IBS Support: The Different Types of IBS
What Is IBS?
IBS stands for Irritable Bowel Syndrome. It is a common diagnosis and has a broad spectrum of symptoms. For this reason, health professionals divide IBS into three sub-categories to help focus treatment more effectively. The different types of IBS are:
- IBS-C – Irritable Bowel Syndrome, where the main bowel symptom is constipation.
- IBS-D – Irritable Bowel Syndrome, where the main bowel symptom is diarrhoea.
- IBS-M – Irritable Bowel Syndrome with a mixed bowel symptom – most often alternating between constipation and diarrhoea.
It is important to note that if you think you are suffering from IBS, you should make an appointment to speak to your doctor or healthcare practitioner to get a proper diagnosis.
Symptoms of IBS Attack
As well as diarrhoea and constipation, the other most common symptoms of IBS include:
Irritable bowel is often regarded as a ‘minor’ complaint, but for those who suffer, this couldn’t be further from the truth. Indeed, IBS can affect people’s quality of life. It can lead to stress and anxiety, impact their ability to socialise, and those with IBS tend to have more days lost to illness.
Another problem with IBS is that bowel problems still invite a lot of embarrassment for sufferers. It is important to try and overcome this.
How To Calm IBS Flare Up & Control Symptoms
Because IBS has such a broad range of symptoms, and different people suffer in different ways. There is no one-size-fits-all solution. No single product or list of guidelines will help everyone. However, as a rule, anyone with IBS could benefit from taking on board the following suggestions:
• Eat slowly – Ensure that you chew your food thoroughly and effectively. This helps to stimulate the digestive system properly, ensuring proper digestion of food. Eating too quickly can result in poor digestion, wind and bloating.
• Eat more bitter flavoured foods – Bitter flavours – from foods such as radicchio, chicory and rocket – help support the production of digestive enzymes, thus supporting better digestion.
• Stay hydrated – For those who suffer from diarrhoea, this is important because diarrhoea can deplete essential minerals and leave us dehydrated. For those with constipation, water is equally important as it helps to provide lubrication for the bowel.
• Focus on cooked and easy to digest foods – Whilst raw foods and salads are indeed good for us, they are not very easy to digest. Focusing on steamed vegetables, soups, and stews will make life easier on the digestive system. Also, try not to overeat bread and pasta, as these are too hard to break down. Choose more rice and potato as your carbohydrate sources.
• Consider a specific good bacteria supplement – Probiotics are well known for being beneficial for bowel complaints. Broad-spectrum good bacteria supplements have been reported by many as helpful for reducing symptoms. However, these days there are better, more specific probiotic combinations available.
There are also more specific suggestions that may benefit those suffering from IBS-C or IBS–D.
What is IBS-D?
Common symptoms of IBS-D are abdominal pain and discomfort, abdominal bloating, distension, urgency and diarrhoea. This complaint can be very uncomfortable and embarrassing, with some people struggling to leave the house on days when the problem has flared up.
In surveys of people with IBS-D symptoms:
- 46% of IBS-D patients agreed with the statement: “I’m willing to try anything to help manage my IBS.”
- 11% agreed with the statement: “When my IBS is bad, I wish I was dead.”
- 20% of people with IBS-D agreed with the statement: “My IBS has badly affected my working life”. (1)
Clearly, the impact of this condition, both physically and emotionally, should not be underestimated.
I have advised many clients on diet and supplements which may help manage IBS-D, these include:
In the Diet:
- Ensure you are properly hydrated. Diarrhoea often means that extra fluid is leaving your system. It may be an idea to ask a pharmacist for an electrolyte drink to use.
- Eat enough of the right type of fibre! It may sound backwards to use fibre to help when the bowel moves too frequently; however, certain fibres – including oats, beans, sweet potato & mango are known as soluble fibres. This means they absorb water and would, therefore, help to form a more solid bowel movement.
- Look for supplements that include L-Glutamine. L-Glutamine is an amino acid: It has been shown to help reduce inflammation in the intestinal mucosa and slow down diarrhoea. Glutamine has been hailed by many of my clients as ‘the ultimate remedy for IBS-D’. Clinical studies have also indicated that L-Glutamine may improve ‘gut permeability’ (leaky gut) – thought to be one of the causes of IBS-D. (2, 3)
- Try some Saccharomyces Boulardii. This amazing yeast has been shown in research to slow down the bowel by reducing inflammation and preventing infection. S. boulardii may also help to encourage the growth of other friendly bacteria. The suggested level is around 5 billion bacteria per dose, and again many of my clients have reported benefits. (4)
- Add in some beneficial bacteria. In previous blogs, I have talked about how scientists have determined we can use specific bacteria to target specific health complaints. The good bacteria shown to be particularly helpful in reducing diarrhoea and reducing inflammation in the bowel include; L. casei, L. rhamnosus and S. thermophilus. (5) These bacteria could also be taken in conjunction with Saccharomyces Boulardii.
A Lovely Case Study
A few years ago, I had the pleasure of consulting with a lovely older gentleman. He was suffering so dreadfully with IBS-D symptoms that he planned his trips out of the house and his meals around his bowel habits and whether or not there were toilets he could access if required. As a result, his quality of life was severely limited, and he felt miserable.
We discussed changes he could make to his diet, and I suggested he try a remedy combining L-Glutamine with saccharomyces boulardii and those probiotics – L. casei. L rhamnosus and S. thermophilus. He took my suggestion (“I’m willing to try anything!”) and started on a high dose of 6 capsules per day.
After only seven days, he noticed a benefit and telephoned me with cautious delight, hoping not to be disappointed over the next few days. He was not disappointed. The improvements continued, and he gained more and more faith that our regime was working! I have a particularly fond memory of the day he came in to tell me he had just booked a coach holiday with his wife – the first he had felt confident to take for years!
What is IBS-C?
The most common symptoms of IBS-C are constipation, bloating and abdominal pain. These issues can have a huge psychological impact in addition to the physical symptoms.
A survey of those with IBS-C showed that:
- 33% felt depressed
- 76% did not feel ‘normal’
- 64% felt self-conscious.
Many people also feel embarrassed to discuss their condition. This can make getting the right help difficult.
1 in 7 adults is affected by constipation. The stats rise to 1 in 3 for children. In the UK alone, an average of 182 people every day are admitted to the hospital with constipation as the main complaint. (6)
Irritable Bowel Syndrome (IBS) is the most common condition diagnosed by gastroenterologists, and IBS-C affects 34% of all people diagnosed with IBS – so if you suffer from this problem, you are not alone! (7)
I have worked with many clients and the advice I have given on diet and supplements which may help them manage their IBS-C has included the following:
- Drink enough plain water to provide the bowel with the fluid it requires.
- Eat enough fibre.
In addition, I make the following suggestions to my clients:
- Consider a fibre supplement. If you struggle to add fibre by changing your diet, it might be worth trying a natural fibre supplement like Inulin. Inulin is a fibre extracted from Chicory root.
- Extra Magnesium. Magnesium is known to help support good muscle function. The bowel works by using muscular contraction to move waste around, so supporting good muscle function should be helpful – particularly for those who feel their bowel is ‘lazy’. I have suggested magnesium supplements to many clients who suffer constipation, and most have reported improvements.
- Try some good bacteria. Research into different probiotics strains has shown that they all have individual actions and that certain blends can be used to target specific health complaints. Those with IBS-C may want to look for a blend providing B. animalis subsp. lactis, L. plantarum and L. rhamnosus, as this combination has been subject to a large clinical trial on IBS-C sufferers. When combined with Inulin, this specific combination was found to be effective for inflammation, bloating, abdominal pain, constipation, cramps, and flatulence: 80% of those who tried it reported improvements within 2 weeks! (8)
Written by Jenny Logan DNMed. (Jenny is a Nutritional Therapist who has worked with clients in health foods stores and private clinics for over 20 years, and is Product Development & Training Manager for Natures Aid)
1) IBS Global Impact Report 2018
2) Effect of glutamine supplementation on diarrhoea J Pediatr Gastroenterol Nutr. 2004 May;38(5):494-501.
3) Min-Hyun Kim; The Roles of Glutamine in the Intestine and Its Implication in Intestinal Diseases; Int J Mol Sci. 2017 May; 18(5): 1051.
4) (9) Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders; Therap Adv Gastroenterol. 2012 Mar; 5(2): 111–125.
5) Saavedra JM et al Feeding Streptococcus Thermophilus…for the prevention of diarrhoea Lancet 344 (8929)
6) Cost of constipation report 2014/15
7) IBS Global Impact Report 2018
8) A Randomised, Double Blind, Placebo Controlled Trial: The Efficacy of Multispecies probiotic supplementation in alleviating the symptoms of IBS-C; Mezzasalma V et al; 2016