Irritable bowel syndrome

At the Vitalis Health Clinic we have seen more than our fair share of IBS this year. At least 1 in 5 patients. I attribute this increase to the additional stress on families due to the pandemic and the uncertainty of our international trade relations that have affected so many jobs of late. The brain simply can not turn off. We simply can’t separate the stress in our head from the stress in our body. We sincerely hope that this article provides you with some insight about this age-old problem of IBS

Those who suffer from irritable bowel syndrome often feel that they are not being taken seriously. But the complaints about the complex interaction of two nervous systems are not imaginary.

Stress, anger, fear? It’s hot on the data highway between head and stomach: stress hormones activate the nerve and immune cells in the intestinal wall. The muscles tense up. The intestinal nerves send pain and stretching stimuli to the brain. This registers a general malaise and decides that it would be better to go to a toilet.


Overactive abdominal brain can lead to irritable bowel syndrome

The psyche and intestines are in lively exchange via nerve fibres, messenger substances and immune cells. On the one hand, anger and stress activate the bowel movements, on the other hand, digestive disorders cause a bad mood. More recent studies also indicate that the composition of our intestinal flora also has an impact on the psyche.

The communication centre is the “abdominal brain” – a network made up of millions of nerve cells that independently controls digestion. Via the nerve fibres of the intestinal-brain axis, it constantly supplies information to the limbic system in the brain, where feelings are processed. But when the abdominal brain becomes too “communicative”, those affected suffer from abdominal pain, cramps, flatulence, diarrhea or constipation. A phenomenon known as irritable bowel syndrome.


“Irritable bowel syndrome has many organic causes with defined disorders in the intestine or brain,” explains Professor Michael Schemann from the Department of Human Biology at the Technical University of Munich. “Some patients have subliminal inflammation in the intestinal lining.” The inflammatory cells their release messenger substances such as serotonin, histamine and proteases, which sensitize the nerve cells of the intestinal brain and the intestinal-brain axis and increase the sensitivity to pain in the digestive tract.

Affected people often feel that they are not being taken seriously despite the high level of suffering. “Unfortunately, we do not yet have suitable instruments and biomarkers in clinics and practices to detect and specifically treat the subtle changes found in basic research,” regrets Professor Thomas Frieling, internist and neuro-gastroenterologist at the Helios-Klinikum Krefeld.

“Not all irritable bowel syndrome is created equal”

The causes can be very different: “Not all irritable bowel syndrome is created equal,” stresses Frieling. Some patients react more sensitively to external influences and are more anxious. “A changed central stimulus processing in the brain is suspected here,” he says. “But this does not mean that there is a mental illness.” Other sufferers, often after gastrointestinal infections, show a subliminal inflammation with increased immune cells in the intestinal wall, which can cause flatulence and changes in the stool. Still others react to food components with an intolerance.

Many sufferers try to treat their complaints on their own first. At the Vitalis Clinic we recommend herbal medicines first: “Combination preparations and gastrointestinal teas relieve cramps and flatulence and regulate the movements of the intestinal muscles.” If the symptoms persist or if there is weight loss and a fever, it is best to see you doctor or naturopath  so serious illnesses can be excluded.”

Exclude other diseases

The art of the doctor is to find out the cause in each individual case. “To rule out cancer, inflammation and infections, all patients should have a colonoscopy and women should be examined gynecologically,” says Frieling. Particularly in the case of diarrhea, an intensive diagnosis must be carried out right from the start.

For now, doctors can only relieve symptoms. “There will never be a miracle pill for irritable bowel syndrome,” Frieling is certain. That is why he tries out various therapy strategies with his patients and observes what works best for them.

Clinically, those affected can be divided into pain, flatulence, constipation, or diarrhea, depending on the prevailing symptoms. If the focus is on flatulence, herbal remedies and probiotics are worth a try. “Sometimes colon bacteria settle in the small intestine. By fermenting carbohydrates, they cause gas and can be treated with antibiotics,” explains Frieling. In the case of pain, antispasmodics, Phyto-therapeutics and probiotics can be used. “Low-dose antidepressants normalize the increased pain sensation in some patients,” he explains.

Stress is bad – also for the intestines

As with other organic diseases, naturopaths recommend a healthy lifestyle with weight loss, exercise, and a balanced diet. At the Vitalis Clinic we always advise our patients to reduce stress and relax actively and regularly. Professor Paul Enck, noted psycho-physiologist says: “Although stress does not cause irritable bowel syndrome, it can, like depression and anxiety, worsen the symptoms.” According to studies, psychotherapeutic measures are just as effective as drugs.

Follow up with our other articles this month on reducing stress.


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