Irritable Bowel Syndrome (IBS), When the Mind-Body Connection Short Circuits

So many diseases and conditions in America are automatically treated with a prescription pad. But what if pills won’t help?

“The mind and the body are linked, physically, neurologically, as well as emotionally, and that things that affect the mind can affect the gut and vice versa. If you do something to alleviate mind stressors, you can improve body functions.”

Truer words have not been spoken, by Dr. Arnold Wald in a recent Reuters Health article on the mind-body connection and Irritable Bowel Syndrome (IBS). IBS is characterized by abdominal pain and constipation, diarrhea, or both. The abdominal pain is typically due to gas and bloating. While the cause is unknown, many factors appear to play a role in the development and treatment of IBS.

• Infection. The risk of developing IBS is elevated after a bacterial, protozoan, helminth, or viral gastrointestinal infection, including travelers diarrhea.
• Inflammation. The immune system is activated in some IBS patients, particularly those with diarrhea (though inflammatory blood markers will appear normal). Increased intestinal permeability may also be present.
• Gut flora. Emerging data suggest that the microbiota of those with IBS differs from healthy individuals and varies with the predominant symptom (constipation versus diarrhea). Gut flora is often disrupted after taking antibiotics, especially repeatedly.
• Food sensitivities. Some IBS sufferers have sensitivities to carbohydrates (like FODMAPs), fructose, gluten, and/or dairy.
• Genetics. There may be gene polymorphisms that increase the risk of IBS. One study on twins did indicate that familial nature of IBS may be due to social learning as well as genetics.
• Stress and mental health. Patients with IBS symptoms report more stress in life and day to day. They tend to have more anxiety, depression, phobias, somatization, and sleep problems. This isn’t surprising, as 90% of the neurotransmitters in the body are located in the intestinal nervous system. A problem in the mind can transmit to a problem in the gut, and vice versa.

Because of the many contributory elements to IBS, treatment is a multi-faceted approach. Because it is likely unclear what is causing your IBS, it is best to treat each possibility, one at at time. A first line of treatment will consist of dietary modifications like eliminating lactose, starting a no-FODMAPs diet, very low carb diet, or gluten free diet.

Diet and Supplements. An evolutionary, or “Paleo” diet plan combines several of these approaches and can be easier to implement. Fiber, probiotics, or anti-inflammatory supplements may be a next step if symptoms continue.

Mind-Body Medicine. Because of the apparent mind-body connection with IBS, psychotherapy may be very helpful in alleviating symptoms. A randomized controlled trial of 431 adults showed that cognitive-behavioral therapy (CBT) was effective at treating severe IBS, and probably more effective than medication. Other studied mind-body techniques include meditation and acupuncture. Medications can be effective, but the best long-term strategy often involves a multi-modal approach.

Physical activity is another natural option that may help alleviate stress and improve gut comfort and motility.

With so many options for treatment, it is important to try one thing at a time to see what helps your symptoms and what does not. Tracking the symptoms and changes is important for differentiating between what works and what doesn’t. Medically-supervised self tracking, using our model of a Quant Coach and Quant-Friendly Doctor, can guide you in your experiments and ensure that they are done in the most efficient and safe manner, as well as provide support on your journey, and keep an eye on your medical status.