Irritable bowel syndrome (IBS), often simply referred to as "irritable bowel," affects many people and presents them with a significant challenge. Symptoms such as bloating, flatulence, belching, constipation, burning in the intestines and diarrhea significantly reduce the quality of life. Going to restaurants can become unthinkable and social life also suffers.

The intestine is, in a figurative sense, the "root" of the human being. Nutrient absorption takes place here and a large part of the immune system is also located here. If nutrient absorption in the intestine is impaired, any healing is made even more difficult. It is therefore extremely important for those affected to take action when it comes to irritable bowel syndrome (IBS). Fortunately, it is possible to get the intestines free of symptoms again. With the right adjustments, nothing will soon stand in the way of a visit to a restaurant. In this article, we will examine the causes of irritable bowel syndrome and provide valuable tips on how to deal with it.

The structure of the digestive tract

Before we take a closer look at how irritable bowel syndrome develops, it is important to first understand the structure of the digestive tract. Our digestive system consists of a chain of organs, each of which plays a specific role in the digestive process.

Mouth: This is where the digestive process begins with chewing and the production of saliva, which breaks down the food and prepares it for further passage. The enzyme amylase, for example, breaks down carbohydrates. Thorough chewing is important so that all the other organs can do their job properly.

Esophagus: A muscular tube that carries food from the mouth to the stomach.

Stomach: This is where food is further broken down by stomach acid and digestive enzymes. The stomach has a very acidic pH. In a young, healthy person, this is typically between 1 and 2. This is necessary to break down food and kill pathogenic microorganisms. The strong acid production is made possible by the parietal cells in the stomach, which produce hydrochloric acid. The stomach can theoretically even melt iron nails with its acid. Please don't try it, but it gives an idea of ​​how important the stomach is in the digestive process.

Small intestine: The longest part of the digestive tract, where most nutrients are absorbed. It consists of three sections: duodenum, jejunum, and ileum. The pH in the small intestine increases and becomes slightly alkaline. It is usually between 7.0 and 8.5. The alkaline environment is promoted by the inflow of bile and pancreatic enzymes into the small intestine, which help to neutralize the acidic food from the stomach and further break down the food components. If there is a lack of stomach acid in the previous section, the food cannot be neutralized here and remains there. Flatulence can occur.

Large intestine: The large intestine is also called the colon and is often affected by constipation in irritable bowel syndrome. The large intestine absorbs water and forms stool. It is divided into the ascending colon, transverse colon, descending colon and sigmoid colon. The large intestine has a slightly acidic to neutral pH value, which is typically between 5.5 and 7.0. This pH value is influenced by the fermentation of food residues by the colon bacteria. The large intestine is the last intestinal section in the chain. It has to pay the price for the "digestive errors" of all previous organs.

Rectum: The last section of the large intestine that stores stool before it is excreted from the body.

Anus: The opening through which stool is expelled from the body.

In addition, there are also supporting organs such as the liver, gallbladder and pancreas, which are responsible for producing digestive enzymes and other secretions that aid the digestive process.

Every link in the digestive chain is important

So we see that digestion does not only take place in the intestines. Although "irritable bowel syndrome" primarily affects the intestines, the cause does not necessarily lie there. If the stomach lacks stomach acid, proteins (such as gluten) cannot be broken down and split. People with irritable bowel syndrome can therefore have an increased sensitivity of the small intestine to certain foods. There is also evidence that an overgrowth of bacteria in the small intestine (SIBO, Small Intestinal Bacterial Overgrowth) could play a role in some people with irritable bowel syndrome (IBS).

It is therefore important to look at the entire digestive tract holistically when dealing with irritable bowel syndrome. In the following, we will take a closer look at the structure of the intestinal mucosa.

Structure of the intestinal mucosa

The intestinal mucosa is the innermost layer of the intestine and plays a central role in digestion and nutrient absorption. It is a barrier that protects the intestine from harmful substances while allowing nutrients into the body. In people with irritable bowel syndrome, this mucosal barrier can be impaired, leading to increased permeability (so-called "leaky gut"). This can trigger inflammation and typical irritable bowel symptoms. The most important structures and layers are:

Epithelium: The top layer that directly touches the intestinal contents. It consists of cells that have different functions depending on their position in the intestine.

Microvilli: Small projections of the epithelial cells that increase the surface area of ​​the intestine to improve nutrient absorption. If you have celiac disease, it is especially important to avoid gluten in order to protect these projections.

Lamina propria : A layer beneath the epithelium made of loose connective tissue. It houses blood vessels and immune cells and supports the epithelium.

Muscularis mucosae : A thin layer of muscle that supports the mobility of the mucosa.

There are further layers beneath the mucosa, including the submucosa with larger blood vessels and nerves. Let's now look at what the causes of irritable bowel syndrome can be.

If you have irritable bowel syndrome, you may notice visual changes in the epithelium and microvilli. A colonoscopy can give you certainty. Very often, however, no visual signs are visible, which does not mean that your symptoms are not real.

Symptoms and causes of irritable bowel syndrome

Irritable bowel syndrome (IBS) is characterized by a variety of symptoms. These usually include abdominal pain, flatulence, diarrhea or constipation. The symptoms often occur in phases and can vary in intensity. Irritable bowel syndrome is often accompanied by changes in the intestinal mucosa, although these can heal again.

Causes of irritable bowel syndrome

Diet: Certain foods can trigger irritable bowel symptoms in some people. These often include lactose, gluten or FODMAPs (fermentable oligo-, di-, monosaccharides and polyols). A food diary can be helpful in finding out which foods are causing the symptoms.

Pesticides : Pesticides, herbicides and fungicides used in non-organic farming can irritate the gut. There is some research that indicates this, with a particular focus on changes to the microbiome. [ 1a ]

Lack of exercise: Regular physical activity promotes bowel movement and can prevent constipation, a common symptom of irritable bowel syndrome.

Stress: Both emotional and physical stress can have a significant impact on irritable bowel syndrome. When the body is in a stressed state, neither stomach acid nor enzymes important for digestion are produced. Intestinal motility also comes to a standstill.

Toxins and antibiotics : Toxins, whether from the environment or from food, can damage the intestinal mucosa. Likewise, antibiotics can disrupt the intestinal flora, affecting the balance of beneficial and harmful bacteria.

Luxury foods: Certain luxury foods such as alcohol or caffeine, as well as highly processed foods, can lead to irritable bowel symptoms. Industrially processed foods often contain a variety of unnatural additives. It is difficult to know what has irritated the intestines. As a rule of thumb, be careful with ingredients that you don't know what they are.

What to do if you have irritable bowel syndrome?

An important first step in dealing with irritable bowel syndrome is to find out which foods or habits irritate the bowel. Below are a few practical tips that anyone can implement.

Keep a food diary

The two most important questions you can ask yourself when you have irritable bowel symptoms are:

1. When did the symptoms appear?
2. What did I eat before?

Since many people cannot always remember every detail of their meals, a food diary offers valuable support.

Elimination diet for irritable bowel syndrome

This diet offers a way to de-stress the gut and identify which foods may be causing symptoms. Consistently following this diet and then gradually reintroducing foods can help identify the exact triggers for IBS symptoms. The goal is to eat very few foods for 7 days. Foods that you are sure you can tolerate well. Avoid gluten, lactose, acidic fruits, sugar and anything that could irritate your gut. Try to switch to organic foods, as there may also be pesticides left on the vegetables that irritate your gut.

If the symptoms go away, you can continue the diet for another 7 days. After that, you can gradually add new foods to your diet. Watch to see if your symptoms return. If so, you have found the culprit for your irritable bowel syndrome.

Mental hygiene at the dinner table

A stress-free environment promotes healthy digestion because the body can function optimally in a relaxed state. The dinner table is not a good place for arguments or the bad news of the day. Stress and negative news prevent your body from producing stomach acid and enzymes. Create a calm and relaxed atmosphere when eating.

Eating moderately and regularly for irritable bowel syndrome

Have you ever noticed that if you eat every day at 1pm, your stomach starts growling loudly just before that? The body loves habits and regularity. So try to stick to your meal times and don't overeat. When you overeat, there isn't enough stomach acid and enzymes, which causes problems in the digestive chain.

Exercise before or after eating

A walk after eating can do wonders by stimulating intestinal motility and aiding digestion. A walk also helps you relax. Giving 100% to exercise on a full stomach is not a good idea, as it will cause digestion to come to a standstill.

Natural remedies for irritable bowel syndrome

Many people with irritable bowel syndrome look for natural alternatives to relieve their symptoms. While conventional medical approaches can be effective, studies show that certain natural remedies can have many benefits for sufferers.

Turmeric: A natural remedy for irritable bowel syndrome

Turmeric, especially known for its active ingredient curcumin, has proven its health benefits in many studies. Used in India for thousands of years, the golden yellow turmeric is considered a powerful natural remedy for digestive problems.

Antioxidant effects : Turmeric is a powerful antioxidant that can fight free radicals in the body. This can help the body recover from oxidative stress, which can play a role in many medical conditions. [ 2 ]

Promotes digestion : Turmeric can stimulate the production of digestive enzymes. [ 3 ]

Balancing the Doshas: In Ayurveda, it is believed that digestive problems are often due to an imbalance of the three doshas (Vata, Pitta, Kapha). Turmeric is used here to correct dosha imbalances.

Natural antibiotic: Turmeric is also considered a natural antibiotic in Ayurveda. It can help maintain the balance of intestinal bacteria. [ 4 ]

Liver health: Turmeric has traditionally been used to support liver function, which plays a key role in digestion.

Especially if you have irritable bowel syndrome, it is important to choose a turmeric product that does not contain piperine. Piperine can further irritate the intestines and should therefore be avoided.

Sauerkraut and fermented foods against irritable bowel symptoms

Fermented foods have been an integral part of the human diet for centuries. They can be particularly helpful for intestinal and digestive problems.

Sauerkraut, made from fermented cabbage, is rich in probiotics, the beneficial bacteria found in the gut. In addition to sauerkraut, other fermented foods such as kimchi, kefir, miso and fermented dairy products are also known to promote gut health. They provide not only probiotics but also prebiotics, which serve as food for the good bacteria in the gut and support their activity and proliferation.

In addition, fermented foods contain vitamins and enzymes that can aid digestion. The short-chain fatty acids formed in the fermentation process, especially butyrate, have anti-inflammatory effects and protect the intestinal lining. Some people with irritable bowel syndrome may find that certain fermented foods make their symptoms worse, so it is advisable to introduce new foods slowly and observe your own reactions.

Glutamine: Natural Treatment for Leaky Gut

Glutamine is an amino acid that plays an important role in the health of the intestinal epithelium. A 2018 study published in the journal Gut showed that glutamine supplementation can strengthen the intestinal barrier in patients with irritable bowel syndrome and reduce symptoms[ 6 ].

Apple cider vinegar: A home remedy for gastrointestinal problems

Apple cider vinegar is a popular home remedy and is used for many ailments. 1-2 tablespoons in a small glass of water can help stimulate stomach acid. People also report that it can balance the digestive system and relieve the symptoms of irritable bowel syndrome. [ 7 ]

Warmth on the stomach

A simple hot water bottle on the stomach has helped many sufferers of irritable bowel syndrome. The warmth allows the stomach and intestines to relax, and blood circulation and intestinal motility are also promoted.

Conventional medical treatment methods for irritable bowel syndrome

A thorough understanding of irritable bowel syndrome and its treatment requires knowledge of both traditional and conventional medical approaches. The conventional medical perspective offers both diagnostic and therapeutic options.

Conventional medical diagnostics

There is currently no gold standard test to definitively diagnose RDS. The most important steps in diagnosis are:

Anamnesis and diagnosis: Here the patient is asked about his lifestyle, diet and medical history.

Laboratory tests: Blood tests may be done to rule out other conditions such as inflammation or infection.

Stool tests: These can be used to rule out infections, inflammation and other diseases of the digestive tract.

Imaging: In some cases, imaging tests such as ultrasound or colonoscopy may be necessary to rule out other bowel diseases.

After the diagnosis, conventional medical practice focuses on finding the best possible treatment for the patient.

Conventional medical treatment methods

Once irritable bowel syndrome has been diagnosed, conventional medical treatment aims to relieve symptoms and improve the patient's quality of life. Treatment may vary depending on the type and severity of symptoms:

Diet and nutritional advice: Many people with IBS benefit from changes in their diet. A frequently recommended diet is the low FODMAP diet. We have already discussed this in more detail earlier in the article.

Medications : Various medications can be used to relieve symptoms of irritable bowel syndrome. Antispasmodics help reduce cramps, while laxatives can help with constipation and antidiarrheals can help with diarrhea. For patients with pain caused by bloating, simethicone-containing preparations may be helpful. Tricyclic antidepressants in low doses can be used to control pain, and serotonin antagonists are also prescribed in certain cases. It is important to discuss medication with a doctor and have regular check-ups to monitor effectiveness and possible side effects.

Probiotics: Probiotics are live microorganisms that can provide health benefits when taken in adequate amounts. In people with irritable bowel syndrome, they can help restore balance to the gut flora and relieve symptoms. The most commonly used strains of bacteria in probiotics are Bifidobacterium and Lactobacillus. There are also probiotic yeasts, such as Saccharomyces boulardii, that have been shown to be effective for certain digestive problems. Since reactions to probiotics can vary, it is wise to try different products and discuss taking them with a professional.

FAQ on Irritable Bowel Syndrome

What exactly is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a functional intestinal disorder characterized by symptoms such as abdominal pain, flatulence, diarrhea or constipation without any organic cause being identified.

What are the typical symptoms of irritable bowel syndrome?

The most common symptoms are abdominal pain, bloating, constipation or diarrhea. The intensity and type of symptoms can vary from person to person.

How is irritable bowel syndrome diagnosed?

Diagnosis is based primarily on the patient's symptoms in the absence of structural abnormalities, but tests such as blood tests, stool tests, and colonoscopy may also be performed to rule out other conditions.

What are the causes of irritable bowel syndrome?

The exact cause is unknown, but factors such as genetic predisposition, infections, changes in the intestinal flora, food intolerances and stress can play a role.

Is there a connection between diet and irritable bowel syndrome?

Yes, certain foods can make symptoms worse. Many sufferers report an improvement in symptoms when they avoid foods such as lactose, gluten or fructose.

What treatment options are there for irritable bowel syndrome?

There are a variety of treatment options, including dietary adjustments, home remedies, mental hygiene at the dinner table, probiotics, medications to relieve specific symptoms, and behavioral therapies.

Is irritable bowel syndrome the same as Crohn's disease?

No, irritable bowel syndrome (IBS) and Crohn's disease are not the same thing. IBS is a functional disorder of the digestive system in which the structure of the intestine is normal but function may be impaired. Crohn's disease, on the other hand, is a chronic inflammatory bowel disease in which parts of the digestive tract are inflamed. Both conditions have different causes and symptoms and require different treatment approaches.

Conclusion

Irritable bowel syndrome is complex and can be influenced by many factors. Anyone suffering from irritable bowel syndrome needs a holistic approach that takes into account diet, lifestyle and psychology. The intestines and digestive tract in particular are closely linked to our psyche. Stress brings the digestive tract to a standstill. Industrially processed and cultivated foods also make life difficult for the intestines. Once the intestinal mucosa is inflamed and damaged, a leaky gut can occur. This is where unwanted proteins enter the blood. The liver is increasingly burdened because it has to break down the proteins. Leaky gut can lead to food intolerances.

The first step is to avoid inflammatory foods and give the intestines time to regenerate. Natural remedies such as turmeric can be a great help here, as they both stimulate digestion and help with detoxification. However, with a holistic approach and, above all, patience (!), it is possible to help the intestines return to radiant health.

Sources

[1a] Samsel, A., & Seneff, S. (2013). Glyphosate's Suppression of Cytochrome P450 Enzymes and Amino Acid Biosynthesis by the Gut Microbiome: Pathways to Modern Diseases. *Entropy*, 15(4), 1416-1463. doi:10.3390/e15041416.
[1b] [Randomized clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome](https://pubmed.ncbi.nlm.nih.gov/26060009/).
[2] Menon, VP, & Sudheer, AR (2007). Antioxidant and anti-inflammatory properties of curcumin. In The molecular targets and therapeutic uses of curcumin in health and disease (pp. 105-125). Springer, Boston, MA.
[3] Prasad, S., & Aggarwal, BB (2011). Turmeric, the golden spice: From traditional medicine to modern medicine. In Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition.
[4] Haniadka, R., Saldanha, E., Sunita, V., Palatty, PL, Fayad, R., & Baliga, MS (2013). A review of the gastroprotective effects of ginger (Zingiber officinale Roscoe). Food & Function, 4(6), 845-855.
[5] Moghadamtousi, SZ, Kadir, HA, Hassandarvish, P., Tajik, H., Abubakar, S., & Zandi, K. (2014). A review on antibacterial, antiviral, and antifungal activity of curcumin. BioMed Research International, 2014.
[6a] Vizzutti, F., Provenzano, A., Galastri, S., Milani, S., Delogu, W., Novo, E., ... & Marra, F. (2010). Curcumin limits the fibrogenic evolution of experimental steatohepatitis. Laboratory Investigation, 90(1), 104-115.
[6b] Bruck, R., Ashkenazi, M., Weiss, S., Goldiner, I., Shapiro, H., Aeed, H., ... & Oren, R. (2007). Prevention of liver cirrhosis in rats by curcumin. Liver International, 27(3), 373-383.
[7] [L-Glutamine Supplementation Alleviates Constipation during Late Gestation of Mini Sows by Modifying the Microbiota Composition in Feces](https://gut.bmj.com/content/early/2018/07/06/gutjnl-2017-315983 ).
[8] Kondo, T., Kishi, M., Fushimi, T., Ugajin, S., & Kaga, T. (2009). Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Bioscience, Biotechnology, and Biochemistry, 73(8), 1837-1843.