Chances are you or someone you know suffers from IBS. Symptoms range in severity from mild to debilitating and include digestive discomfort, excessive flatulence (gas), bloating, constipation or diarrhoea, or alternation between the two[1]. These symptoms can be associated with three underlying factors: gut inflammation, an imbalance in the number of ‘good’ and ‘bad’ gut bacteria and stress.
Understanding the Role of Gut Inflammation
You may be familiar with other forms of inflammation, such as the heat, swelling and pain of a sprained ankle. Regardless of where in the body it occurs, the role of inflammation is to alert the immune system to the presence of damage or infection, allowing healing to begin. This is the same whether the inflammation occurs in a sprained ankle, or in your gut. When inflammation in the gut is severe (e.g. a bad bout of food poisoning), or perpetual (e.g. regularly consuming gluten when you’re intolerant to it), inflammation can become chronic and damage the cells lining the gut. This may inhibit nutrient absorption and disturb the balance of gut bacteria.
Good Bugs Vs Bad Bugs
A healthy gut is teeming with beneficial bacteria which ferment dietary fibre and produce compounds that feed our gut cells and support overall health. However, when chronic inflammation damages intestinal cells, beneficial bacterial species are lost, creating an environment where ‘bad’ bacteria can flourish. Having less ‘good’ bacteria and more ‘bad’ bacteria represents a dysfunctional imbalance that causes excessive bloating and gas due to the over-fermentation of fibre. In other words, when the balance swings in favour of ‘bad’ bacteria, symptoms arise.
Let’s Talk About Stress, Baby
Stress exacerbates gut symptoms. Why? Because of the two-way, biochemical connection between the central nervous system and the gut, known as the brain-gut axis, which is responsible for the ‘butterflies’ and nervous bowel associated with stress.
One way stress aggravates IBS is by boosting pain sensitivity. The enteric nervous system (the gut’s dedicated nervous system) normally perceives and transmits pain signals from, for example, gut inflammation, or pressure from excessive gas, and these signals are amplified by stress. Research indicates that people with a heightened stress response are more likely to experience IBS,[2] indicating that your response to stress can affect your symptoms.
Research indicates that people with a heightened stress response are more likely to experience IBS,[2] indicating that your response to stress can affect your symptoms.
Time to Take Action
Now we know what drives IBS symptoms, here are my top strategies for tackling this condition.
Tip #1: Start with a strain-specific probiotic
Research indicates that specific probiotic strains can rapidly reduce and manage IBS symptoms. One strain, Lactobacillus plantarum 299v, has been shown to provide relief in under two weeks,[3] specifically:
51.9% reduction in pain frequency;
45% decrease in pain severity;
60% reduction in bloating occurrence;
50% decrease in bloating severity; and
An increased sense of ‘complete evacuation’ (the feeling of fully emptying your bowel[4]
Beyond this, Lactobacillus plantarum 299v has been shown to reduce gut inflammation[5] and ‘bad’ bacteria,[6] addressing two drivers of IBS. These effects are specific to the 299v strain at a dose of 20 billion bacterial units, the dose and strain used in clinical trials.
Tip #2: Familiarise yourself with a low FODMAP diet
Certain types of dietary fibre may stimulate excessive fermentation by gut bacteria, aggravating symptoms; this includes FODMAPs. FODMAP stands for fermentable oligosaccharides (such as fructans found in wheat, garlic and onions), disaccharides (such as lactose found in milk), monosaccharides (such as fructose found in fruit juice) and polyols (such as sorbitol found in prunes), which are all types of fibre that gut bacteria ferment naturally. These fibres normally feed beneficial bacteria, supporting a healthy intestinal environment and bulking up the stool.
However, in IBS, FODMAP-containing foods are over-fermented by ‘bad’ gut bacteria, resulting in excessive gas production and pain. Limiting high FODMAP foods can help identify your food triggers; however, restricting any food group should always be a short-term strategy. A high intake of diverse fibre types is critical for health, and therefore FODMAP elimination should always be professionally supervised by a healthcare Practitioner.
Tip #3: Beat stress before it beats you
How do you beat stress? First, identify the sources of stress in your life and then seek solutions to help minimise stress and improve your resilience. If you are feeling tense, take a moment to acknowledge that, and see if you can visualise a knotted ball gently unravelling within your gut. Techniques such as this example can help to break the cycle of stress that aggravates IBS symptoms.
Beyond this, natural medicine offers a range of effective solutions to build resilience. These include supporting sleep, enhancing nutritional status, and soothing the nervous system with herbal medicines and mindfulness.
Take Control of Your IBS
If you or someone you know suffers from IBS, being equipped with the right knowledge and tools can significantly improve your IBS symptoms, helping you step into better health. For
more personalised guidance on how you can take control of your IBS, book an appointment with Power by Nutrition today.
[1] Ng KS, Nassar N, Hamd K, Nagarajah A, Gladman MA. Prevalence of functional bowel disorders and faecal incontinence: an Australian primary care survey. Colorectal Dis. 2015 Feb;17(2):150-9. doi: 10.1111/codi.12808.
[2] Mykletun A, Jacka F, Williams L, Pasco J, Henry M, Nicholson GC, et al. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC Gastroenterol. 2010 Aug 5;10:88. doi: 10.1186/1471-230X-10-88.
[3] Ducrotté P, Sawant P, Jayanthi V. Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World J Gastroenterol. 2012 Aug 14;18(30):4012-8. doi: 10.3748/wjg.v18.i30.4012.
[4] Ducrotté P, Sawant P, Jayanthi V. Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World J Gastroenterol. 2012 Aug 14;18(30):4012-8. doi: 10.3748/wjg.v18.i30.4012.
[5] Seddik HA, Bendali F, Gancel F, Fliss I, Spano G, Drider D. Lactobacillus plantarum and its probiotic and food potentialities. Probiotics Antimicrob Proteins. 2017 Jun;9(2):111-122. doi: 10.1007/s12602-017-9264-z.
[6] Kujawa-Szewieczek A, Adamczak M, Kwiecień K, Dudzicz S, Gazda M, Więcek A. The effect of Lactobacillus plantarum 299v on the incidence of Clostridium difficile infection in high risk patients treated with antibiotics. Nutrients. 2015;7(12):10179-88. doi:10.3390/nu7125526.