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ABCs of IBS
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New insights may help solve the mysteries of this malady
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By Jane Wise
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REMEDY Summer 2006
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Irritable bowel syndrome (IBS) is a sometimes painful, always uncomfortable condition characterized by intestinal cramping, diarrhea, constipation, gas and bloating. Extreme sensitivity in the colon or large intestine is thought to be the cause. But the reason for oversensitivity is not clear. What’s clear is that IBS affects 10 to 20 percent of the population and is the disease most commonly diagnosed by gastroenterologists. The best way to determine if you have IBS is to go to your doctor; often this condition can be effectively treated.
IBS may be related to a lack of bile—a liquid released by the liver into the small intestine that promotes absorption of nutrients and protects against harmful bacteria.
A team of researchers at UT Southwestern Medical Center in Dallas have been looking closely at a receptor that, when turned on, helps protect the lining of the intestine from infectious bacteria. In cases where this receptor, called FXR, is activated by binding with bile, the lining of the intestines retains its full function. When there is an absence of bile and FXR is not activated, the lining of the intestine is compromised and overgrowth of bacteria and infection can result. “Since bacterial overgrowth is found in many IBS patients, drugs that activate FXR could be useful in treating the disease,” explains Steven Kliewer, Ph.D., professor of molecular biology and lead researcher on the team. Will this help cure IBS? “Since we did not test FXR activation in an IBS model, this is speculation,” says Kliewer. “More studies are needed.”
What we do know about IBS People with IBS have more sensitive pain receptors in their GI tract; symptoms can cause depression and anxiety; being depressed and anxious can worsen symptoms. “Sometimes the colon may be sensitized by an infection, and then it overreacts to physical or emotional stress, altering intestinal chemicals controlling pain perception and motility,” says Douglas A. Drossman, M.D., codirector of the Center for Functional GI & Motility Disorders at the University of North Carolina. Dr. Drossman and his colleagues have also shown that “IBS can be controlled 70 percent of the time through psychological treatments such as cognitive behavioral therapy or antidepressants.”
Lifestyle changes are an important part of treatment for IBS. “First we have to understand what causes flare-ups and stress,” says Dr. Drossman. “After that, the first step in IBS treatment is to make changes in lifestyle, stress response and diet.”
Foods that may worsen IBS symptoms include:
• Carbonated drinks
• Caffeine
• Fatty foods
• Milk products
• Alcohol
How you can reduce constipation:
• Eat vegetables, fruits, whole-grain breads, cereals.
• Drink lots of water.
• Eat smaller meals more often.
• Keeping track of foods that cause symptoms can help you develop a diet plan.
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