Causes of Irritable Bowel Syndrome.
Although Irritable Bowel Syndrome is a very common condition, there is no
specific cause. There are many suggestions as to why Irritable Bowel
Syndrome develops in certain individuals but like most things about IBS,
no one knows exactly why.
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No one will give you a specific cause of IBS. Some experts think IBS is a
Motility Disorder. This suggests that IBS patients have an oversensitive
or hyperactive gut and will react to changes influenced by stress, food
With the typical chaotic bowel habit of IBS, it is not surprising that it
is thought of as a motility disorder. The transit time from ingestion of
food to excretion is abnormal.
Sometimes it is slower than normal causing constipation and other times
it is faster causing diarrhoea. IBS is generally divided into two groups,
diarrhoea predominant or constipation predominant. Some have diarrhoea
and constipation alternating.
As a general rule, however, the transit time in IBS is unpredictable and
at any time can be faster or slower, and explains why stools vary in
frequency and consistency from hard pellets to watery and unformed.
Some say IBS is a dietary problem.
Certain foods will trigger IBS and others seem to help.
IBS ResearchUpdate.org gives a list of food that triggers IBS and others
that are beneficial. Some items are mentioned in both lists. This is the
nature of IBS.
Just eating food stimulates intestinal muscle activity. This is a normal
action and the most common is the Gastro colic reflex. This reflex is
strongest after breakfast. In IBS, large meals, fatty meals or just the
wrong meal can trigger a very strong gastro colic reflex. This results in
abdominal pains and or diarrhoea.
There is no evidence that food causes IBS but certain foods and the
volume consumed at one time can trigger symptoms.
One suggestion is that the fault that results in IBS resides in the
Nervous System. The gut has a complex network of brain cells called the
Enteric Nervous System. It has more nerve cells than the Spinal Cord.
This "Brain of the Gut" is connected to the Brain. Some researchers
believe that to understand IBS, we have to understand the workings of the
Enteric Nervous System.
The Gut has the richest supply of serotonin in the body. This chemical is
closely connected to the nervous system. At present a lot of research is
focused on gut serotonin receptors.
Serotonin affects the nerves in the intestine and controls contractions
of the smooth muscles of the gut. This result is peristalsis, a smooth
rhythmic contraction along the gut that facilitates the movement of
faecal matter along the large bowel.
Low levels of serotonin lead to constipation and higher than normal
levels cause diarrhoea.
If the gut and the brain is interconnected by the Gut Brain Axis, then
various factors that affect the Central Nervous System (Brain), can
affect events in the gut. This includes psychological factors such as
anxiety, stress and depression. In addition psychological trauma such as
physical, emotional and sexual abuse can affect the gut. Statistics show
that there is a greater incidence of psychological trauma and
disturbances in IBS. It is suggested that in addition to treating the
IBS, treating the other issues will give better long-term results.
Gastroenteritis and IBS: Between 20-30% of patients who develop severe
gastroenteritis will go on to develop IBS. The common infective organisms
are Campylobacter jejuni, Salmonella shigella, and Escherichia coli.
Gastroenteritis results in inflammation of the gut lining resulting in an
overproduction of serotonin. In the thirty percent that develops IBS, the
serotonin imbalance continues.
In some women, symptoms fluctuate during the menstrual cycle. The two
hormones that control the menstrual cycle are oestrogen and progesterone.
These hormones can affect the colon and the passage of residue al ong the
gut. In some women IBS is worse at certain stage of their cycle.
Prof. Jonathan Brostoff of Middlesex Hospital believes that yeast is
involved in some cases of IBS. These patients have reduced levels of
friendly bacteria, Lactobacilli and Bifidobacteria in their large bowel.
This results in overgrowth of Candida
Low yeast diets have been promoted for IBS. This diet involves stopping
cheese, all cheese not just blue cheese, and change bread to soda bread,
scones, chapattis and any other unleavened bread. Sugar should be
avoided. Avoid alcoholic drinks but spirits are distilled to a high level
and have little or no yeast. Consume in moderation.