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Causes of Irritable Bowel Syndrome.The true cause of Irritable Bowel Syndrome still remains a mystery. |
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Causes of IBS.By Dr. Phil Hariram.No one will give you a specific cause of Irritable Bowel Syndrome. but there are lots of suggestions. Some say IBS is a Motility Disorder.This suggests that Irritable Bowel Syndrome patients have an oversensitive or hyperactive gut and will react to changes influenced by stress, food and hormones. Abnormality of the electrical pattern in the gut in patients with IBS has been demonstrated. This pattern is related to the nervous system of the gut. With the typical chaotic bowel habit of Irritable Bowel Syndrome, it is not surprising that it is thought of as a motility disorder. The transit time from ingestion of food to excretion is abnormal. Sometimes it is slower than normal causing constipation and other times it is faster causing diarrhoea. Irritable Bowel Syndrome is generally divided into two groups, diarrhoea predominant or constipation predominant. Some have diarrhoea and constipation alternating. As a general rule, however, the transit time in Irritable Bowel Syndrome is unpredictable and at any time can be faster or slower, and explains why stools vary in frequency and consistency from hard pellets to watery and unformed. Some say IBS is a dietary problem. Diet and Irritable Bowel Syndrome are linked.Certain foods will trigger IBS and others seem to help. IBS ResearchUpdate.org gives a list of food triggers for Irritable Bowel Syndrome and others that are beneficial. Some items are mentioned in both lists. This is the nature of IBS. Just eating food stimulates intestinal muscle activity. This is a normal action and the most common is the Gastro colic reflex. This reflex is strongest after breakfast and as a result some people train themselves to open their bowels after breakfast, thereby freeing up the rest of the day. In IBS, large meals, fatty meals or just the wrong meal can trigger a very strong gastro colic reflex. This results in abdominal pains and or diarrhoea. There is no evidence that food is a cause of IBS but certain foods and the volume consumed at one time can trigger symptoms. One suggestion is that the fault that results in Irritable Bowel Syndrome resides in the Nervous System. The gut has a complex network of brain cells. We now know it as the Enteric Nervous System. It has more nerve cells than the Spinal Cord. This “Brain of the Gut” is connected to the Brain. Some researchers believe that to understand Irritable Bowel Syndrome, we have to understand the workings of the Enteric Nervous System. As a rule, IBS patients have abnormal REM sleep. During sleep, the electrical activity of the Enteric Nervous System (ENS) is the same as that of the Brain. This is an indication that there is a strong interconnection between the Brain and the Gut. The Gut has the richest supply of serotonin in the body. This chemical is closely connected with the nervous system. At present a lot of research is focused on gut serotonin receptors. Serotonin affects the nerves in the intestine and controls contractions of the smooth muscles of the gut. This result is peristalsis, a smooth rhythmic contraction along the gut that facilitates the movement of faecal matter along the large bowel. Low levels of serotonin will mean less peristalsis and slow transit time. This leads to constipation. When there is too much serotonin in circulation around the gut, there is increase peristalsis, and increased bowel movements. If the gut and the brain is interconnected by the Gut Brain Axis, then various factors that affect the Central Nervous System (Brain), can affect events in the gut. This includes psychological factors such as anxiety, stress and depression. In addition psychological trauma such as physical, emotional and sexual abuse can affect the gut. Statistics show that there is a greater incidence of psychological trauma and disturbances in Irritable Bowel Syndrome. It is suggested that in addition to treating the IBS, treating the other issues will give better long-term results. Studies show that one in five patients with IBS improve after having a hysterectomy. One in five also had increased symptoms and one in ten developed IBS after the operation. It seems that hysterectomy and IBS are linked but this is dubious. The gallbladder stores bile and releases it when food especially fatty food is forced into the duodenum from the stomach by the pyloric sphincter. When the gallbladder is removed, bile is no longer stored but leaks regularly into the duodenum. This can cause irritation leading to diarrhoea. Questran or Colestyramine, which is a sequestrant, can control this very well. This is not a type of IBS. Gallbladder and Irritable Bowel Syndrome are not linked. Gastroenteritis and IBS: Between 20-30% of patients who develop severe gastroenteritis will go on to develop IBS. The common infective organisms are Campylobacter jejuni, Salmonella shigella, and Escherichia coli. Gastroenteritis results in inflammation of the gut lining resulting in an overproduction of serotonin. In the thirty percent that develops IBS, the serotonin imbalance continues. Some people believe mercury poisoning can trigger IBS. Amalgam used by dentists as filling can give off a vapour, which can form mercury chloride. This can destroy gut flora and allow Candida (Yeast) to dominate. Roger Dyson claims that only some people develop sensitivity to the effects of mercury. Removing the Amalgam filling may not cure the problem and in some cases it made things worse. There is no clear evidence that Irritable Bowel Syndrome is related to this. In some women, symptoms fluctuate during the menstrual cycle. The two hormones that control the menstrual cycle are oestrogen and progesterone. These hormones can affect the colon and the passage of residue along the gut. In some women IBS is worse at certain stage of their cycle. Prof. Jonathan Brostoff of Middlesex Hospital believes that yeast is involved in some cases of IBS. These patients have reduced levels of friendly bacteria, Lactobacilli and Bifidobacteria in their large bowel. This results in overgrowth of Candida Low yeast diets have been promoted for IBS. This diet involves stopping cheese, all cheese not just blue cheese, and change bread to soda bread, scones, chapattis and any other unleavened bread. Sugar should be avoided. Avoid alcoholic drinks but spirits are distilled to a high level and have little or no yeast. Consume in moderation. If you benefit from a diet like this and your symptoms improve, you can in time gradually introduce sugar and yeast containing foods. There is no clear evidence that yeast and Irritable Bowel Syndrome are linked. Probiotics and prebiotics are now available to alter gut flora. The jury is still out on the benefits of probiotics on Irritable Bowel Syndrome. Recent research on probiotics are producing some interesting results. Hyperventilation or over breathing can cause colonic pressure and contractions in the ascending and transverse colon. Over breathers, therefore, may experience bowel symptoms especially abdominal pains. Dr. John Hunter observed that quarter of the patients he saw at his clinic with suspected IBS were suffering from hyperventilation. Dr. Phil Hariram. Retired GP. Treated IBS patients for 27 years with support, drugs, hypnotherapy, alternative medication and acupuncture.
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Irritable Bowel Syndrome(IBS).