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Irritable bowel syndrome
Facts About IBS
IBS is a common disorder; it occurs mostly in early to middle age and is suffered by twice as many women as men. IBS is characterised by intermittent abdominal pain and irregular bowel habit (constipation, diarrhoea or both). Other symptoms include spasmodic cramp-like pain in the abdomen, swelling (distension) of the abdomen, feeling of incomplete evacuation of the bowels and excessive wind.
Movement of the bowel or passing wind may temporarily relieve the pain. In some cases, IBS may be confused with lactose intolerance, in which a deficiency in the enzyme lactase causes fermentation of lactose in the intestine, leading to abdominal cramps, bloating and flatulence. IBS is a multi-faceted problem and more than one treatment may be needed.
What Causes IBS?
IBS is thought to be caused by a combination of stress and an over-sensitivity to stressful situations. The digestive tract has a very complex network of nerve cells which help regulate the complicated process of digestion. The colon (large intestine) is controlled by the autonomic part of the nervous system, which also regulates heart beat and breathing rate. Stress can increase both of these and can also cause irregular bowel movements.
However, people with IBS respond to very mild stress which causes the major symptoms of constipation and/or diarrhoea. The reason why IBS patients suffer both of these symptoms, which are in essence at opposite ends of the scale, is thought to be due to the disruption of peristalsis. Peristalsis is the name given to the movement of food along the digestive tract and depends on the contraction and relaxation of specialized muscles in the lining of the intestinal walls.
These muscles are controlled by the nervous system and during bouts of IBS, following a stressor, the communication between nervous system and muscles seems to get confused. This results in irregular movement of waste food as sometimes it is pushed through far too quickly which results in diarrhoea, and sometimes it stops the movement of food altogether, and may even force it in the opposite direction, resulting in intestinal blockages and constipation.
Probiotic bacteria such as lactic acid bacteria and bifidobacteria are now being introduced into many fermented food products and supplements. The consumption of fermented dairy products containing probiotics has increased in the past decades.
Probiotics exert their effects in many ways. One such method is the production of organic compounds such as lactic acid, hydrogen peroxide and acetic acid. The synthesis and secretion of such acidic compounds helps to reduce the pH of the intestinal environment and produce conditions in which pathogenic bacteria cannot thrive.
Probiotics can also produce natural antibiotics called bacteriocins, which directly help to kill unwanted bacteria. Another method, is called 'the barrier effect'. This is simply the production of a wall of friendly bacteria that prevents any bad bacteria from reaching the intestinal wall. (For bad bacteria to exert their unwanted effects, they must adhere to the intestinal wall).
Why don't all probiotics help IBS?
Although all probiotic bacteria are beneficial for general digestive health, only Lp299v has been shown to help alleviate the symptoms if IBS. Many research studies have highlighted the use of a highly specific strain of Lactobacilli called Lactobacillus plantarum 299v (Lp299v). This particular species has been shown to reduce the severity, frequency and duration of IBS symptoms and is more effective than other L.plantarum strains.
One study found that 95% of patients receiving Lp299v for just 4 weeks showed significant improvements in all IBS related symptoms including bloating, diarrhea and constipation.
1. Halpern GM, et al. Treatment of irritable bowel syndrome with lacteol fort: a randomized, double-blind, cross-over trial. Am J Gastroenterol 91: 1579-1585, 1996.