IBS — Mind / Body / Bugs

I rarely blog on medical diseases per se, but IBS [irritable bowel syndrome] is far more than a medical disease.

In fact it is the archetypal mind/body/spirit condition which afflicts millions.  In the past I have referred to it as a panic attack of the gut.  Although not 'serious' in the traditional sense of life-threatening or pre-cancersous, it can certainly make the lives of those affected  quite misserable.

In general, individuals with IBS have hypersensitive guts.  They feel more of their body's internal movements, the gaseous distension, the peristaltic contractions than a 'normal'.   I have often noted that they have a 'Princess and the Pea' gut–they feel everything.

But more than feeling, they experience!  Diarrhea, constipation and lovely combinations of both.

But besides the genetics and emotional connections with IBS, something new has been added to the mix–bacteria.

When reports in the medical literature about the role of intestinal flora [bacteria] first appeared, I was skeptical.  This seemed to add an element of confusion to an already baffling condition.

Do patients with IBS have abnormal bacterial contents in their colons [where gazillions of bacteria normally reside] ?  Does the normally sterile small intestine experience an invasion of bacteria and does this contribute to the condition?

At any rate I now believe that 'bugs' do contribute to IBS.  My opinion arises not merely from scientific studies [always to be taken with a grain of salt ] but from my own patients and their response to probiotics.

Probiotics have usually been associated with the 'alternative' world of treatment.  No longer. They have been scientifically studied and one in particular–bifidobacterium infantis–does work.  My patients are clearly responding.

Researach has also shown that a nonaborbable antibiotic marketed as xifaxin aslo works.

So now I am treating IBS with both–a probiotic and antibiotic.  The antibiotic for short term, the probiotic, long term.

Somehow the bugs affect the bowel's response to stress.  Not sure how but I'm continuing to explore the underlying mechanisms.

The delicate balance of elements that comprise who we are—astounding.

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