Help for IBS: the microbiome and the stress response.
Unfortunately you or someone you know probably suffers from IBS, which affects one in ten Australians (Ng, Nassar, Hamd, Nagarajah, & Gladman, 2015). Symptoms range in severity from mild to debilitating and include digestive discomfort, excessive flatulence (gas), bloating, constipation or diarrhoea, or alternation between the two. These symptoms can be associated with three underlying factors: gut inflammation, an imbalance in the number of ‘good’ and ‘bad’ gut bacteria and stress. Answer the questionnaire on www.melbournemindbodypsychology.com to see if stress is affecting you.
GUT BUGS the good the bad and the ugly-
Beneficial versus destructive bacteria
A healthy gut is teeming with beneficial bacteria in fact there are so many billions of them that they weigh around 2kg, now that’s a lot of bacteria! These bacteria are known as the microbiota and are very important to overall health. More and more research is currently revealing that these bacteria may affect everything from our mental health, to our blood sugar balance and immune function. The microbiota, ferment dietary fibre and produce compounds that feed our gut cells and support overall health. However, when chronic inflammation damages intestinal cells, or beneficial bacterial species are lost, due to disease, medication or stress the intestinal environment can change. When these changes occur ‘unwanted’ bacteria can flourish. Having less ‘beneficial’ bacteria and more ‘destructive’ bacteria represents a dysfunctional imbalance that can cause excessive bloating and gas due to the over-fermentation of fibre. In other words, when the balance swings in favour of ‘bad’ bacteria, symptoms arise.
Stress and the gut
Cortisol is produced each time you are stressed. Every system, every cell and every chemical reaction in the body is affected. Stress affects the gut in particularly and exacerbates gut symptoms. This occurs because of the two-way, biochemical connection between the central nervous system and the gut, known as the brain-gut axis. IBS is also significantly associated with anxiety and mood disorders. Research has shown that people who currently have IBS are also more likely to suffer mood or anxiety symptoms (Mykletun et al., 2010).
Stress may aggravate IBS by boosting pain sensitivity. The enteric nervous system (the gut’s dedicated nervous system) normally perceives and transmits pain signals from, for example, gut inflammation, or pressure from gas, and these signals are amplified by stress. Research indicates that people with a heightened stress response are more likely to experience IBS indicating that your response to stress can affect your symptoms (Mykletun et al., 2010).
Coping with stress
We know we cannot get rid of stress, nor do we want to, because even such things as purchasing a new home, or getting married are stressful. The question is how do you cope with too much stress? First, identify the sources of stress in your life and then seek solutions to help minimise stress and improve your resilience. If you are feeling tense, you could exercise, practice mindfulness or take time out. Specifically for IBS sufferers you can practice visualising a knotted ball gently unravelling within your gut. Techniques such as this example can help to break the cycle of stress that aggravates IBS symptoms. see www.melbournemindbodypsychology.com for more info
Diet for IBS?
Certain types of dietary fibre may stimulate excessive fermentation by gut bacteria, aggravating symptoms; this includes FODMAPs. FODMAP stands for fermentable oligosaccharides (such as fructans found in wheat, garlic and onions), disaccharides (such as lactose found in milk), monosaccharides (such as fructose found in fruit juice) and polyols (such as sorbitol found in prunes), which are all types of fibre that gut bacteria ferment naturally. These fibres normally feed beneficial bacteria, supporting a healthy intestinal environment and bulking up the stool.
However, in IBS, FODMAP-containing foods are over-fermented by ‘bad’ gut bacteria, resulting in excessive gas production and pain. Limiting high FODMAP foods can help identify your food triggers; however, restricting any food group should always be a short-term strategy. A high intake of diverse fibre types is critical for health, and therefore FODMAP elimination should always be professionally supervised by a healthcare Practitioner.
By Erica Patrick
Mykletun, A., Jacka, F., Williams, L., Pasco, J., Henry, M., Nicholson, G. C., . . . Berk, M. (2010). Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC gastroenterology, 10(1), 88.
Ng, K. S., Nassar, N., Hamd, K., Nagarajah, A., & Gladman, M. (2015). Prevalence of functional bowel disorders and faecal incontinence: an Australian primary care survey. Colorectal Disease, 17(2), 150-159.