5 Simple Steps to Cure IBS without DrugsPosted on August 26th, 2009 |
Categories: Supplements | Nutrition | Irritable Bowel Syndrome | Health | Digestive Problems
Imagine having a condition with symptoms so severe that you can't leave the house, yet your doctor calls it a "functional," or "psychosomatic," disease -- meaning that it's all in your head.
Frustrating? Absolutely.
But it's a very real problem for the 60 million people -- that's 20 percent of Americans -- who have irritable bowel syndrome (IBS). These people are plagued by uncomfortable and often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain.
I have lots of patients with IBS, some of whom have suffered for decades without relief. Their previous doctors couldn't find the cause of the illness, so they were told to just get more fiber or take Metamucil, or were prescribed sedatives, anti-spasm drugs, or antidepressants.
That is NOT the answer. I've found a better way. And in today’s blog I am going to share 5 steps you can take right now to cure IBS without drugs.
But first I want to tell you about a patient of mine ...
Alexis and Her Lifelong Irritable Bowel
At age 45, Alexis had suffered from IBS for 33 years -- almost all of her life! Her major symptom was sudden, painful, cramping diarrhea. She was doing the best she could to prevent it. She didn't consume dairy, didn't drink or smoke, and took Citracel every day. Yet nothing helped.
She would go to the bathroom 4 to 5 times before she even left the house in the morning. And she couldn't go out of the house at all without knowing where all the closest bathrooms would be in case she had what she called "s--- attacks."
That wasn't Alexis' only problem ... She also felt full and bloated after every meal, which starchy foods made worse.
An upper endoscopy had shown that she had gastritis, or inflammation of the stomach, and she had taken many antibiotics over the years. She also had severe premenstrual syndrome (PMS), with irregular periods, breast tenderness, sugar cravings, headaches, and agitation.
She also had unusual symptoms like rectal itching (often a clue to yeast infections or food allergies). And she was tired all the time.
Alexis tried to eat healthy, but her diet was less than ideal. She had a bran muffin and coffee in the morning and a salad for lunch. But her "drug of choice" was sugar -- in the form of cakes, ice cream, Jell-O, diet sodas, and other junk food. Not surprisingly, she was also about 20 pounds overweight.
To help Alexis, all I really did was identify and treat the UNDERLYING CAUSES of her digestive problems! To understand how I did that, you first have to understand a little bit about how the gut works.
How Gut Imbalances Can Lead to IBS
Imagine a tennis court. That is the surface area of your small intestine, where food is absorbed. Your small intestine is also the site of about 60 percent of your immune system. And this sophisticated system gut-immune system is just one-cell layer away from a toxic sewer -- all of the bacteria in your gut.
If that lining breaks down -- from stress, too many antibiotics or anti-inflammatory drugs, intestinal infections, a low-fiber, high-sugar diet, alcohol, and more -- look out! Your immune system will suffer and you can develop all sorts of digestive problems -- including IBS.
Let's talk a little more about all that bacteria. You've got about 3 pounds of it -- 500 species -- in your gut. In fact, there is more bacterial DNA in your body than there is human DNA! Among all that gut bacteria, there are good guys, bad guys, and VERY bad guys.
If the bad guys take over -- or if they move into areas that they shouldn't (like the small intestine which is normally sterile) -- they can start fermenting the food you digest, particularly sugar or starchy foods.
This is called small bowel bacterial overgrowth -- and it's a major cause of IBS.
The major symptom it causes is bloating, or a feeling of fullness after meals. What causes this bloating? The overproduction of gas by the bacteria as they have lunch on your lunch!
Small bowel bacterial overgrowth can be diagnosed by a breath test, which measures gas production by the bacteria, or by a urine test that measures the byproducts of the bacteria after they are absorbed into your system.
Bacterial overgrowth is a real syndrome and was recently described in a review paper published in the Journal of the American Medical Association. The condition can be treated. In fact, a major paper was recently published in the Annals of Internal Medicine that showed using a non-absorbed antibiotic called rifaximin for 10 days resulted in a dramatic improvement in bloating and overall symptoms of IBS by clearing out the overgrowth of bacteria.
That's great news for many IBS patients. But, unfortunately, not all patients with the same diagnosis are created equal. There's more than one factor that leads to IBS. Another major cause of IBS is food sensitivities.
A landmark paper, was recently published in the prestigious British medical journal Gut that found eliminating foods identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms. Another article, an editorial in the American Journal of Gastroenterology, stated clearly that we must respect and recognize the role of food allergies and inflammation in IBS.
So the research tells us that these are the two main causes of irritable bowel -- food allergies and overgrowth of bacteria in the small intestine -- but there may be others, including a lack of digestive enzymes, parasites living in the gut, zinc or magnesium deficiency, and more.
And this is precisely why it is so critically important to personalize treatment based on the unique circumstances that exist for each person who suffers from IBS -- the solution is most certainly not a one-size-fits-all one. But solutions can be found if we look carefully at the underlying causes and treat them.
Which leads me back to Alexis ...
How I Helped Alexis Heal from IBS
I prescribed Alexis a non-absorbed antibiotic, an antifungal drug for her yeast problem, and had her eliminate the foods to which she was allergic. I believe in treatment that addresses the underlying cause of the problem. If there is a bacterial or yeast infection, then medications are often the best treatments. The key is to effectively treat the cause. If medications do that, then I use them.
Then I gave her supplements of healthy bacteria to normalize her gut and zinc to help with her digestive enzymes (chronic diarrhea can result in zinc deficiency).
I also gave her extra fiber to feed the healthy bacteria, fish oil to reduce gut inflammation, a multivitamin, and herbs to balance her hormones (which are greatly affected by abnormal bacteria).
What happened then may shock some, but I wasn’t surprised. It is the same result I have seen in patient after patient when the principles of functional medicine are applied ...
Alexis came back to see me two months later, and she was a different person. Not only did she lose 20 pounds, she had not had a "s---- attack" and was having normal bowel habits for the first time in 33 years! She also had more energy, and her PMS vanished.
She looked and felt 10 years younger and was free of the suffering she had endured for over three decades.
Do you suffer like Alexis did? It doesn't have to be that way. We have the understanding and tools to deal with this chronic problem and the suffering it causes one in five people. There is no need to wait for any more studies. I have been treating IBS in my practice for over 10 years with dramatic success.
In fact, just recently, one of my patients told me that, for the first time in his life, he didn't have any more stomach pains or digestive problems. He had previously been so bad that he had to have a phone installed in his bathroom!
To take advantage of these discoveries today, simply follow these five steps.
5 Steps to Curing IBS
2. Test yourself. If you can't afford the test mentioned above, then just eliminate the most common food allergens for 12 weeks -- that's dairy, gluten, yeast, eggs, corn, soy, and peanuts. And then reintroduce them to see if they cause symptoms. This is an effective way to isolate the foods that may be causing you problems.
3. Get rid of the unwanted visitors in your small bowel. Ask your doctor to prescribe rifaximin (Xifaxin) and take two 200 mg tablets 3 times a day for 7 to 10 days. This is often the best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome.
4. Repopulate your digestive tract with good bacteria. I don't usually recommend brands, but when it comes to probiotics the quality varies so much that I suggest taking two specific brands. Take one packet of VSL3 or other high potency probiotic twice a day for 1 to 2 months. This probiotic has over 450 billion organisms per packet. I also recommend a probiotic called S. boulardii take two capsules twice a day for 2 months. This is a special probiotic that helps to further normalize gut function.
5. Read more about the condition and your options. My favorite book on this subject is Digestive Wellness by Elizabeth Lipski.
By taking these steps and seeking out the underlying causes of IBS, you can dramatically improve your health and overcome your digestive disorder.
Now I'd like to hear from you...
Do you have IBS? How long have you had it and how has it been treated?
Have you noticed whether stress, certain foods, or other factors affect your symptoms and how?
Have you tried any of the recommendations in this blog? How have they helped?
Do you have any other suggestion for successfully treating IBS?
Please let me know your thoughts by adding a comment below.
To your good health,
Mark Hyman, M.D.
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19 year old female, IBS sufferer
Hello Dr. Hyman,
I really need your help/advice. I've suffered from stomach issues my entire life. I can remember being 5 years old, hiding under my mom's desk in the fetal position because my stomach hurt so bad. When I was 16 and going through a stressful time (finals at school), I had to go to the emergency room for the pain because it got so bad. The doctor told me I had IBS and prescribed me donnatal. It worked well, for the most part, but I am in a horrible situation as of late. I need this medication to function (not even 100 percent, just to function well enough to do the simple, normal, every day tasks), but I lost my health insurance. I can't get a job because the pain is too bad, but without a job I can't get insurance. But the worst part is, my main symptom is horrible cramping spasms. I can't even sit down because I get shooting pains in my pelvic area, and even my behind. I am overweight, but can't exercise properly because it irritates my stomach problems, even though I desperately want to get healthy. I try to eat healthy, but my stomach reacts badly to so many foods, I get so frustrated with food that I just give up most of the time. I can't even go to school or drive because sitting causes me so much pain, but I have to ration my medicine or use some of my dad's pain medication (hydrocodone), because the worst pain is right before/during my period. It's the worst pain I've ever felt, definitely a 10 out of 10 on the pain scale. I can't move, I can barely breathe the few days before my period, and the first few days during. I have to take hot baths to calm myself, because I know stressing about it makes it worse... but I can't help but stress when I'm running low on medicine. I don't know what I'll do when I finally run out, because every time I have an attack I feel like I should be in the hospital, but I can't afford it. I'm at the end of my rope with this syndrome, disease, whatever it is. I don't know what to do anymore. I'm only 19 and I feel like my life has been hijacked, and I don't want to live like this anymore. If there is any advice or help you can give me, I would very much appreciate it.
Thank you for your time,
Robyn
Relaxation technique
Robyn,
I read your post after I had made my own, and I remembered when my pain approached the intensity of yours. It must be dreadful for you. I used alot of breathing techniques to try to quell the stress that would lead to the painful cramps. You probably know about how your bowels stop moving with stress and then start moving (with organization) as you begin to relax. Well, the bottom line is that I found a product called RESPeRATE that made all the difference for me.
It is a product designed (and proven) to decrease blood pressure by teaching you how to use your particular breathing patterns. I originally purchased them for several of my clients and then decided to try one myself. It was great... I learned how to use my breathing BEFORE my bowels "locked up" from the stress. I was able to manage most all stressful situations and get back to work myself.
It is worth the investment. Check it out at www.resperate.com
After learning how to use my breath effectively, I started doing 10 minute meditations that seem to help "bleed off" the stress of the day and prevent the cramps.
Good luck,
s.
EFFECT ON CROHN'S?
Somebody I love has Crohn disease, has had several feet of small intestine removed. I worry about her reduced ability to absorb nutrients. I'm tempted to forward this article, but don't want to bother her with irrelevant information. Would this regime help someone with Crohn disease or not? Thanks.
One of my friends has Chron
One of my friends has Chron disease and follows a similar regime. The problem is that she had drugs problem and she's been in an Addiction Treatment for a couple of months and now she can't stand pills of any kind.
removing bad bugs
My food allergy test showed high reactions to gluten grains, eggs, and dairy. Other tests showed increased intestinal permeability, malabsorption, h. pylori bacteria and blastocystis. I've been cleared of Celiac and IBD by biopsies. Elimination of above foods several months ago largely eliminated IBS symptoms, but joint & muscle pain, severe fatigue, and susceptibility to infection all continues. Could the blastocystis be contributing (my doctor says it’s “normal” to have this parasite)?
Things that have helped my gut
Since I did not do well on cow's milk as a young child, my parents bought two milk goats, and I grew up on goat's milk. As a teenager and adult, I drank cow's milk as goat's milk was not available. Several years ago, when having more trouble than usual with my GI tract, I decided to try goat's milk exclusively for a month. Many of the problems vanished! I get my goat's milk from Whold Foods, which fortunately has a store near us. I also buy powdered goat's milk from Amazon.com to carry with me on trips.
I used to have frequent vaginal yeast infections. When I started eating yogurt several times a week, I stopped having them. It also seems to prevent constipation and some other intestinal problems. When I take an antibiotic for some infection, I make sure to eat yogurt to replace the good bacteria that may be lost.
IBS
My symptoms of IBS started my first year of college with severe cramps and bloating. Until I was 39 y.o. I fluctuated between constipation and occasional diarrhea. With my first pregnancy at 39 y.o. I was hospitalized when my water broke at 35 weeks. I was treated with IV antibiotics and IV steroids for a week, until labor was induced at 36 weeks. The day after I delivered by beautiful boy I started having diarrhea, and it hasn't stopped for over 7 years now. I battle fatique regularly and have tried so many different treatments that it makes my head spin. I recently did some food allergy testing, though I think it was IgA rather than IgG that they used. I am allergic to casein, soy, eggs, and borderline on gluten.
I have been trying to avoid all of these, and I confess that I have found that very difficult to do 100%. Your article, however, gives me renewed incentive to get clean of all of the allergens.
My sugar cravings have increased more and more over the years, and I can tell that I have considerable yeast overgrowth. I am planning to contact my GI doc for the ab prescription that you recommended, and I will also ask him for an anti-fungal since my sx are so profound.
Do the food allergies/sensitivities abate over time away from them, or are people rarely able to go back to eating something (like soy or dairy) once they've developed the allergy?
I hope to report back some great news in a few months.
This has been my 2009
wow I wish I had read your list back in April!
I got violently ill with IBS this spring after using the antibiotic Levaquin 750 twice in a 4-month period for sinus infections. I tried many alternative remedies (potato water, enteric coated peppermint) but it was ultimately many tests by a gastroenterologist and using Xifaxin that brought me some peace. I also discovered a very good pre/probiotic that seemed to provide comfort immediately: Dr. Ohhira's Probitiocs Plus. I plan to continue on the probiotic and eat a low-inflammatory-low gluten diet to try to keep the bad bugs away. The gastroenterologist said that the bad bacteria overgrowth can return in 3-4 months.
I also intend to educate my allergist on what that antibiotic did to my system. When I complained to him about my IBS he offered me antidepressants, which I declined.
Hi Dr. Hyman,
Hi Dr. Hyman,
My husband, Doug suffers from a rare disease called Myotonic Muscular Dystrophy. He was diognosed 6 years ago. His muscles are deteriorating and he is losing the ability to move his hands. Functional medicine has nothing for him but a pace maker, which we're unsure he needed.
I believe the problem started in childhood when he came down with Meningitis and of course had extensive antibiotic treatment. He has had diarrhea his entire life and I now wonder if he is really dying from IBS? i would appreciate your comments. Thank-you Emily
post infectious IBS
I am curious if there are others who developed acute onset IBS---abdominal pain, nausea, diarrhea and vomiting. This was diagnosed in my 20 year old daughter after she had w/o for colitis and crohn's disease. She has lost 20 pounds (in first month) never regained the weight, has persistant nausea for which she takes 24 mg of Zofran a day!, xanax for a new anxiety, and hasnt had a menses in 8 months (no body fat stores). She eats 6 foods only--- cheerios, oatmeal, turkey breast, peppermint tea,bread,and the inside of a baked potatoe. She has been on antibiotics, 2 courses and the antibiotic you speak of "good antibiotic" without improvement. She is depressed and still gets intermittent diarrhea and crampy lower abdominal pain. She has become afraid to eat anything other then those few foods in hopes of avoiding any pain or diarrhea. Do you have any recommendations? Do you see patients?
Diarrhea
Hi,
From past 2 years I was having diarrhea after eating spicy or fried foods. I never observed my body & never thought seriousness about it.As it was happning not everyday. But last 6 months I started paying attension. I stopped eating very spicy food .
I drank pomegranate juice every morning for one week, which helped me control diarrhea. You can eat fresh pomegranate also.
I eat everyday in equal proportion of cumin seed,coriander seed & fennel seed powder like 1 tea spoon all together & add pinch of sugar.
Also, take cabbage,carrot,spinach blend & make a soup or juice. It will help your stomuch & digest easily.
Take care
After few
I have been having
I have been having digestive track issues for more than a year. I have following symptoms:
1. Burning in the tip of the penis (usually starts after urination and stops after some time)
2. Burning in the rectum
3. Fatigue in the legs (muscle pain/fatigue), some times weakness in the hands, and pain in the backbone area
4. Low pain in the lower right abdomen (this pain comes and goes , it is not constant)
5. Heartburn (Acid reflux)
6. Pain/burning in the left groin area (this also comes and goes)
7. Bowel movements 1-2 times a day. When it is twice, it usually is before and after breakfast.
8. Stool color - Greenish. Used to be consistent, now it is sometimes. Since taking the naturopathy medicines.
9. I have lost some weight..I was in upper 160 (pounds), now my weight has come down to 152 lbs
I have gone through endoscopy, colonoscopy, and CT scan. I started seeing a local naturopathy doctor. He recommeded a comprehensive stool test and based on the stool test results, he prescribed following herbal supplements that I have been taking for more than a month now:
1. DGL plus - 3 times a day
2. Caprylic acid - 2 before each meal, 3 times a day, 5 days a week
3. GI Fortify – 1 scoop a day for healthy fiber
4. Entrocap – 1 capsule, 3 times a day, 5 days a week
5. L-Glutamine – 1 capsule, 3 times a day to rebuild intestinal lining
I have also been taking 2 probiotic tablets a day.I have also been taking vitamin D supplement for last three weeks (1 tab a week) after my blood test found really low vitamin d levels.
I really need to diagnose my situation. This is really affecting my work. Every one i know tells me how thin I have become. My apetite is good, but i have been slowly losing weight through this year, it looks like it accelerated in last few weeks.
Dr. Hyman, I need your help.
ibs and ileocecal valve dysfunction
Hi
I have had ibs for 20+ years. It was treated (untreated actually) with high fiber diets and bulk laxatives. Ironically, i have a gluten intolerance and so the "cure" became the cause of more suffering. I accidentally discovered this gluten problem while trying to change my diet for a bout with severe reactive arthritis from salmonella poisoning. I went from severe impacting constipation to normal bowel function.
It was hard to make the lifestyle change but well worth it.
I notice that certain foods do make it worse but i suspect that i have "ileo-cecal valve dysfunction" and know how to avoid that discomfort. are they related? what is the best tx for icv dysfuntion? do i need to find a functional chiropractor?
what was once thought to be an inguinal hernia is now this valve problem. it is so hard to find info on it and you haven't mentioned it in your book "ultra mind solution" and your program at kirpalu this summer. by the way, we did some abdominal massage techniques and asanas to help bowel function that worked well. i want to mention that my depression and anxiety got soooo much better when i got rid of the gluten from my foods. your book is right on and i can relate wholeheartedly to all of that. now if i can just totally cure my gut, i will be even better. i have felt so much better =no more crushing fatigue and less mental fog. thanks for writing the book. any info is greatly appreciated.
pb
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