Irritable Bowel Syndrome

 IRRITABLE BOWEL SYNDROME

What is IBS?
Almost everyone has had constipation and diarrhea at one time or another. But many people have “Irritable bowel syndrome” which includes both diarrhea and constipation. They are caused by two entirely different mechanisms. Bowels habit is disturbed by diarrhea or constipation, occurring alone or alternating. Some forms of this IBS have in the past been called spastic colon and idiopathic or nervous diarrhea. Constipation occurs from a sluggish contraction of the bowel and diarrhea by an overactive bowel.

What are the causes?
Although the etiology of the irritable bowel syndrome is uncertain, some relate this to psychological disturbances, especially anxiety. Some relate their onset to an attack of infective diarrhea, or certain foods may precipitate symptoms.
• It is true that stress can affect bowel function. It has been demonstrated that the bowel can flush or become very pale in response to emotional reactions. Severe acute stress may cause diarrhea.
• A close look at dietary factors is a must in evaluating the cause for an irritable bowel, one cause i.e., lactose intolerance is a very common problem. The inability to digest lactose sugar in milk and dairy products. The undigested lactose acts like a laxative and causes the symptoms of an irritable bowel.
• Another and less common is gluten intolerance. Some individuals may have an allergic reaction to gluten protein, which is found in all cereals except rice and corn. This can cause diarrhea.
• Fat may also be a cause of diarrhea, they stimulate strong contractions of colon, contributing to pain and diarrhea.
• Alcohol is another often-unrecognized cause for such symptoms, particularly diarrhea. The patient may not think that his or her alcohol habit can be the cause. Alcohol is a cellular poison. Its initial contact with the lining of the bowel may cause some cellular damage. As the alcohol in the blood is recirculated regularly and bathes the intestinal cells, it creates further damage. Damaged cells mean inadequate digestion, followed by diarrhea and IBS.
• Coffee, tea, colas, and chocolate are all can cause IBS, as they stimulate muscular contractions and acts as a causative factor in diarrhea.
• Spices may also irritate the bowel. In some case, it may be due to food allergies or food poisoning.
• Diarrhea may also be a symptom of vitamin deficiency, e.g., niacin, B-12 or folic acid.
• Various infectious diseases may cause this, but this is usually of short duration. Parasites may be a cause like Giardiasis.
• The abuse of laxatives is a common cause, which is often overlooked.
• Disease of the pancreas may cause large, frequent, fatty stools. The pancreatic enzymes needed for digestion and when these are in short supply, symptoms follows.
What are the symptoms of IBS?

Diarrhea characteristically occurs in the morning, and almost never at night.
• Urge to defecate after meals.
• Pain in the lower abdomen, pain often occurs in attacks, usually relived by defecation and sometimes provoked by food.
• Bowel habit is variable. All most all patients notice ribbon like stools with or without mucus.
• Sensation of incomplete emptying of the rectum.
• Abdominal distension, excessive flatus, dyspepsia, heartburn, increased urine frequency 

How Ayurveda describes this symptom?
Ayurveda mentioned one disease known as ‘Grahani’. The symptom of this grahani resembles most of IBS symptoms.
Grahani is the seat of Agni and is called so because of holding up the food. Normally, it holds up the food (till it is digested) and releases it from the side after it is digested. But when it is deranged due to weak digestive fire, it releases the ingested material even in unripe condition.
Causes of deranged Agni: Agni is deranged by fasting, eating during indigestion, over eating, irregularly eating, intake of unsuitable, heavy, cold, too rough and contaminated food. Emaciation due to some disease, faulty adaptation to place, time and season, faulty administration of emesis, purgation and unction, and suppression of natural urges.  Agni thus deranged becomes unable to digest even the light food and the food being undigested gets acidified and toxic.
Symptoms

IBS is diagnosed in people whose symptoms include abdominal pain, bloating, gas, diarrhea, and constipation, or a combination of these symptoms. Though sometimes confused with inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, IBS is a separate condition.

Prodromal symptoms are - thirst, lassitude, debility, delayed digestion and heaviness in body.
Thirst, anorexia, abnormal taste in mouth, excessive salivation and feeling of darkness, eructation’s have metallic or fleshy odor and bitter sour taste, edema on feet and hands, joint pain, vomiting and fever, cutting pain in abdomen, lassitude, debility, dryness in throat and mouth, burning in cardiac region and throat. The patient passes stool as liquid, dried, thin & undigested with sound, broken, mixed with mucus and heavy.
Frequent motions, which are of sometimes, dry & sometimes watery consistency, is the classical symptom.

Nongastrointestinal symptoms

Other symptoms that don't affect the intestines, such as:

·         Anxiety or depression.

·         Fatigue.

·         Headache.

·         Unpleasant taste in the mouth.

·         Backache.

·         Sleeping problems (insomnia) not caused by symptoms of IBS.

·         Sexual problems, such as pain during sex or reduced sexual desire.

·         Heart palpitations (feeling like the heart skips a beat or is fluttering).

·         Urinary symptoms (frequent or urgent need to urinate, trouble starting the urine stream, trouble emptying the bladder).

A number of other problems may cause symptoms similar to those of irritable bowel syndrome (IBS), including:

·         Abuse of laxatives or antacids.

·         Use of sorbitol or other artificial sweeteners.

·         Lactose intolerance.

·         Inflammatory bowel disease.

·         Malabsorption syndrome, such as celiac disease.

·         Tumors of the digestive system.

·         Problems with the pancreas.

·         Parasitic infestation, especially in people who have traveled to areas with poor sanitation.

·         Thyroid disease.

·         Diverticulitis.

·         Diseases of the female reproductive organs, such as endometriosis.

·         Gallstones.

·         Gastroesophageal reflux disease (GERD).

Can I prevent this?
As the name itself suggests, it is very irritable. There are plenty of things you can do to take some irritability out of your bowels.
1. Try changing your diet.
2. Eliminate the use of milk and milk products from your diet. This should be simply to test and determine if you do have lactose intolerance. You should not eliminate milk or milk products on a permanent basis unless you make sure you have other adequate calcium sources.
3. Avoid excess tea, coffee, alcohol, cola, and carbonated beverages.
4. You should eat slowly and in a relaxed environment as possible, don’t eat during indigestion, or eating irregularly.
5. Avoid intake of unsuitable food, heavy, cold, contaminated or too sweet food, which is heavy to digest. Ayurveda explains how to eat, when & what? So follow such rules.
6. Omit strong spices; too oily i.e., fried food, fatty foods, and flatus alleviating foods.
7. Tobacco should be eliminated entirely. Avoid all forms of tobacco, including smoking, chewing, or snuffing.
8. Diet adjustments are not enough to improve your bowel function and avoid IBS. It is important to eliminate nervous tension if possible. Relive your anxiety and stress by adjusting your lifestyle. Most of those measures are the things we should all do for better health anyway.
9. Train your bowel, as this is also an important part of managing irritable bowel symptoms, when the problem is mostly constipation.
10. Don’t suppress the urge of urine & stool
11. Take fiber rich diet in case of constipation.

How Ayurveda help me for treating this disease?

Ayurveda suggests warm water for drinking first, when morbidity is situated in grahani and is flared up with the half burnt food. Appetizers, lightening, and digestive measures like liquid gruel etc. followed by ghee mixed with appetizers, vata alleviating drugs and enema’s is then advise as a line of treatment. If you have this problem, you must consult your physician for proper treatment. Ayurvedic treatment is based on semi digested (Sama) or properly digested (nirama) stool. According to this, physician decides your treatment.

Some formulations that will help you in reliving symptoms
1. Powder of four sours (Vrukshamla, Amlavetasa, Dadima and Badara) 640 gm, trikatu 120 gm (Pippali, Shunthi, Black Pepper), and five salts 160gm added with sugar 320gm should be used with vegetables, pulses, cooked cereals etc. It is efficacious in colic, indigestion, anorexia etc.
2. Panchakola is to be added in cereal soup, Radish soups with black pepper are recommended as diet.
3. Buttermilk, sour gruel, and arishta should be taken as post meal drink.
4. Buttermilk is specifically advised in this disease due to its appetizing nature, astringency and lightness in all ways. This aids recovery of disease. So take in profuse quantity.
5. One passing undigested diarrheic stools due to deficient Agni should take adequate
6. Dose of ghrita (ghee) mixed with appetizing drugs, as they are excellent stimulants of weak fire.
7. Ayurveda advise ‘Parpati Kalpa’ in this disorder, which is very efficient for treating this disorder, but strict dietary regimens one has to follow during this therapy.
8. Various Asavas / Arishta’s, Medicated ghee & appetizer drug formulations are advised some of them are -

Do’s - Eat old rice, jawar, gourd, coriander leaves, lentil, green grams soup, black pepper, dried ginger, wood apple, Pomegranate, nutmeg, skimmed milk, buttermilk, hot water, complete rest, adequate sleep.

Don’ts - Eat wheat, maize, barley, pigeon pea, pea, cow pea, spiked dolichos, black gram, gram, Soya bean, saga, kidney bean, potato, sweet potato, navalkoal, onion, coconut, groundnut, chili, oily food, chicken, red meat, crabs, prawns, fish, leafy vegetable like sorrel, drum stick etc, mango, pineapple, apple, watermelon, cashew, pumpkin gourd, papaya, fig, jack fruit, excess milk, day sleep, awakening at night,