irritable bowel syndrome.? ( symptoms, couses & treatment )

irritable bowel syndrome. What is happening internally that causes all of the annoying symptoms?

If doctors knew what causes irritable bowel syndrome (IBS), we would call it a disease and not a syndrome (which is merely a set of symptoms that tend to happen together). Many causes for IBS have been proposed, ranging from excess bacterial gas production to failure to down-regulate inflammation in the mucosal lining after a intestinal infection. IBS patients are much more sensitive to bowel distention by intestinal gas than normal, suggesting an lower threshold for sensing pain due to alterations in brain and/or peripheral nervous system function.

In over 35 years of GI practice, I have observed that the most severe IBS symptoms are typically seen in people who are stressed by recent events and/or have a history of "adverse childhood events" such as neglect, abuse (psychological, physical or sexual) or loss of a family member to death, divorce, mental illness, or incarceration. These childhood traumas are collectively known as "ACE events", and have recently been shown to dramatically increase the risk of later developing anxiety, depression, drug abuse, heart disease, liver disease, lung disease and other medical problems including otherwise unexplained symptoms such as IBS.

The human body responds to stress with the "fight or flight" response, which evolved to help us survive brief episodes physical danger such as escaping from a fire or animal attack. Digestion is not a priority when your life is in danger, so the stress response also reroutes blood flow away from the intestines to more vital organs such as the heart, brain and muscles. This may explain the diarrhea, constipation, bloating and other symptoms characteristic of IBS.

If stress causes the most severe forms of IBS, then we would expect that stress reduction brought about by exercise, meditation, yoga, and other mindfulness practices should help IBS patients feel better (depression also causes stress, and should be treated if present). I have had considerable success referring my IBS patients to mindfulness-based stress reduction (MBSR) programs (MBSR is a form of meditation specifically designed to help manage challenging illnesses of all types).

Many other approaches can help, including avoiding foods that generate gas (FODMAPs), using antidiarrheals such as Imodium for symptoms of diarrhea and laxatives such as senna or Miralax for constipation. Antispasmodics and antibiotics also help some patients. In my opinion, however, treating stress comes closest to addressing the "root cause" of IBS, at least for those patients with the most severe symptoms.

In summary, IBS may be viewed as a normal response of the body to an abnormally stressful environment. Humans evolved to live in an environment that was dramatically different from what most of us experience now. Our lives continue to change far too quickly for evolution to keep us properly-adapted to our environment. While most of us can usually cope with the stresses of modern life, we should not expect to avoid all consequences.

What are some ways to cure IBS and get back to a normal Gym routine?

IBS is an umbrella term to describe a set of unexplained bowel symptoms. If your IBS manifests as bloating after eating, excessive gas and loose stools, dietary intervention such as a low fibre, low fermentable (Low FODMAP) diet reduces symptoms in 60-70% of people. If you tend more towards constipation (i.e., passing small, hard stools up to 3-days or more apart) then new treatments like Linaclotide seem to work very well and can be taken in conjunction with dietary measures such as increasing fibre and fluid intake. Taking a daily probiotic (such as VSL#3) also works well in treating bacterial imbalances which can upset bowel function. A hydrogen breath test to check for bacterial overgrowth or Fructose / Lactose intolerance can be very useful.

If your South Indian diet contains garlic and onions, these can be quite difficult to digest so minimise those, but reasonable amounts of chilli and ginger can actually be beneficial. Reducing stress either by talking to your boss and changing your work practice would help and relaxation techniques (think Yoga etc) really help to balance your system. Exercise is also an excellent way to wind down nervous energy. So in summary, decide which type of IBS symptoms you have. Change your diet accordingly. Seek treatment from your Doctor if applicable. Identify and reduce stressors. Get back in the gym and feel good about yourself.