Overload

IBS

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Irritable bowel syndrome (IBS, or spastic colon) is characterised by chronic abdominal pain, discomfort, bloating, wind [flatulence and burping] and alteration of bowel habits. In some cases, the symptoms are relieved by bowel movements, in other cases not. Diarrhoea or constipation may predominate, or they may alternate.

It can have any number of different causes, and is frequently misdiagnosed and misprescribed medicinally. Published research has demonstrated that some very poor patient outcomes are due to treatable illnesses being mis-diagnosed as IBS and IBS being mis-diagnosed as something else.  For example, Colon cancer can feature abnormal defecation and abdominal pain with other IBS like symptoms and Thyroid disorders can produce IBS like symptoms including abnormal defecation and abdominal pain.

Gallstones cause a searing stabbing pain, but in the lead in to the really dreadful stage of stabbing pain, there can be IBS like symptoms. In a rather ironic twist, a recent (2008) study found that IBS patients are at increased risk of having unnecessary cholecystectomy (gall bladder removal surgery) not due to gallstones, but rather to abdominal pain the doctor has assumed is gallstones! A 2005 study reported that IBS patients are 87% more likely to undergo abdominal and pelvic surgery, and three times more likely to undergo gallbladder surgery, despite the fact that the IBS like symptoms can be caused by a host of alternative problems and underlying pathogens.

 

There is a cynically held view amongst some patients in the UK [where the NHS is less than helpful in providing more detailed analysis in the less obvious illnesses], that the name IBS is simply a catch all phrase designed to put the patient off bothering the doctor any more.

A questionnaire in 2006 designed to identify patients’ perceptions about IBS, [Halpert AD, Thomas AC, Hu Y, Morris CB, Bangdiwala SI, Drossman DA (2006). "A survey on patient educational needs in irritable bowel syndrome and attitudes toward participation in clinical research". J Clin Gastroenterol 40 (1): 37–43] found IBS patients were most interested in learning about

  • foods to avoid (60%),
  • causes of IBS (55%),
  • medications (58%),
  • coping strategies (56%), and
  • psychological factors related to IBS (55%).

So they wanted to know what caused the illness and if their doctor couldn’t be bothered to find out or tell them what the causes were, to at least give them some idea how to cope with it.

The respondents indicated that they wanted their physicians to be available via phone or e-mail following a visit (80%) [i.e. to listen and help] , have the ability to listen (80%)[i.e. to listen and help], and provide hope (73%) [i.e. to listen and help] and support (63%)[i.e. to listen and help]. Fairly damning I think of the medical profession in this instant.

Due to often unsatisfactory results from medical treatments for IBS up to 50 percent of people turn to complementary alternative medicine.

Symptoms

I now quote - and you can be as horrified as you wish:

IBS is, ...such a common presentation that testing for these conditions would yield such low numbers of positive results that it is considered difficult to justify the expense.

IBS is a source of chronic pain, fatigue, misery and social cost and contributes to work absenteeism. Its constant debilitating nature can result in depression. It can dramatically affect the quality of a sufferer's life.

Socially it can be a nightmare. There may be urgency for bowel movements, a feeling of incomplete evacuation (tenesmus), bloating or abdominal distention. People with IBS, more commonly than others, have gastroesophageal reflux, chronic fatigue, headache, backache and psychiatric symptoms such as depression and anxiety. Some studies indicate that up to 60% of persons with IBS also have a psychological disorder, typically anxiety or depression.

Small Intestinal Bacterial Overgrowth can make
men look as though they are pregnant

Some IBS sufferers also suffer from Small intestinal bacterial overgrowth (SIBO), also termed bacterial overgrowth, or Small bowel bacterial overgrowth syndrome (SBBOS), which is a disorder of excessive bacterial growth in the small intestine. Unlike the colon (or large bowel), which is rich with bacteria, the small bowel usually has fewer than 104 organisms per millilitre. People with bacterial overgrowth typically develop IBS symptoms including nausea, bloating, vomiting, diarrhea, malnutrition, weight loss and malabsorption.  The causes are the same incidentally, but this is just one more problem to contend with.

It is worse for the sufferer because the doctor gives it a name -  ‘IBS’ - but, in the UK at least, then does nothing about it by following up the symptoms to determine their ultimate cause. There appears to be a view held by many in the medical profession that it is stress related – because the doctors tend to see a person who is stressed by the condition and the need to work under considerable duress and when in pain. Thus one of the medications frequently given for the problem is a sedative – which can simply exacerbate the condition.

Causes

What we need to recognise here is that the term IBS is actually meaningless and that the same set of symptoms can be caused by quite a large number of pathogens and causes – all of which need to be investigated.

In the section on Intestine disease I have tried to go into the causes of Intestinal diseases and illnesses in general.  I suggest you read this section as well, as it is a comprehensive analysis of the area.

Common examples of the true cause or illness causing the same symptoms, being simply labelled as IBS include:

Viral infections 

 

IBS may develop after an infectious illness where the symptoms of the original infection are actually quite clear to see: fever, vomiting, diarrhoea, or positive stool culture. But the infection lingers and this post-infective syndrome is then termed "post-infectious IBS" [which, let’s face it, is no help at all in curing it]. The risk of developing IBS increases sixfold after acute gastrointestinal infection, rather suggesting that the infection is lingering.

There is a much higher incidence of IBS now than there was 50 or so years ago and one of the reasons appears to be that we travel more and pick up both viruses and bacteria [see below] – bugs – that our own internal protecting flora and antibodies have never met before. A study of United States residents returning from international travel, for example, found a high rate of IBS and persistent diarrhoea that developed during travel and persisted upon return.

Apart from these unusual viruses, we know from observation that many other well known viruses can also cause diarrhoea, a symptom also associated with IBS:

The present study investigates the cause and the source of an acute gastroenteritis outbreak that occurred ...in February 2013. ... Symptoms were predominantly vomiting (n=17, 85%) and diarrhoea (n=9, 45%).  ..... No pathogenic bacteria were found in stools however virological analysis revealed the presence of multiple enteropathogenic viruses, namely Norovirus GI (GI.3), Norovirus GII (GII.4 New Orleans 2009), Astrovirus and Sapovirus, as single or co-infections.  PMID: 26071340

In cases where the immune system is not up to the challenge faced, viruses can reproduce very rapidly and lodge themselves in adipose tissue or the joints, waiting to re-emerge when the immune system is again low - at times of stress for example.

Thus IBS may in part be caused by stress but only because viruses may persist in some people, emerging from the joints and adipose tissue when the immune system is compromised by the stress.

Vaccines

 

The name for a vaccine that has a live virus in it is an attenuated vaccine.   Although most attenuated vaccines are viral, some are bacterial in nature. Examples include the viral diseases yellow fever, measles, rubella, and mumps, and the bacterial disease typhoid.  As we can see from the description above, IBS can be caused by viruses and bacteria.  There appears to be a belief by those promoting vaccines that the immune system defeats the virus as it builds up an immunological record.  But there is now enough research to show that this is not the case.  A virulent strain of attenuated virus may replicate very fast before the immune system has had time to muster its defences - particularly if the virus is injected or administered by nasal spray. A virus is capable of then secreting itself in adipose tissue and the joints and 'laying low'.  Adipose tissue apears to provide a safe haven for a number of viruses.

As such IBS may be caused by viruses, obtained from vaccines, emerging at times of stress, or high emotion and thus low immunological function.

Food intolerances and allergies

There are a range of foodstuffs which have a known IBS like effect for some people.  It is possible to test for intolerances and avoid the foods.  Several reputable laboratories supply home test kits that can be used to tell you what you are intolerant to.  Examples include:

  •  
    Wheat and gluten - It is a quite common for doctors to simply pass off coeliac disease, which can be ‘treated’ by avoiding gluten and wheat, as IBS, which is not in the strictest sense treatable. The American College of Gastroenterology recommends that all patients with symptoms of IBS be tested for coeliac disease, this does not happen in the UK – more’s the pity.
  • Lactose  - is a disaccharide sugar that is found most notably in milk, but it is also used commercially. It is sometimes used to sweeten stout beer as it is non-fermentable in beer; the resulting beer is usually called a milk stout or a cream stout.  Lactose can cause IBS like symptoms in some people.  Another major use of lactose is in the pharmaceutical industry. Lactose is added to pills as a filler because of its physical properties (i.e., compressibility) and low price.
  • Fructose -  both fructose and fructan can cause IBS like symptoms in patients with 'fructose malabsorption'. 

I would urge you here, however, to read the section on food allergies, as these themselves have causes, as such a food allergy may provide you with an intermediate cause that can be avoided, but what gave you the food allergy also needs to be understood.

Bacterial infection

Tyra Banks suffers from IBS

More than 50% of the world's population harbor H. pylori in their upper gastrointestinal tract. When I first wrote this section I assumed, along with everyone else, that it was a 'bad bacteria'. 

But I am starting to change my mind. 

H.  pylori may actually be a 'good' bacteria when it is in the Intestine, but because we have somehow compromised the stomach [perhaps by pharmaceuticals or surgery], the bacteria is able to migrate to other parts of the body - like the stomach - where it does do harm.  Thus Helicobacter pylori may not be responsible for any IBS symptoms. 

There are, however, many other bacteria that are - these are described in the Intestine disease section.

Parasites and protozoans

Rachel Riley has IBS and has also become allergic to
many foods

Another cause of IBS like symptoms is protozoal infection. More and more parasites are being implicated in IBS, but if we give just three of the protozoa investigated which have a high prevalence in industrialized countries and infect the bowel, we find:

  • Blastocystis  - a single-cell organism that has been reported to produce symptoms of abdominal pain, constipation and diarrhoea in patients.  Studies from research hospitals in various countries have identified high Blastocystis infection rates in patients with IBS symptoms, with 38% being reported from the London School of Hygiene & Tropical Medicine, 47% reported from the Department of Gastroenterology at Aga Khan University in Pakistan and 18.1% reported from the Institute of Diseases and Public Health at University of Ancona in Italy. Reports from all three groups indicate a Blastocystis prevalence of approximately 7% in non-IBS patients. Researchers have noted that clinical diagnostics fail to identify infection, and Blastocystis may not respond to treatment with common antiprotozoals
  • Dientamoeba fragilis is a single-cell organism that also produces IBS symptoms - abdominal pain and diarrhea. Studies have reported a high incidence of infection in developed countries. Researchers have noted that methods used clinically may fail to detect some Dientamoeba fragilis infections.
  • Giardiasis also produces IBS like symptoms, it is a diarrheal infection of the small intestine by a single-celled organism Giardia lamblia. Giardiasis occurs worldwide with a prevalence of 20–30% in developing countries. In the U.S., 20,000 cases are reported to the CDC annually, but the true annual incidence is estimated at 2 million people

There is suspicion that with the increase in international travel and the lack of awarness of this source of the problem, that as a cause it enjoys a far higher proportion of those who are ill than once thought.  A glance at the parasites section should show you that parasites are a major cause of disease in general.

Toxins

Cybill Shepherd struggled for many years receiving
numerous misdiagnoses and poor medical advice

Pesticides, insecticides, herbicides and other chemicals sprayed on food, disrupt the gut flora and can thus be a cause of IBS. Included in the toxin category is also Heavy metal poisoning.  This paper shows that toxins cause a whole range of illness, not just IBS

The aim of this research was to study the association of the accumulated human exposure to persistent organic pollutants with serum lipid levels and obesity, in a cohort of 298 adults. In the multivariable analyses, HCB concentrations evidenced a significant quadratic association with levels of total cholesterol, HDL, LDL, and total serum lipids. Likewise, PCBs 138 and 180 were associated with triglycerides and total serum lipids, and PCB 153 with LDL. HCB, p,p'-DDE, and β-HCH showed quadratic associations with BMI. Additionally, PCB 138 was positively associated with BMI but in a linear manner. Our results suggest a potential relationship between historical POP exposure and serum lipids/obesity, which followed a non-linear pattern in most cases.KEYWORDS: Obesity; IBS, BMI, Organochlorine pesticides; Persistent organic pollutants; Polychlorinated biphenyls;  PMID: 25173983

Surgery

Here is a long winded quote

Bile acid malabsorption is often cited as a cause in patients with diarrhea-predominant IBS. SeHCAT tests suggest that around 30% of D-IBS have this condition,  "this can be treated and most respond to bile acid sequestrants".

Zoe Salmon the Blue Peter presenter has IBS

This tells us nothing, as it does not say why there is bile acid malabsorption, in effect this is just another symptom.  One of the causes of bile acid malabsorption is  Psychological trauma.  Another cause is  Bacterial infection as we have shown above, but there is another cause and that is Surgery.

Although surgery can very directly damage the various organs of the digestive system, causing them to malfunction, one very often overlooked problem is the damage done to the lymph system by all sorts of surgery - including plastic surgery.

Physical damage can very easily affect the lymph system causing it to block or malfunction.  Any problems with this system can cause IBS simply because the lymph system is the mechanism by which the immune system works.  Since IBS can be caused by pathogens and our only defence against pathogens is our immune system, damage to the lymph system is likely to lead to disease, and one of those diseases is intestine disease and IBS.

Appendix removal - It is worth knowing that the appendix is part of the lymph system.  It is now known to store friendly bacteria, which is used to replenish the bacteria in the intestines, if one should get a bout of diarrhoea.  Thus having your appendix out is a very bad move in the scheme of things and could easily result in IBS.

Gall bladder removal - Western doctors seem to have an almost obsessive thirst to remove the gall bladder at any opportunity and there is a very clear link between gall bladder removal and IBS, simply because the gall bladder is an essential organ in processing food and tackling pathogens.

...We evaluated 80 patients with postcholecystectomy problems following gallbladder removal, consecutively admitted during a period of 36 months. ... Final diagnosis was confirmed by a combination of imaging findings, as well as clinical follow-up of 6 months. .... In 53 patients biliary or pancreatic diseases were diagnosed: common bile duct stones, chronic pancreatitis, pancreatic cancer, papillary tumors, cholangiocarcinoma, insufficient cholecystectomy or sphincter of Oddi dysfunction. The other 27 patients had non-biliary symptoms  - dyspepsia, and IBS, etc. PMID: 19337637

IBS was almost an afterthought in this paper, but I suppose if the other effects of gall bladder removal are cancer, IBS does seem insignificant.

Pharmaceutical Drugs

Milly Evans from Knutsford, Cheshire had IBS ,
but says that her depression has been helped by
modelling

An enormous number of pharmaceuticals are now being implicated in causing IBS, not just the more obvious ones like proton pump inhibitors, antibiotics or antihistamines

Laxatives, because they flush out the system - good and bad bacteria - are a known cause.  This aspect is worth emphasising because there is a known tendency in those who seek to lose weight to use laxatives.

Chronic administration of certain sedative-hypnotic pharmaceuticals especially the benzodiazepines cause irritable bowel. Thus you can go into the doctor with mild depression and end up addicted to benzodiazepines and with IBS symptoms.

The eHealthme site collect and compile the Adverse Health Reports submitted by doctors to SEDA and the FDA in the USA.  If you follow this LINK it should take you to the IBS section on this site.  If the link has been broken, please use the table they provide of 'conditions'. 

Now scroll down the page and you will find a section headed 'Drugs that cause'.  By pressing this link you will be presented with a succession of list of all the drugs implicated in causing IBS.  This list is dynamically updated on an ongoing basis with new reports.

As of December 2016, there were about 1,400 drugs in this list.

There are, as you can see, hundreds and hundreds of pharmaceuticals in this list and some have caused a great deal of suffering to a lot of people. Accutane, for example, has resulted in nearly 4,808 cases of IBS in the USA alone.

Antibiotics

 A special mention needs also to be made of the role of antibiotics in IBS.  Antibiotics destroy bacteria, but they destroy good and bad bacteria, including all the friendly bacteria in the intestine. 

Although a number of man made pharmaceuticals [anti-virals, anti-fungals, etc] are implicated in causing microbiota destruction and damage, antibiotics seem to stand out as one of the biggest culprits:

The healthy human intestine is colonized by as many as 1014 bacteria belonging to more than 500 different species forming a microbial ecosystem of unsurpassed diversity, termed the microbiota. The microbiota's various bacterial members engage in a physiological network of cooperation and competition within several layers of complexity…………
An increasing number of human disease conditions, such as inflammatory bowel diseases (IBD), type 2 diabetes, obesity, allergies and colorectal cancer are linked with altered microbiota composition. ……………
A general feature of a normal, healthy gut microbiota can generate conditions in the gut that disfavor colonization of enteric pathogens. This is termed colonization-resistance (CR). Upon disturbance of the microbiota, CR can be transiently disrupted, and pathogens can gain the opportunity to grow to high levels. This disruption can be caused by

  • exposure to antibiotics,
  • changes in diet,
  • application of probiotics and drugs, and
  • a variety of diseases.

Breakdown of CR can boost colonization by intrinsic pathogens or increase susceptibility to infections. One consequence of pathogen expansion is the triggering of inflammatory host responses and pathogen-mediated disease.
Interestingly, human enteric pathogens are part of a small group of bacterial families that belong to the Proteobacteria: the Enterobacteriaceae (E. coli, Yersinia spp., Salmonella spp., Shigella spp.), the Vibrionaceae (Vibrio cholerae) and the Campylobacteriaceae (Campylobacter spp.). …… proteobacterial "blooms" are a characteristic trait of an abnormal microbiota such as in the course of antibiotic therapy……PMID:  26185088

 Fungal infection

Candida is a genus of yeasts and is currently the most common cause of fungal infections worldwide. Many species are harmless, however, when mucosal barriers are disrupted or the immune system is compromised they can invade and cause disease. Antibiotics promote yeast infections, including gastrointestinal Candida overgrowth, and penetration of the GI mucosa. Prolonged antibiotic use increases the risk for both men and women.

Many patients with irritable bowel syndrome (IBS) are disillusioned by the lack of efficacy of treatments and suffer from numerous symptoms not covered by the Rome criteria for IBS, as the current empirical treatment regimens fail to address these persistent debilitating 'IBS associated symptoms'. These symptoms are similar to other symptom complexes like chronic fatigue and ...many seek help from alternative medicine. .... there is increasing evidence for yeasts being able to cause IBS-symptoms in sensitized patients via Candida products, antigens and cross-antigens.  PMID: 15647635

Nutritional deprivation and other dietary problems

 

A poor diet can cause IBS like symptoms.  One of the symptoms of IBS can be constipation. In a few cases, the recommended treatment [without the person being given the proper tests to identify the true cause] has been a high fibre diet e.g., bran.

BUT not only has insoluble fibre like bran not been found to be effective for IBS, in some people, insoluble fibre supplementation may even cause the symptoms.

In patients who have constipation predominant irritable bowel, soluble fibre can reduce some symptoms but will not reduce pain. Neither are cures for the underlying problem.

Overdosing on fructose and sucrose is a proven cause - see fructose and sucrose digestion.

The intestine has a finely balanced flora, it is almost like a garden with a vast population of 'friendly' bacteria that are used to fight pathogens and then process food.  All the above - toxins, pharmaceuticals, 'unfriendly' bacteria, viruses and so on can damage and disrupt this flora, but it can also be 'starved' or 'overfed' by the nutrients you eat.  A person who spends most of their day skipping meals but consuming vitamin supplements is killing their intestinal flora.  A person who consumes mineral supplements is doing much the same thing.  In the end only natural foods contain the right balance of nutrients and foodstuffs for our bodies.  Some of the bacteria in our gut thrive on cyanide, for example, and this is found in just the right amounts in apricots and almonds.

By replacing good wholesome foods with pills, we effectively lay ourselves open to just about every disease going, and one of them is IBS.

Radiation

Of course men laugh at such wild assertions, but there are links to
infertility too, laugh on my fine friend

All radiation whether 'cosmic' or electromagnetic impacts our bodies and depending on its frequency, it resonates different parts of us. 

The reason that nuclear radiation is so dangerous is that it impacts cells, but what we appear to have overlooked is that all radiation impacts some part of us. 

Every aggregate in our bodies - organs, cells, the body itself, has natural ‘resonance’.  Resonance is a substance’s natural tendency to oscillate – vibrate – at maximum amplitude at certain frequencies, known as the thing’s resonant frequency.  And some radiation affects the Intestines.  High intensity radiation affects the intestines in the short term, but even low exposure radiation of the 'right' frequency can have an effect in the long term. This is a much larger problem than people realise .....

Cell phone emissions have a negative impact on exposed sperm motility index, sperm acrosin activity, sperm DNA fragmentation and seminal CLU gene expression, especially in OAT cases. PMID: 25918601

Treatments

There are two different approaches used

Symptom based approach

The current symptom based approach tackles the problem using pharmaceuticals notable IBS treatments 

Cause based approach

This approach aims to find out why this is happening.  One study reported that an IgG antibody test, for example, is effective in determining food sensitivity in IBS patients, with patients on the elimination diet experiencing 10% greater symptom reduction than those on a sham diet.  But as we can see this is only one of the many causes that need to be investigated.  For more details see the section on Intestine disease.

How it works

It depends largely on the underlying disease, however, most of the hallucinations are caused by the pharmaceuticals used to treat IBS.

A number of food options can be used to help heal the problems.

Related observations