Have you been to a gastro enterologist with symptoms of persistent bloating, gas, abdominal pain and occasional diarrhoea or constipation. And are you confused because all examinations and tests including analysis of blood, faeces and endoscopy did not reveal any infections, inflammations or other issues? Your doctor may have already diagnosed your condition as irritable bowel syndrome, commonly called IBS. 

Irritable bowel syndrome is really an annoying condition. Though not critical, it can really affect your quality of life. 

It is estimated that about 15- 45% of all people around the world are suffering from IBS. (1) Interestingly, 60-80% of this are women. 

Irritable bowel syndrome is a chronic condition. That means it lasts for a long time and you will need to manage it for long time, according to conventional medicine.

Ayurveda, by its wholistic approach recommends herbs, medicines, diet regulations and exercises to improve the symptoms of IBS and is being very effective in improving life quality of patients with IBS.

How to know if you have Irritable Bowel Syndrome:

Symptoms of IBS are mostly related to pattern of bowel movements, consistency of feces and abdominal pain. But these are altered by almost all conditions affecting the digestive system. So we have to differentiate whether the symptoms are caused by other similar diseases. 

The criteria for diagnosing IBS is called ‘Rome IV’ criteria. Accordingly, the most important feature of IBS is abdominal pain for at least one day per week in the last three months. Along with that if you have change in frequency of stool or / and change in appearance of stool, you can be diagnosed as having IBS. Studies which lead to the criteria also points out that the diagnosis shall be made only if the symptoms are prevalent for more than six  months after the first onset. Also the abdominal pain is mostly related to bowel movements. Meaning it shall be relieved after passing stool or it will be more when you feel to pass stool.  Most often, there is a feeling of incomplete evacuation (tenesmus).

If you have IBS, you may have intermittent diarrhea, but for some people, it will be constipation or diarrhea alternating with constipation. Sometimes IBS can be present even with neither constipation nor diarrhea occurring frequently.

What causes IBS?

The exact cause of IBS is not known. However, most people (about 89%) with IBS are found to have food sensitivities. (2) The most common food items to which people are sensitive include legumes, lactose, artificial sweeteners, stone fruits, and fatty food.

Research shows that in people with IBS, the entire ‘microbiota-gut-brain axis’ is affected. That means the chemical and nervous impulses which convey information between the digestive system and brain are disrupted. This causes alterations in the motility and secretions of the digestive tract, resulting in either food being pushed through too fast or not passing fast enough, excess fermentation, etc.

Some people may develop IBS after an infection. About 20% of people who catch acute stomach infections develop IBS later. After the infection subsides, they might feel recurrent abdominal pain, altered bowel habits, etc.

Many people having IBS showed a local inflammatory response in the intestines. Some people reported developing IBS after they are cured of inflammatory conditions of the bowel like celiac disease, inflammatory bowel diseases, etc. This indicates a relation of IBS with immunity and inflammatory response, but the exact mechanism is yet to be identified. 

Overgrowth of gut bacteria in the small intestine is another cause found in some people with IBS.

Many people with IBS are found to be efficient in vitamins, especially Vitamin D. Whether this is a cause or a result of impaired intestinal permeability is yet to be found out. 

Some researchers even suggest a hormonal link because of the fact that women are more susceptible to IBS.

Anxiety, Stress, Depression and IBS:

These are inter related as mental conditions like anxiety, depression etc will trigger onset or bouts of IBS symptoms. Also, as IBS affects the quality of one’s life, it adds to anxiety and depression. Thus these conditions are found inter related in  most people.

How Ayurveda views IBS?

Irritable bowel syndrome is directly related to ‘AGNI’ which Ayurveda regards as the core for health or disease. Modern medicine does not have a specific treatment for IBS because there is no specific pathology like structural damage, infection, or inflammation involved in IBS. But Ayurveda has a clear idea about the condition because it has a clear understanding of the functioning of ‘agni’, factors that can affect it, the symptoms of low or improper ‘agni’ etc. And the symptoms of IBS are similar with the symptoms of impaired ‘agni’.

IBS is often classified as one of the conditions under the ambit of ‘grahani’, especially when it is associated with diarrhea. IBS with constipation or alternating symptoms is considered as having a predominance of ‘Vata’ and often named ‘anaha’ or ‘grahani’. 

The factors contributing to IBS according to Ayurveda are:

1. ’Midhya aahara’ or food which hinders the ‘agni’ (digestive fire). This means eating irrespective of one’s agni can lead to grahani. This can be due to habitually eating in the wrong time or wrong food items. Otherwise, eating wrong food after or during a digestive issue or general illness can cause the same problem.
2. Ayurveda explicitly states that diarrhoea if not treated well can progress into grahani.
3. Infection is also pointed out as a cause of diarrhoea even 3000 years ago, which can progress to ‘grahani’.

What are the treatment options for IBS in Ayurveda:

In managing IBS, Ayurveda considers the type of IBS – whether vata, pitha or kapha is predominant by analysing the symptoms you are experiencing. Also the state of ‘agni’ should be assessed. Emotional factors including stress, anxiety, depression and mental ‘prakruthi’ are also considered.

Afterwards, your ayurvedic physician may draw up a plan including food to avoid and eat, herbal medicines to normalise the agni and doshas and routines to follow. The aim is to reduce the sensitivity of the gut mucosa, normalise movements and permeability of the digestive system,  improve digestion and more importantly to control stress and balance emotions. 

The common medicines used in IBS treatments include kaidaryadi kashayam, dadimashtakam choornam, charngeryadi gulika, pranah tablets etc. 

In some cases, panchakarma cleaning will also be effective in removing the metabolic toxins or ‘aama’ from the body to treat IBS.

Do home remedies for IBS work?

Although using some herbs and food items as home remedies may help to reduce the symptoms to an extent, it is better to consult a qualified ayurvedic doctor near you and take appropriate medicines and diet to get rid of the symptoms for long term.

The most effective home remedies are:

1. Buttermilk: Buttermilk is a sour drink which is made by removing all the butter from yoghurt or curd. It helps to increase the digestive fire and reduce gut sensitivity.
2. Herbs like carom seeds (ajwain), coriander (dhania), fennel (jeera), ginger etc can be boiled in water and that water can be used instead of normal drinking water. (You may require any one or two of the above herbs according to your symptoms. Consult your ayurvedic doctor for recommendations)

If you think that you are having IBS, you can consult online with our ayurveda doctor. Please feel free to comment below if you have any doubts or questions.

References:

1. https://pubmed.ncbi.nlm.nih.gov/12641512/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826071/
3. Vagbhata, Ashtanga Hurdaya, Nidanasthana, Chapter 8.