Blog

Why you shouldn’t ignore your IBS

Irritable bowels syndrome (IBS) affects approximately one in five people in the developed countries.

Characterised as chronic abdominal symptoms, accompanied by bloating and pain, and in the absence of major mechanical, inflammatory or biochemical diseases, this condition affects the quality of life of many.

IBS types vary between IBS with constipation, IBS with diarrhea, mixed IBS or un-subtyped IBS.

Currently, there is no pharmacological cure for IBS.

Our digestive system is a weblike structure. We may think that the role of our digestive system is simply to digest food, but in fact its main goal is to provide nutrients for the cells in the whole body. In this way, the gut has a connection (albeit often invisible) to every organ, every tissue in our body. It provides nutrients for the cardiovascular, neurological, endocrine, immune, metabolic systems in the body.

The digestive tract is the main port of entry for everything we ingest. It is our gut that needs to sort out and distinguish between a friend and a foe. And for this reason most of our immunity lies in the gut. It evolved with us so that every time we picked an orange or found an interesting-looking flower petal and decided to eat it, we wouldn’t die.

When substances (such as foods, drinks, medicines, supplements, alcohol, etc) enter our digestive system, they are met with several non-specific and antigen-specific mechanisms - these are the components of our innate immune system, including peristalsis, gastric acid, bile, mucus, antibacterial peptides, antibodies (IgA). These stop microbes and pathogens from infecting the body.

Our body’s first response is to watch and be tolerant. In fact, in majority of cases, the immune system’s job is not to respond.

When the digestive system detects something out of the ordinary, it has an orderly way to respond with layers of response - these layers of response are called the GALT and the MALT.

GALT - the gut-associated lymphoid tissue consists of 100-150 lymph nodes embedded in the gastrointestinal walls. They underlie the single-cell epithelial lining. In the mucosal lining of the digestive lumen, we have the mucosal-associated lymphoid tissue - the MALT. Together the GALT and the MALT form about 70-80% of our immune system responses.

Our modern lifestyle means that we often ingest foods and drinks that our digestive system has a hard time identifying. The ‘substances’ that we evolved with, and the microbes that come into our body from things found in nature, such as water, vegetables, fruit, fish, meat, nuts and seeds, legumes, beans - our gut sees as “self”. This is because for thousands of years those substances were the only things available to us. There were no supermarkets, there were no fast-food chains, there were no Slushy-making machines, no trans fats, or drinks in cans. These processed foods are largely based on chemical food-like substances. The immune system sees them and treats them as “nonself” and mounts an immune response. In fact, our bodies are constantly walking a fine line between just the right amount of immune surveillance and inflammation. When challenged, the immune system produces a response that is adequate and in right proportion to the threat received. It produces a variety of inflammatory molecules, such as cytokines, interleukins, chemokine, secretory IgA, IgE, IgM and IgG antibodies, and others.

Inflammation in the gut is often presented silently at first, it is not the same as a finger cut we’ve got while chopping veggies for dinner, or a muscle ache we have in the ankle after playing a game of tennis. The latter two types of inflammation are both visible and discernible. There is blood, pain, perhaps heat and swelling. When it comes to the inflamed gut, the symptoms might take days or weeks to come. First there’s pain, discomfort, bloating or gas, maybe heartburn, differences in stool patterns of consistency, then come diarrhea, constipation. And only later a medical diagnosis. Inflammatory bowel diseases result from an exaggerated immune response to what would be normal reaction in the people with a healthy microbiome.

When the gut has a balance of probiotic (beneficial) and disease-causing bacteria, there is a balance between inflammation and healing. But when there is a lot of disease-causing microorganisms and few probiotic bacteria to balance them out, the result is inflamed gut - and IBS is the most frequent manifestation of it.
The state of inflamed gut means that the nutrients we are meant to be extracting from food are not absorbed and utilised properly. They also don’t reach their final destination - their designated cells or organs recipients. Thus, people with IBS also experience chronic headaches, fibromyalgia, back pain, poor sleep, insomnia, restless leg syndrome, migraines, chronic fatigue, bladder infections and many more conditions. It is the poor absorption and utilisation of the necessary nutrients that entail a wide range of conditions.

Recent research shows there is a high association between IBS and psychiatric disorders. More than 60% of people who have irritable bowel syndrome (IBS) are also reported to experience some sort of mood disorder, including anxiety, depression, panic attacks and schizophrenia. The Enteric nervous system has a lot to answer for it. It is often called our “second brain”. The ENS is the nervous system that runs through our digestive tract and is found in sheaths of tissue lining the organs of the digestive tract. This is the body gut-brain connection. The constant communication between the gut and the brain is facilitated via the vagus nerve, gastric hormones and neurotransmitters. More neurotransmitters serotonin and dopamine are produced in our gut, than in our brain. If there is inflammation in the gut leading to dysbiosis, the resulting effects are behavioural and cognitive issues.

IBS is not a straightforward thing to tackle. It takes time to heal and reset the digestive tract to come back to its norm. One needs a good diet approach together with supporting lifestyle changes - such as restorative sleep and stress reduction. But we need those for everyday living and optimal health anyway, so by treating one condition we are working towards our longer term health.

Reach out if you’ve been struggling with IBS unable to tackle it yourself. I’m here to help.