Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is somewhat of a mystery in the conventional gastroenterology model. There is a clear link to mental stress, sexual abuse, and depression. There is an association with previous acute infections or “food poisoning.” There seems to be some association with food sensitivities and Celiac disease. IBS can be constipation predominant, diarrhea predominant, or mixed. There is no wonder why it is so poorly understood. It seems to be a combination of many symptoms and causes in one disorder. To top it off, treatment options are typically ineffective and patients return again and again frustrated.
In the Western medical model, illness is diagnosed based on a pattern of symptomatology and diagnostic tests. This is not an accurate representation of the disease process. IBS does not appear to be a uniform. There many potential causes and manifestations. It can be caused by dysbiosis (abnormal bacterial population in the gut) from previous infections, antibiotics, medications, emotional stress, and improper diet. Intestinal permeability may be involved. The individual specifics need to be addressed. The mainstay of care is laxatives, fiber supplements, antispasmodics and anti-diarrheal medications. These are frequently ineffective at even treating the symptoms.
In order to get to the source of the problem, the associated dysbiosis and intestinal permeability need to be corrected. This can be done with dietary modification, supplementation with quality nutritional supplements, and management of emotional stress. One aspect of IBS is a visceral hypersensitivity. In essence in IBS, the gut is more sensitive and normal function is perceived as pain. Studies in both Osteopathic and Gastroenterology journals have suggested that manipulative medicine and in particular visceral manipulation can improve the pain, distension, and the bowel function associated with IBS.(1,2) Visceral manipulation is a gentle manipulative therapy which corrects the mobility of the structure. Improved mobility is associated with improved function.
Diet is a very important factor and is frequently overlooked in the conventional model. IBS is associated with food sensitivities and often foods can be a trigger for symptoms. The low FODMAP diet with a reduction of short chain carbohydrates (FODMAP’s) has been studied and is effective in some patients. A food elimination diet based on IgG antibodies has been shown to decrease symptoms as well.
IBS is a complex of several dysfunctions which manifest in different ways. The conventional treatment is frequently ineffective an individualized approach is often needed.
- Hundscheid HW, Pepels MJ, Engels LG, Loffeld RJ. Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study. J Gastroenterol Hepatol. 2007;22(9):1394-1398.
- Effinger, MA., Halbeisen A., G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS. The Journal of the American Osteopathic Association, May 2014, Vol. 114, 408-409. doi:10.7556/jaoa.2014.079