction, ulcer and so on can be found to explain symptoms.
Work-ups sometimes can be extensive, including scopes, X-rays, blood and stool testing.
Treatment options are variable since it expresses differently in a range of people, reflecting that, despite naming it, we may not really know exactly what it is.
Some basic helpful treatments for the syndrome are:
1. Increased fiber in the diet
2. Optimize management of stress
3. Supplemental probiotics
4. Identify food allergies or sensitivities
5. Botanical and nutritional supplements
6. Pharmaceuticals
Stress has been found to play a big role in triggering IBS through what has been called the brain-gut axis. Our perception of stress affects neurochemical receptors in the gut, activating the painful signals of the syndrome. Cognitive behavioral therapy, hypnosis, meditation, yoga, deep breathing, regular exercise and other relaxation methods can down-regulate this trigger and help better manage the symptoms.
Food sensitivities and allergies can best be identified by a comprehensive elimination diet with a rotation back into the diet of one food group at a time to see which seem to be culprits. Dairy, wheat, soy and peanuts are common culprits. A high fiber diet is essential and should include both soluble and insoluble fibers to the dose of 25 to 30 grams daily.
Probiotics in the dosage range of 3 to 100 billion units daily are often very helpful. Enteric-coated peppermint or caraway oil before meals is a natural therapeutic. Fennel, camomile, ginger and Iberogast are all potentially helpful for symptom relief.
The syndrome is generally a lifetime condition starting in adolescence or before, so be patient with your unhappy gut. Always utilize the basic approaches described here before escalating therapy to a prescription drug.