Let mind help tame an irritable bowel

IBS, with its symptoms of bloating, abdominal pain, flatulence, diarrhoea or constipation or an alternating cycle of the two, can seriously impair the ability to work and enjoy leisure activities. Up to 15 per cent people are affected with this, though only half seek medical help.

The gut and brain are intimately connected, with more nerve cells in the intestines than in the central nervous system. The gut has been called the body’s second brain, containing 95 per cent of the body’s neurotransmitter serotonin and direct nerve connections to the brain.

So it is no surprise that this common disorder of intestinal function has a strong mind-body connection. This does not mean IBS is a psychosomatic condition caused by emotions, but rather that emotional upsets can aggravate symptoms in someone with a hyper-reactive bowel.

This is perhaps an overreaction to the past, when most patients with IBS were told there was nothing physically wrong with them -- it was all in their heads. After all, they had no obvious organic cause like a tumour, infection or ulcer.

In the modern era of medication, the pendulum swung the other way. Gastroenterologists now recognise that IBS is a real physiological, or “functional,” disorder, though no specific cause has been discovered.

Recent studies have implicated serotonin as one factor, since patients with IBS have reduced receptors for this chemical. And studies have shown that low levels of selective serotonin reuptake inhibitors can sometimes relieve its symptoms.

In many patients, symptoms can be set off by large meals or certain foods — wheat, rye, barley, chocolate, milk products, alcohol, coffee, tea and colas. By keeping a food diary and recording symptom flare-ups, patients can identify their sensitivities and avoid the culprit foods.

Reuniting mind and body

A small but growing number of specialists are seeking to reunite mind and body by treating patients with a combination of medication, dietary precautions and emotional re-education. Their early studies indicate that this mind-body approach is more effective than either alone.

... contd.