Irritable bowel syndrome - like the leftovers in your fridge.

It has to be that way, as irritable bowel syndrome has no specific diagnostic test - and some of the other possibilities are rather serious.

Your tests so far have hopefully included tTG blood test and an upper abdominal ultrasound. These are for celiac disease and pancreatic cancer.


If however, you've had your complaint for, say 3 years or more, then your story may allow a pretty definite diagnosis. Serious complaints will have been largely ruled out by passage of time.

Symptoms present for only a few months, definitely need looking into.

If you find it hard to remember back, think specifically of special occasions, birthdays, holidays etc. and whether you had the trouble then.

The story in irritable bowel syndrome is likely to be of pain in your lower tummy, associated with irregular bowel habit and sometimes relieved by passing a bowel action.

Bloated feeling, incomplete emptying, urgent bowel actions and even accidents are typical. Anxiety can lead to attacks (and vice versa.)

Certain foods may aggravate your symptoms. For instance, chilli may increase pain.

Keep a diary for a week or two at the start, for later comparison of symptoms. It is really difficult later on to remember exactly what one was feeling, months earlier.

We tend to whitewash our memories, particularly regarding unpleasant things like irritable bowel syndrome symptoms.

If you've just been given this label, be thankful. Dorothy Owens et al¹ followed up 112 people with your diagnosis, for a median time of 29 years, and found no excess adverse health nor longevity outcomes.


This condition can follow gastroenteritis or travellers diarrhoea.

Campylobactor and Salmonella infections can be followed by this.
Follow up studies after local epidemics have shown 1 in 4 people had "IBS" for up to four years subsequently.

Chlostridium difficile infection can persist for up to a year. This is a very resistant germ which can cause diarrhoea after antibiotics knock out its competition.

Low grade intermittent diverticulitis and pelvic inflammatory disease are are difficult to distinguish from IBS.

Food sensitivities and irritable bowel syndrome

Food allergy is usually reserved for immediate reactions such as sneezing from pollen or anaphylaxis from peanut or shellfish.

This is an area of medicine where opinions are severely polarized, and very few allergy specialists would agree with my attitude. I was fortunate to come in contact with people such as William Rae, in the 1980's, and to have very good specialists in this area available in Victoria.

One example of research on IBS was by Jones et al². 14 of 21 patients were able to find foods which aggravated their IBS by elimination and re-challenge tests.
Some of the 14 were hospitalized and tested by feeding through a stomach tube, and in nearly all cases they were able to tell when fed a food bad for them.

At any rate, my advice is to check this out.
You may be happy you did.

Atkinson et al³ found that using IgG4 blood tests then excluding foods based on the tests, was very effective. People who did exactly what was advised had two chances in 5 of improving.

A combination of IgE plus IgG4 blood tests is reputed to give 80% concordance with the result of careful elimination and re-introduction of foods.

This all costs money, and you can test yourself for free.
You can combine Dr. Marshall Mandell's 5-day elimination diet⁴, for example, with Dr. Arthur Coca's pulse test.

When a food is totally removed from your diet for between 5 and 14 days, intolerance symptoms are likely to improve. Re-introduction during this time window is likely to bring on more immediate and more definite symptoms.

If your symptoms don't tell you, the pulse test may.

Do not do this if you have asthma or other serious allergic symptoms. Do not re-introduce foods if you are home alone, or unable to be taken quickly to an emergency room.

The author of one of my allergy books always got his patients to come to his surgery waiting room to have the first dose of each food.

There are a number of other ways you can test for food sensitivity, including electrodermal tests, dowsing, kinesiology or just going on your gut feelings (intuition.)

Now I may be in danger of losing you at this point.
Please stick around.

One way to see if this area is important for you, is to live briefly on an elemenal diet - Vivonex or Emsogen are examples, consisting of food broken down into its components which we can't be allergic to.

Our enteric nervous system - the second brain.

Yup, I no kid.

Guess what - it takes less pressure than in people without IBS.
This is called "visceral hypersensitivity" (of the rectum here.)

The part of our autonomic nervous system which runs our bowels, may not be functioning as per "normal" in irritable bowel syndrome.

We have more nerve cells (neurones) in our gut than in our spinal cord. In animal experiments, this part of our nervous system can operate when completely cut off from the brain. Most of our body's serotonin neurotransmitter, is here - more than in our brain.

Our gut nerve system can be repaired. There are stem cells there, capable of turning into new neurones, under the influence of neurotrophic factors such as BDNF, NT-3 and GDNF.

The production and activity of these neurotrophic factors may be supported by nutrient supplements such as tryptophan, acetyl-l-carnitine, vitamin A and possibly D.

Our central nervous system and irritable bowel syndrome

Placebo reactor rates range from 25 to 70% in different studies of IBS. If nearly half can improve with a dummy treatment, it shows how much our mind is able to control it.

Anti depressant drug trials have given 40 to 83% (average 70%) response in IBS.

This involvement of our brain is seen in the high levels of corticotrophin releasing factor found in a majority of studies on IBS patients. CRF is the chemical messenger from our brain to our pituitary gland, governing our adrenal gland.

The function of our emotional motor system^{note a} can be supported.
This may involve restoring balance between the sympathetic and parasympathetic arms of our autonomic nervous system^b.
It may be by helping our hypothalamic pituitary adrenal axis^c, or our endogenous analgesic system^d.

Naturopaths have protocols for such help, such as those from Henry Osiecki at Bioconcepts / Orthoplex in Australia.

Hypnosis, meditation and hatha yoga are paths to these ends.

Herbal remedies for irritable bowel syndrome.

Iberogast is a good one, to all accounts. It has stood the test of time and even the "double-blind, randomised, placebo-controlled trial."

This last is when no one knows who got the active and who the dummy treatment, until after the trial.

Peppermint oil enteric coated capsules are probably worth a try. It apparently can burn your bum, though.

Probiotics use in irritable bowel syndrome

Nitroglycerin, glyceryl trinitrate to you - Dynamite your irritable bowel syndrome

Our skeletal muscles are made of "striated muscle fibers," so called because of the microscopic appearance.

The muscle of our lower gullet, stomach and gut is called "smooth muscle" as it doesn't have that appearance. This is also the muscle of our gallbladder and our blood vessels.

As smooth muscle spasm may be responsible for colicy pain from our innards, GTN may be a useful treatment here.

Explanatory notes for irritable bowel syndrome.

b. The "sympathetic nerves come from our spine between the base of our neck and the small of our back.
Our "parasympathetic nerves come from our neck and the base of our spine.

They make up the "autonomic nervous system," which along with our gut hormones, control the muscles and glands in our abdomen.

There is a current concept that dysfunction here can involve one being dominant (over the other.)

Parasympathetic dominance shows as increased appetite, loose bowel movements, slow pulse and possibly low blood pressure.
Sympathetic dominance includes reduced appetite, constipation, bloating and burping, higher pulse rate and blood pressure

Other sympathetic dominance indicators are anxiety and depression, sweaty palms and soles, dry mouth and eyes and intolerance to fatty foods.

c. The hypothalamic pituitary adrenal (HPA) axis consists of those three links in the chain of command between our brain and our cortisol and adrenaline stress hormones.
The hypothalamus is part of our brain.
The pituitary is a gland behind our eyes.
Our adrenal glands are on top of our kidneys.

CRF is the hormone messenger between the first two parts of this chain.
ACTH is the messenger between the second and third parts.

d. Our endogenous analgesic system involves central nervous system production of opium - like substances, and diffuse noxious inhibitory controls, whereby pain is disregarded, reduced or blocked completely.

From irritable bowel syndrome to home page

From irritable bowel syndrome to pain emotions page.

References for irritable bowel syndrome

2. Jones V. A. et al Lancet. 1982 Nov 20;2 pp:1115–1117.

3. Atkinson W, Sheldon TA, Shaath N, Whorwell PJ.
Gut. 2004 Oct;53(10):1459-64.
http://www.ncbi.nlm.nih.gov/pubmed/15361495

4. The Complete Guide to Sensible Eating p 92 By Gary Null
google "dr mandell 5 day elimination diet" to view this book

5. Saggioro, Alfredo MD
Journal of Clinical Gastroenterology 2004;38(suppl 2):104-106