What is IBS?

Understanding Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) or spastic colon is a bowel disorder characterized by diarrhea, constipation, gas, bloating and chronic abdominal pain. It is fairly common and makes up 20-50% of visits to gastroenterologists. Although formal diagnosis depends on a very specific set of symptoms, the range of symptoms that occur in patients diagnosed with IBS is fairly wide.

The cause of IBS varies from person to person, which is what makes irritable bowel syndrome and its symptoms so difficult for most doctors to treat. However, through proper testing it is possible to identify the exact cause or causes of the symptoms and live a life free of digestive problems.

There are several hundred potential causes of IBS, but they can be broken down into two major categories:
Food Allergies and Intolerances; and Intestinal Microorganisms and Parasites.

Food Allergies

Most people with IBS are suffering at least in part because of an allergic reaction to one or more foods. This often surprises people, who don't believe that they have allergies. This is because they have friends whose allergy symptoms are different, or they think that food allergies result in hives, a rash, or some kind of medical emergency.

But even for those who have already had food allergy testing, chances are it wasn't very helpful. This is because the majority of food allergy testing is only designed to measure allergies that produce skin rashes. The skin prick testing that is standard practice does demonstrate whether or not the patient will have a rash in reaction to exposure to the allergens used. However it doesn't and can't measure other types of immune system responses or immune system activities that involve certain types of antibodies.

People often have a tough time believing that they may have a food allergy because they've eaten the "offending" foods before, some every day, and have not suffered from consistently severe symptoms. Maybe they've had just a little diarrhea or constipation once in a while, until suddenly it gets worse or new symptoms develop. Symptoms of food allergies, including IBS symptoms, can show up at any age, from birth to old age. The challenge in discovering the food allergy is in getting the proper testing done and in getting the proper education about where the offending foods are hidden in your diet. Most clinics offer neither, even those that supposedly focus on allergies.

The immune system functions like a sentinel standing guard against foreign invaders. In the case of an allergy, the invaders are called allergens. The primary weapon that it uses against invaders is the production of antibodies. The antibodies cause reactions that result in the offending allergens being removed from the body. In many people, foods act as allergens rather than nutrition. This can result in the symptoms of IBS.

The immune system produces numerous kinds of antibodies, called immunoglobulins. IgE and IgG are acronyms for two of the different kinds of antibodies produced by the immune system in allergic reactions to food. These types of reactions typically occur immediately after contact with or ingestion of the allergen, and in some cases can cause serious, even fatal, health problems. Potential IgE reactions include swelling of the lips and tongue, hives, bloating, abdominal pain, or sudden diarrhea. These are the reactions that people usually think of when they hear the word allergy. However, IgE reactions can also lead to many other symptoms not traditionally recognized as being caused by food allergies.

The problem with this type of testing is that most food allergies are not IgE reactions, but are rather IgG reactions, which usually show up hours or even days after ingestion of the allergen. They are generally not nearly as dramatic as the more severe IgE reactions, and usually result in "mere" constipation, diarrhea, bloating, gas and abdominal pain. Both antibodies are important, and food allergy testing should include both or the cause of IBS may be missed.

For more information about Food Allergies, check out our page about food allergies.

Intestinal Microorganisms and Parasites

Our intestines are a rich and thriving ecosystem, when we are healthy. The massive surface of our intestines (about the same as a tennis court) provides everything needed for life - space, moisture, and nutrients. Given the ubiquity of anti-bacterial products in our society, many people are surprised to learn that they have about 10 trillion bacteria living in their intestines. But not only do we have bacteria lining our digestive tract, we desperately need them.

There are basically three types of micro-organisms living in our intestines: Good bacteria; Bad bacteria/microorganisms; and Disease organisms.

The good bacteria include species and strains that we evolved with, like acidopholus and bifidobacterium. These are an essential part of our digestive systems and we would not survive without them. They help us to digest food by producing enzymes, manufacture some of the essential nutrients that we need to live, assist in the development of our immune system, and prevent infection by occupying the space in the intestines that unwelcome organisms would thrive in, if they could.

The bad bacteria and microorganisms include many species and strains that don't symbiotically help us, but rather upset the balance. These can include bacteria that crowd out the species we need or other organisms like yeast. While some bad bacteria and yeast are often present in small numbers in healthy people, excessive yeast growth can upset the balance and trigger all kinds of effects. Since the advent of medical antibiotics it is quite common for people to use wide-spectrum anti-biotics and unwittingly kill off the bacteria they need, allowing bad microorganisms to 'claim more turf' and upset the balance.

Finally, disease organisms like salmonella, Heliobacter pylori, even certain strains of E. coli can infect the intestine and lead to IBS symptoms or worse. Parasites like Giardia, Cryptosporidium, even worms, can be contracted through contact with pets, infected persons, or contaminated food or water. These can cause a whole host of symptoms, but may only be evident from the symptoms that define IBS - altered stool habits and abdominal pain or discomfort. In some cases these disease organisms can be eradicated by your own immune system, but often they need to be treated.

IBS can be caused by these and other health conditions. In order to identify and treat the cause of the symptoms it is necessary to consult with a physician familiar with all the causes and testing. For more information on testing visit the website of our partner the IBS Treatment Center.

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