IBS (Irritable Bowel Syndrome)

What is IBS?

IBS is described as pain in the stomach and intestines otherwise known as the GI tract
with altered bowel movements. It can result in gas, irritation in the belly, bloating,
diarrhea and constipation. There is no set cause that leads to IBS but experts have
concluded to a multiple combination of problems. Symptoms are connected to nerves on
the walls of GI tract and how they communicate with the brain.

Demographics

IBS is common, ultimately seen more in women than men. It affects 15% of people in
the US. People have reported symptoms earlier than 40 years old. It ranges from those in
their early life to adulthood.

IBS: Western Perspective

It is considered as described previously as pain in the GI tract. The walls of the GI tract
have nerves that communicate between the bowels and the brains. The nerves become
active during stress. During this stress, it causes the nerves to contract more affecting
function. The pain can be triggered by inflammatory foods: foods that are fatty, caffeine
or other food sensitivities (gluten, dairy).

Symptoms:

It can last anywhere from 3 days to 3 months varying from person to person (mild to
severe)

• Abdominal pain or cramping
• Fullness, Distention
• Bloating
• Constipation
• Diarrhea or watery stools
• Urgency
• Mucus in stool
• Loss of appetite

Symptoms that may not be in the intestines but accompanied with in IBS:

• Migraines
• Sleep disturbances or insomnia
• Anxiety and Depression
• Pelvic Pain

Some people are able to tolerate symptoms and go on with a regular schedule, for others
it disrupts their routine. Stress tends to accompany the onset of the symptoms but they get
better when stress is managed. It usually fluctuates depending on the trigger.

Diagnosis

IBS is diagnosed through a physical exam to go over medical history and symptoms.
Some doctors may suggest a colonoscopy if a person is over the age of 50, weight loss or
bloody stools, or abdominal blood tests. There are no specific tests for IBS.

Western treatment:

Relieving symptoms and possible lifestyle changes:

• Exercising regularly
• Improving sleeping habits to reduce anxiety to relieve bowel symptoms
• Reducing stress (psychological therapy)
• Avoiding foods that are considered inflammatory for the body
• Eating smaller meals

Medications that might be prescribed:

Probiotics

• Anticholinergic medicines (dicyclomine, propantheline, belladonna, and
  hyoscyamine) taken about a half-hour before eating to control intestinal muscle
  spasms
• Eluxadoline (Viberzi) for IBS-Diarrhea
• Loperamide to treat IBS-Diarrhea
• Low doses of tricyclic antidepressants to help relieve intestinal pain
• Lubiprostone (amitiza) for IBS-Constipation
• Bisacodyl to treat IBS-Constipation
• Rifaximin, an antibiotic
• Linaclotide (Linzess) for IBS-Constipation

IBS is typically life-long, but managed when treated. It does not lead to more serious
illnesses or cause any other illness.

IBS Eastern TCM Perspective:

IBS is known as spastic colon. It is described as “abdominal pain” “Xie-xie” and
“Yuzheng”, abnormal emotion, diet and “external evil”.

Clinical Manifestations/Symptoms:

Abdominal pain (triggered by eating, relieved by defecation)

• Constipation or
• Diarrhea
• Bloating
• Flatulence
• Nausea
• Mucus in the stool
• A feeling of incomplete defecation
• Pain in the anus or rectum
• Headache
• Fatigue
• Lassitude
• Depression
• Anxiety
• Poor concentration

Patterns:

It includes Spleen Qi Deficiency, Spleen and Kidney Yang deficiency, Jue Yin cold and
heat being present, Yang Ming Fluid Xu.

TCM has been used as treatment due to cost effectiveness, convenience, affectiveness
and low adverse reactions. Studies have shown higher efficiency with TCM treatment
versus Western treatment. There are many treatments depending on causes.

Spleen Qi Deficiency:

Manifestations:

Fatigue after eating

• Limbs feel heavy and week
• Hungry but cannot eat
• Loose stools
• Diarrhea with mucus
• Alternating diarrhea and constipation
• Nausea
• Bowels soon after eating
• Weakness

Treatment: Benefit Qi, Dry Dampness, Strengthen Spleen
Points: SP3, ST 25, SP4, BL20, SP 6
Herbs: Wan Dai Tang, Qi Pi Wan, Si Jun Zi Tang

Jue Yin Cold and Heat (Pericardium and Liver):

Manifestations:

Cold in lower body

• Sensation of Qi rushing to the chest
• Chronic thirst
• Hungry but can’t eat
• Chronic diarrhea
• Vertex headache
• Vomits food
• Tongue: Red or Pink
• Pulse: Deep, Weak or Wiry

Treatment: Clear Heat and Revive Yang
Points: LI11, LV 3, REN 17
Herbs: Wu Mei Wan

Yang Ming Fluid Xu(Large Intestine and Stomach):

Manifestations:

• Previous history of Yin, Jin Ye, or Blood Deficiency
• Previous history of Yang Ming
• Fluid and Yin depleted
• Anhidrosis
• Numbness
• Weakness
• Dryness
• Constipation
• Tongue: Red
• Pulse: Weak and thready

Treatment: Nourish Yin and Fluids
Points: KD 6, LI 11, ST25, BL25
Herbs: Ma Ze Ren Tang

General Eating: It is important to avoid inflammatory foods such as milk, foods high in
sugar, carbonated beverages, and caffeine. This helps with the gas and diarrhea aspects of
IBS.

FOODS for dampness and phlegm: Barley, basil, broad bean, buckwheat, cardamom,
celery, cilantro, clam, dill, olive oil, ginger, garlic, green tea, horseradish, lettuce, onion,
oats, nutmeg, potato, pumpernickel, radish, rye, relish, shalots. Sourdough bread, thyme,
yams, turnip, watercress

• Should be cooked and warm, avoid cold and raw, avoid deep fried and junk food, eat smaller meals, low intake of fat, oils, dairy and sugar.

FOODS for heat: alfalfa, apple, barley, beets, broccoli, cabbage, cauliflower, crab,
cucumber, millet, pear, radish, spinach, spirulina, tomato, wheat, watermelon, Yogurt,
zucchini
FOODS for KD Yang: barley, beef, black beans, carrot, chestnut, chicken, cinnamon,
dates, fennel seed, garlic, kidney, leek, mussles, molasses, onion, parsnip, pistachio, rice,,
rosemary, salmon, shrimp, squash, sweet potato, tuna, yams, walnuts star anise
FOODS for SP QI Def: Barley, beef, black beans, carrot, chicken, chickpea, dates,
fennel, ginger, lamb, liver, mackerel, nutmeg, rice, pepper, pumpkin, squash, tuna,
walnuts, yams, onion, oats

Other Treatments:

• Moxa has been shown to work to restore balance
• Acupuncture has also been shown to clear meridians, smooth the body’s Qi,
  regulate serotonin, and smooth muscle movement of digestive tract
• Meditation proves to reduce stress and anxiety, and improve sleep
• Exercise

Ways to deal with Irritable Bowel Syndrome

Exercise!

Tai Chi, Yoga, walking, swimming are a few examples of activities that are
good to fit into a routine! It helps lower your stress and keep you fit. This
can help your digestive system get moving and preventative from keeping
your movement stagnant!

Avoid!

Greasy foods, junk food, alcohol, dairy and caffeine! This can irritate your
nerves and cause you to have IBS symptoms!

De-stress!

Meditation is a good way to relax and lower stress. Stress is a huge factor in
IBS and stops movement of your digestive system.
Get massages on a regular basis to encourage relaxing your digestive
system!
Speak to a therapist or counselor about your stressors!

Eat Healthy!

Eat cooked, warm, whole foods. Eat smaller and stop eating before you are full. This will
help your organs process your foods, and stop the IBS from getting triggered! Eat foods
that make it easier for your system to process.

References:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/irritable-bowelsyndrome-ibs
https://www.mountsinai.org/health-library/diseases-conditions/irritable-bowel-syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710221/
https://www.americandragon.com/conditions/IrritableBowelSyndrome.html