what is irritable bowel syndrome

Irritable bowel syndrome is a common gastrointestinal condition that affects millions of people.

Irritable Bowel Syndrome (IBS) comprises several different GI symptoms and is not a well-understood condition. Often conservative interventions are effective at controlling the disease.

What is IBS?

Irritable bowel syndrome (IBS) is a common disorder of the large intestine. Being a syndrome means that it encompasses many different symptoms but not every person will display every symptom. These symptoms include bloating, cramping, diarrhea, constipation, and abdominal pain. IBS is usually categorized as “with diarrhea,” “with constipation,” or mixed, meaning both constipation and diarrhea. IBS  has a set of diagnostic criteria that includes changes in stool appearance, frequency of passing stool, and occurring for a certain amount of time. IBS should not be confused with inflammatory bowel disease (IBD) like Crohn’s and Ulcerative Colitis, which are far more severe autoimmune conditions that often require prescription interventions to manage.

Causes of IBS

IBS has many causes and is not fully understood. Early life stress, intestinal infection, being female, dysbiosis (microbial imbalance), disordered muscle contraction in the intestinal wall, and nervous system disorders are possible causes of IBS. Research has linked traumatic experiences early in life with an increased risk of IBS. This may be due to the strong connection between the central nervous system (CNS) and the gut. The gut is called the “second brain” because there are as many nerves in the gut as are found in the brain. Scientists theorize that elevated amounts of stress hormones in childhood may change how we respond to stress as adults.

Additionally, stress hormones have various effects on the gut. When our brain perceives a threat, it goes into “fight or flight” mode. This pushes blood flow to the extremities so we may fight or flee. Prioritizing muscles over internal organs means inhibiting activities like digestion and reproduction, which are not considered essential to survival at that moment. Chronic alterations in these stress hormones can lead to constipation from impaired digestion or diarrhea from the feeling of anxiety that adrenaline can cause. The gastrointestinal tract can also swing between extremes as it will overcompensate for constipation, resulting in diarrhea and vice versa. 

While it is not totally understood, most of the possible causes of IBS bring us back to a connection between the gut, the brain, emotions, and stress hormones. Disturbed intestinal bacteria is also a possible cause of IBS because the good bugs in our gut help regulate mood and regular bowel movements. Another midlife health article from this month will further explore the functions of beneficial gut flora.

Stress hormones have various effects on the gut.

Ways to manage IBS

IBS usually does not require medication, and the first-line treatments are dietary changes, lifestyle modification, and stress management. 

Remember, this is merely an educational article and does not replace your qualified medical provider’s advice. Many people will experiment with an elimination diet to try to identify possible food triggers of their IBS. The most common food allergies are wheat/gluten, dairy/casein, eggs, soy, peanuts, tree nuts, fish, and shellfish. Keep in mind that a true food allergy is typically an immediate response like itching or swelling. These reactions can be life-threatening. Many people experience food intolerance or food sensitivity which is a less severe and more delayed response. Reactions due to food sensitivities can occur up to 3-4 days after ingestion of the food. An elimination diet will take out any common food triggers for at least four weeks and then slowly re-introduce foods one at a time and watch for reactions. This is a good way to get a personalized understanding of your individual reactions. Blood tests for food allergies or food sensitivities are another possible route to look for food triggers.  Lifestyle modification includes improving food hygiene. Many of us eat in a hurry and do not adequately chew our food which impairs digestion. Americans are also famous for drinking large amounts of ice water with meals. Digestive enzymes work best in a hot environment, so ice water during meals hampers digestion.

Too much liquid with meals also dilutes our digestive enzymes. Many common dietary habits are also counter-productive to good digestion – eating too quickly, on the run, in the car, while standing over the kitchen sink, eating too much fast or processed food, etc. Food hygiene includes slowing down, chewing thoroughly, avoiding too much liquid at meals, and eating mostly fresh, home-made food. Stress management can take many forms. Improving work/life boundaries may be beneficial. Setting aside time for self-care is often crucial. Many patients benefit from mindfulness training like meditation, yoga, tai chi, journaling, or prayer. Natural healthcare providers can also recommend various tools to improve the stress response, including herbal medicine, acupuncture, and homeopathy. 

IBS can be very disruptive to normal life, but there are many ways to manage it effectively. Speak to your healthcare provider for options to improve your quality of life.


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Dr. Jessica Keating
Owner & Physician , Willow Clinic of Natural Medicine
Jessica Lodal Keating graduated with her doctorate in chiropractic medicine from National University of Health Sciences (NUHS) in Lombard, IL in December of 2016. She graduated summa cum laude and salutatorian of her class. She completed a primary care internship at the in-house clinic in the Salvation Army’s Adult Rehabilitation Center in downtown Chicago. There she was able to provide natural approaches to health and wellness to an under-served population. She also led efforts to solicit supplement donations from local doctors in order to provide these supplements to patients free of charge. During her time at NUHS, Dr. Keating also studied traditional Chinese medicine (TCM) and became certified to perform acupuncture, moxabustion and fire cupping. She uses the wisdom of eastern medicine to complement her holistic approach to assessing each individual patient and treating the whole person. She participated in various other seminars and trainings over the course of her studies including MPI’s full-spine adjusting seminar and Apex’s Fundamentals of Functional Blood Chemistry. Dr. Keating also completed her Doctorate of Naturopathic medicine in 2018, graduating valedictorian and summa cum laude. Dr. Keating has worked in several natural primary care offices in the greater Chicagoland area. She is also a full-time naturopathic clinician at National University of Health Sciences. There she is able to help shape the next generation of naturopathic doctors. She has a home-call practice where she treats patients in the comfort of their own homes all around Chicagoland. Dr. Keating loves balancing private practice with teaching and clinical supervision. Dr. Jessica Keating received her bachelor’s degree in International Affairs from Lewis & Clark College in Portland, Oregon before deciding to attend NUHS. After her undergrad degree, she grew frustrated with the field of political science and sought a new career path. Her own health had been dramatically improved through diet, yoga and herbal medicine. Because of these experiences, she decided to deepen her understanding of natural medicine by pursuing a higher degree. Dr. Keating remains committed to her own health journey on a personal and professional level. She aims to help others thrive and maintain optimal health by guiding them down the same path and educating her patients by empowering them to take their health into their own hands. Dr. Keating practices holistic, natural primary care. She treats GI conditions, autoimmune disorders, women’s health, sleep issues, heart disease, diabetes, anxiety, depression, back pain as well as working with patients on weight loss and general wellness promotion. She treats pediatric, adult and geriatric patients using diet, lifestyle modification, herbal medicine, physical medicine and acupuncture. In her free time, Dr. Keating loves reading, biking, cooking and playing with her cats. Dr. Keating also enjoys yoga, tennis, rollerblading, going to the movies and travelling with her husband. She has been to 28 different countries in Africa, Asia, Europe, and North and South America.
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