To begin to understand IBS and its multifactorial causes and treatments is to bring insight into the nature of the relationship between the mind and the body.
The relationship between emotional stress and IBS is easily recognized and acknowledged.
One of the more recent explorations and contributions to understanding the nature and treatment of IBS is the role of the gut flora (known as the microbiota) of the intestinal tract.
The role of probiotics and selected antibiotics (xifaxan) in the treatment of some patients with IBS brings the "bug" contribution to the pathogenesis (cause) of IBS.
But how can we possibly link the two elements together into a cohesive understanding of IBS. Is it possible that the gut flora modifies or modulates the effects of stress on the patient with IBS?
Preliminary investigations from the article in Scientific American by Robert Martone http://www.scientificamerican.com/article.cfm?id=the-neuroscience-of-gut may bring some insight into this relationship.
It seems, first of all, that gut microbes influence the development of the brain.
While human beings possess 30,000 genes we are inhabited by over 3 million bacterial genes.
Genes that influence anxiety have been identified and it is postulated that bacterial genes influence peptides secreted in the gut which also reach the central nervous system.
With this insight it is not difficult to speculate that the gut microflora influence how the gut nervous system modulates stress hormones as well.
It seems as if the science is about to catch up with the clinical observations.
This is nothing new in the history of medicine.