Herbs for the belly: holistic treatment of Irritable Bowel Syndrome.

It's not the kind of condition you mention in polite company. You're out to eat at a nice restaurant with some friends when suddenly you have to excuse yourself and quickly find the nearest restroom. Sufferers of Irritable Bowel Syndrome (IBS), one of the most common causes of chronic diarrhea, may often experience such embarrassing situations.

IBS, responsible for almost half of all referrals to gastroenterologists and experienced by an estimated one in five Americans, is a syndrome, meaning it is a group of symptoms for which there is no known cause. Diagnosis is made by excluding all other potential causes of chronic bowel problems.

Conventional medicine has little to offer except treatment of symptoms. Holistic herbal medicine, however, can treat the causes of IBS by paying strict attention to the multitude of factors so often ignored by modern medicine--food sensitivities, dietary triggers, and fiber intake--while incorporating gentle herbal remedies.

The hallmark of IBS in most cases is diarrhea, but for some people, constipation is the dominant symptom, and yet for others it is both diarrhea and constipation. Any type can be accompanied by abdominal pain, usually in the lower fight side of the abdomen. Although not directly caused by stress, stress can worsen symptoms. There is often mucus in the stool and sometimes blood, If there is blood, it is "always a good idea to get a diagnosis by a medical doctor because this can also be a symptom of more serious problems such as ulcerative colitis, Crohn's disease, diverticulitis or colon cancer.

DIETARY TREATMENT

Before even using herbs, dietary factors need to be addressed, specifically food sensitivities and allergies; probably half of "all IBS sufferers would feel better and possibly never have the problem again if they looked at the possibility of wheat, dairy or other sensitivities. Lactose intolerance and celiac disease (gluten intolerance) can easily mimic IBS, so it may well be worth the effort to eliminate both wheat and dairy for at least two weeks to see what happens. This can be challenging--wheat and dairy are in many products and both have to be completely eliminated during the trial period, so it requires a lot of label reading. Even soy sauce can have wheat. Some foods aren't allergens but irritants. These irritants can manifest differently for each person, but they often include coffee, soda, alcohol, fried foods and high-fat foods. A good idea is to keep a "diet journal" to identify problem foods. It can take hours for symptoms to appear after a problem food is ingested, which is why it's important to track all foods for a couple weeks and then look back to see any patterns.

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And finally, incorporating more fiber into the diet, especially soluble fiber, can be a great help. This can be either as a supplement such as Acacia fiber or Psyllium seed or incorporated into the diet in the form of whole grains. Insoluble fiber is also helpful and is found in many vegetables, including kale and collard greens, for example. Fiber helps prevent and treat both constipation (as is well known) and diarrhea. It treats constipation by increasing bulk and giving the large intestine something to "hold on to" while also moistening the intestines. Soluble fiber, meaning the fiber we can't break down but which dissolves in water, is particularly good for diarrhea because it forms a gel instead of a watery mush that is easier for the colon to process.

HERBAL TREATMENTS

Herbal medicines will depend on the specific symptoms a person is experiencing. For general relief, herb teas such as Peppermint and Chamomile work well for many people. Chamomile is an especially nice choice because it has other synergistic actions in addition to having a digestive regulating effect; it is soothing to the GI tract and is calming to the nervous system. In Europe, an enteric-coated capsule of Peppermint oil is often recommended. An enteric coat allows the capsule to pass through the stomach and open in the small intestine where it can have a stronger effect. Meadowsweet is a classic herb to treat digestive tract irritation. It can be especially useful if there is pain involved or mucus in the stool, indicating irritation of the digestive lining. Soothing demulcent herbs such as Marshmallow root and Slippery Elm can be used in addition to Licorice, which has an additional anti-inflammatory effect. For crampy abdominal pain, try Wild Yam, a plant of local woodlands that is a great anti-spasmodic and anti-inflammatory for the digestive tract. Primarily known as a hormone-regulating herb, it can also regulate contractions of the GI tract.

For IBS where constipation is the dominant problem, there are two herbs that have mild laxative effects and also help tone the large intestine through their astringent action: Yellow Dock and Turkey Rhubarb. Yellow Dock is the milder remedy, which gently stimulates the liver and promotes the smooth flow of the intestines. Rhubarb has a stronger action, which unlike Senna or Cascara Sagrada, can be used in small doses for a gender action. It's wise to start off with smaller doses and work up to me suggested amounts to prevent rebound diarrhea in sensitive colons. Also be aware that like most herbal laxatives, the effects aren't felt for eight to twelve hours. Since stress can exacerbate symptoms, calming herbs such as Skullcap, Passionflower and Valerian can be helpful. For those with anxiety issues, Kava Kava can be a great short-term, stress-relieving herb.

IBS can often be addressed with just these simple remedies and suggestions. If problems persist, there are many excellent herbalists and natural health care professionals who can help. And in the end, treatment means no more embarrassing situations!

CoreyPine Shane is a Holistic Clinical Herbalist who has cared for his clients for over a dozen years and currently practices in downtown Asheville. He is the Director of the Blue Ridge School of Herbal Medicine. For more information, visit www.blueridgeschool.org or call 828-275-6221.