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IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome (IBS) is a common disorder that may affect over 15 percent of the general population. It is sometimes referred to as spastic colon, spastic colitis, mucous colitis or nervous stomach. IBS should not be confused with other diseases of the bowel such as ulcerative colitis or Crohn’s disease. IBS is a functional disorder where the function of the bowels may be abnormal but no structural abnormalities exist.

WHAT ARE THE SYMPTOMS OF IBS?

People with IBS may experience abdominal pain and changes in bowel habits – either diarrhea, constipation, or both at different times. Symptoms associated with IBS include abdominal cramps, fullness or bloating, abnormal stool consistency, passage of mucous, urgency or a feeling of incomplete bowel movements.

WHAT CAUSES IBS?

The symptoms of IBS seem to occur as a result of abnormal functioning or communication between the nervous system and the muscles of the bowel. This abnormal regulation may cause the bowel to be “irritated” or more sensitive. The muscles in the bowel wall may contract too forcefully or too weakly, too slowly or rapidly at certain times. Although there is no physical obstruction, a patient may perceive cramps or functional blockage.

WHAT ROLE DOES STRESS PLAY IN IBS?

IBS is not caused by stress. It is not a psychological or psychiatric disorder, however emotional stress may contribute to IBS. Many people may experience nausea or diarrhea when nervous or anxious. While we may not be able to control the effect stress has on our intestines, reducing the sources of stress in our lives may help to alleviate the symptoms of IBS.

HOW CAN I TELL IF THE PROBLEM IS IBS OR SOMETHING ELSE?

A careful medical history and physical examination by a colon and rectal surgeon or other physician are essential to exclude more serious disorders. Tests may include blood tests, stool tests, visual inspection of the inside of the colon with flexible sigmoidoscopy or colonoscopy, and x-ray studies. Fever, anemia, rectal bleeding and unexplained weight loss are not symptoms of IBS and need to be evaluated by your physician.

HOW IS IBS TREATED?

Understanding that IBS is not a serious or life-threatening condition may relieve anxiety and stress, which often contribute to the problem. Stress reduction, use of behavioral therapy, biofeedback, relaxation or pain management techniques can help relieve the symptoms of IBS in some individuals. Use of a diary may help to identify certain foods or other factors that cause symptoms.

Mild to moderate symptoms can often be managed by dietary changes. Your physician may recommend avoiding meals that are too large or high in fatty or fried foods. Caffeine or alcohol may also cause cramps or diarrhea. Some types of sugar, such as sorbitol commonly used as a low calorie sweetener and fructose, found naturally in honey and some fruits may be poorly absorbed by the gut and cause cramping and diarrhea. Gas producing foods such as beans, cabbage, cauliflower, broccoli, brussel sprouts and onions may cause bloating and increased discomfort in people with IBS.

Increasing dietary fiber may help to improve IBS symptoms. Soluble fiber such as that found in citrus fruits, flaxseeds and legumes may help soften stool and lessen the severity of cramps. Insoluble fiber such as cellulose, cereals and bran can absorb water as it moves through the digestive tract and lessen diarrhea. In some people too much fiber can cause discomfort. Adding fiber to the diet gradually with adequate amounts of liquids may eliminate the discomfort.

Individuals with moderate to severe IBS may benefit from prescribed medication. Medications can help to control the symptoms of IBS but they do not cure the condition. Medications act directly on the intestinal muscles to help the contractions return to normal. Antidepressants in low doses have been shown to be helpful in some with IBS.

HOW LONG DOES THE TREATMENT TAKE TO RELIEVE SYMPTOMS?

Relief of IBS Symptoms is often a slow process. It may take six months or more for definite improvement to be appreciated. Patience is extremely important in dealing with this problem. The tendency for the intestine to respond to stress will always be present. With attention to proper diet and in some cases, use of appropriate medications, the symptoms of IBS can be greatly improved or eliminated.

CAN IBS LEAD TO MORE SERIOUS PROBLEMS?

IBS does not cause cancer, bleeding or inflammatory bowel diseases, such as ulcerative colitis.

AYURVEDIC MANAGEMENT IN IBS

The medicines should have following qualities:

Deepana – carminative property,
Pachana – digestive,
Sangrahi – intestinal restorative, which increases absorption capacity of intestines
Laghu – lightness.

HERBS USEFUL IN IBS :

Dadima - Pomegranate
Kutaja- Holarrhena antidysenterica
Bilva- Aegle marmelos
Musta- Cyperus rotundus
Dhataki- Woodfordia fruticosa
Patha- Cissampelos pareira
Lodhra- Symplocos racemosa
Pushkaramoola-Inula racemosa
Chavya- Piper chaba
Daruharidra- Berberis aristata
Shalmali- Shalmalia malabarica
Lajjalu- Mimosa pudica

AYURVEDIC MEDICINES FOR IBS:

Mustakarishtha – used to treat digestive complaints like diarrhoea, indigestion, etc.
Kutajarishta – used in the treatment of diarrhoea, dysentery, IBS etc.
Pippalyasavam – used for a variety of conditions. It is used in the treatment of anemia, piles, digestive complaints, sprue, liver complaints. It is also used as a medicine to put on weight.
Dantyarishta – used in the treatment of hemorrhoids, constipation, gastric, intestine and spleen related diseases.
Dadimadyavaleha – used in treating fever with diarrhea, bleeding disorders, such as ulcerative colitis, adbominal colic.
Kutajavaleha – used in the treatment of piles,ulcerative colitis, diarrhoea, IBS, anemia, bleeding disorders, gastritis, inflammatory conditions.
Sanjeevani vati – used in Ayurvedic treatment of dyspepsia, indigestion, gastro-enteritis etc.
Kamdudha Ras – used in treating gastritis and bleeding diseases
Jeerakarishtam –used post natal care, in the treatment of frequent passing of stools, diarrhoea, indigestion etc
Bilvadi gutika – used in Ayurvedic treatment of insect bites, rodent bites, gastro enteritis etc. It is widely used in South Indian Ayruvedic practice.
Chitrakadi vati – It improves digestion power.
Brihat gangadhara choorna – It is used in the Ayurvedic treatment for Diarrhoea and gastro intestinal conditions.
Pushyanuga choorna – used in the Ayurvedic treatment of Menorrhagia, Metrorrhagia, Leucorrhoea, Menstrual disorder, Excessive menstrual bleeding of various aetiology.
Jirakadi Modak – used in treatment of diseases of digestive tract.
Bilvarishtha
Bilvasava
Takrarishtha

HOME REMEDIES FOR IBS:

1.Cumin seeds and tender leaves of Guava are taken and made into fine paste.20 gram of this is taken along with buttermilk twice daily.It helps to reduce the frequency of episodes of bowel habit.

2.The fruit cover (epicarp) of Pome granate is rubbed well with lemon juice and fine paste is made.This is taken twice daily along with warm water.This restores the capacity of small intestine.

WHOLESOME DIET AND HABITS IN IBS:

Regular intake of buttermilk
Cumin seeds
Pomegranate
Warm water
Easy-to-digest foods
Moderate exercise
Proper sleep
In many, fiber rich diet is very useful to relieve symptoms.

UNWHOLESOME DIET AND HABITS IN IBS:

Dadhi(Curd)
Madya (Alcohol)
Shukta (Acidic beverages)
Jagarana(Night awakening)
Vegadharana(Suppression of the urges)
Aniyata asana(Improper posture)
Upavasa (Fasting for longer period)
Sodas, junk foods, regular hotel foods.

Foods that cause excess gas production and bloating such as potato, egg plant, cabbage, broccoli, cauliflower

The patient is asked to prepare a list of foods that trigger an IBS attack and is asked to avoid them.

MENTAL ASPECTS TO IBS:

Usually IBS is related with psychaitric aspects. A patient with IBS usually suffers from anxiety or depression. In such a case, along with efforts to restore digestive health with the above said remedies and medicines, treatment to depression /anxiety should also be given.
Hence treatments like
Shirodhara treatment (pouring medicated liquid over forehead in a stream), Regular Pranayama, is very useful. Lifestyle adjustments such as – sleeping and waking up at regular intervals, moderate exercise, Yoga, stress management techniques are very useful.