What is Irritable Bowel Syndrome?
Irritable Bowel Syndrome (IBS) is a Functional Gastrointestinal Disorder, a common long-term disorder of the digestive system characterised by altered bowel habits and abdominal pain. It is estimated that IBS occurs in 5-10% of the worldwide population, most commonly in young to middle-aged adults, and twice as many women as men.
The primary symptoms of IBS include stomach cramps, bloating, acid reflux, sticky stools, diarrhoea and constipation. Some patients also experience migraine headaches, fibromyalgia, lethargy and sleep disturbances, as well as psychological symptoms including anxiety and depression.
It is often viewed as a lifelong condition, with continuous or recurrent pain and discomfort, and worsening symptoms or ‘flare-ups’ triggered by certain foods, drinks or psychological stressors.
Irritable Bowel Syndrome Causes
Different factors lead to IBS symptoms in different people. The exact causes of IBS are unknown, however, it is thought to be an interaction of the gut-brain axis, gut microbiome, immune system of the gut, and psychological and emotional stress. The various factors include:
- Changes in the muscle contractions in the intestine – food is thought to move too slowly or too quickly through the digestive system, causing changes in bowel movements.
- In some cases, IBS symptoms are caused by the hypersensitivity of the nerves found in the wall of the gastrointestinal tract with dysregulation of the gut-brain axis. In these patients, otherwise normal sensations of the digestive process are experienced as painful.
- Some patients experience IBS symptoms following gastroenteritis, a severe bacterial or viral infection. and symptoms are associated with bacterial overgrowth in the intestines.
- There is often a familial component, with IBS patients often reporting other family members with similar symptoms.
- Childhood exposure to psychological and emotional stress is most common in patients with IBS.
- Patients with IBS often have altered gut microbes compared the healthy individuals, which can influence intestinal inflammation and pain.
It is often triggered by:
- Food intolerances, sensitivities or altered eating habits. Many individuals report worse IBS symptoms when they eat or drink certain foods or beverages, such as wheat, dairy products, citrus fruits, high-fibre vegetables and carbonated drinks.
- Psychological and emotional stress.
Irritable Bowel Syndrome Treatments
Western medicine diagnoses IBS by eliminating other related and more life-threatening disorders and then treating the condition symptomatically through a combination of prescription medicines, therapy and lifestyle changes.
The prescribed lifestyle changes include increased physical activity, improved sleep hygiene, stress management and dietary modifications. Some practices for dietary modifications include managing a food diary to monitor triggering foods, seeing a dietician for advice, following a low FODMAP diet and avoiding carbohydrates that are difficult for the digestive system.
Medication is often provided to target specific symptoms such as diarrhoea and constipation, or antidepressants or antispasmodics which are used to help manage abdomen pain.
Can Ayurveda help with Irritable Bowel Syndrome?
In Ayurveda, IBS is a form of Grahani, which refers to the malfunctioning of the small intestine and duodenum and the resulting weakened absorption capacities. According to Ayurveda, when food is consumed, it is held in the duodenum until it is digested by Agni, the digestive fire that converts food into nutrition. In a healthy digestive system, food passes on to the next stage of digestion when the food is completely digested by Agni. However, in those with weakened Agni, food is not fully digested, and this can result in the build-up of toxins (Ama) which can result in IBS symptoms.
IBS is associated with:
- Irregular eating routine including excessive fasting or excessive food intake, eating before the previous meal has been fully digested.
- Eating unhealthy foods including heavy, cold, dry and polluted foods.
- Suppression of natural urges.
- Weakened immune system.
- Disrupted daily rhythm through irregular sleep habits, constant travel or change of environment.
- Digestive issues related to chronic illnesses.
From an Ayurvedic approach, the treatment of IBS focuses on eliminating toxins and balancing the aggravated doshas (body energies) to restore the proper functioning of the digestive system. The aggravation of IBS symptoms is often associated with an imbalance of the Vata dosha (air/ether elements) which leads to irregularity, dryness and coldness. This can manifest as irregular bowel movements and erratic symptoms including constipation, constipation altering with diarrhoea, bloating and abdominal pain. Vata also supports the functioning of the nervous system, therefore, stress, anxiety, lack of routine and other factors that increase the activity of the nervous system can lead to the gastrointestinal symptoms associated with IBS. However, different patients display different symptoms. While Vata dosha is predominant, Pitta and Kapha imbalances also play a role. More than one dosha is involved in these conditions, therefore, treatment aims to find the root imbalance and address the imbalanced doshas. Adapted to each patient’s constitution and the various triggers and symptoms of IBS they experience, the Ayurveda treatment protocol works through a combination of Panchakarma cleansing, Ayurvedic medicine and lifestyle changes.
Ayurvedic Treatments for Irritable Bowel Syndrome
Panchakarma, which means ‘five actions’ in Sanskrit is a treatment programme for cleansing and detoxification – removing the Ama build up. It includes the following five elements: ‘Basti’ (herbal oil enemas), ‘Nasya’ (nasal rinsing), ‘Vamana’ (therapeutic vomiting), ‘Virechana’ (purgation treatment) and ‘Raktamokshana’ (bloodletting therapy). For IBS, Panchakarma therapy focuses primarily on ‘Basti’, the medicated enema to cleanse the colon. These sequential treatments work synergistically to eliminate toxins and alleviate the aggravated doshas.
This is often supplemented by other treatments including:
Abhyanga is Ayurvedic massage therapy, where warmed oils like sesame and coconut medicated with special herbs best suited to your Dosha are applied. Skilled therapists apply special strokes on the body, promoting relaxation, and improved blood flow and lymphatic drainage for detoxification, and focusing on nerve endings of essential organs and energetic points to release blockages.
Shirodhara is an ancient Ayurvedic treatment that helps to induce a profound state of relaxation through the rhythmic flow of warmed medicated oil applied over specific energetic points on the forehead. It is often combined with a scalp, head, or body massage. Shirodhara is an excellent treatment for calming the nervous system and stress relief.
During Chakra Basti, a special paste is made using gram flour that is used to create a boundary on a particular part of the body where warmed medicated oil can be poured to be absorbed by the skin. For IBS, this treatment can be used to stimulate the Marma around the naval area.
Ayurvedic Herbs for Irritable Bowel Syndrome
Depending on the dosha imbalance and symptoms displayed, an Ayurvedic practitioner will prescribe internal herbal medicines which have the following properties:
- Deepana – to improve the digestive fire
- Pachana – to promote digestion and metabolism
- Sangrahi – to increase the holding and absorption capacity of the small intestine and duodenum
Yoga and Meditation for Irritable Bowel Syndrome
The symptoms of IBS are also closely related to emotional and psychological well-being. One study found that those with IBS were three times as likely to have psychological disorders including anxiety and depression. Since stress can alter the gut microbiome and neurotransmitter balance, both key factors in supporting healthy digestion, lifestyle changes and practices that reduce stress including meditation, yoga, breathwork and nature connection are therefore important components of IBS treatment.
A recent meta-analysis illustrated the positive effects of meditation and mindfulness strategies in relieving the pain associated with IBS, as well as improving quality of life measures. In addition, the relaxation response induced by meditation and mindfulness not only reduces the symptoms of IBS, but it also alters the expression of key genes related to stress response and inflammation that are thought to contribute to IBD and potentially IBS. While IBS is less commonly associated with inflammation compared to other disorders such as IBD, many patients with IBS exhibit chronic low-grade inflammation in the bowel wall.
Yoga is another powerful tool for IBS treatment. In addition to enhancing the mind-body connection, there are specific positions that are good for increasing blood flow to the digestive organs and treating abdominal discomfort and bloating, such as Apanasana, Parighasana, Malasana, Ardha Matsyendrasana, Bhujangasana and Trikonasana to name a few.
Another important component of Ayurveda is following a consistent routine, which is particularly important in healing the erratic and irregular symptoms of IBS. Waking up and falling asleep at the same time, as well as eating meals at the same times each day are both important practices for stress management and relieving both the gastrointestinal and psychological symptoms of IBS.
How an Ayurveda Retreat can help
Ayurveda approaches the treatment of digestive problems on a whole being level, through herbal treatments and medicines prescribed alongside meditation, yoga, a balanced diet and a daily rhythm that is in touch with the natural world. Rather than symptomatic treatment, Ayurveda aims to restore the balance of mind, body and spirit.
At the Sen Wellness Sanctuary, each guest receives a personalised wellness programme that has been designed by our in-house Ayurvedic doctor based on the symptoms present, medical history and the observed dosha imbalances. Located in the heart of nature, the Sanctuary is the ideal place to rest, destress and restore balance of the digestive and nervous system.