Irritable Bowel Syndrome: Understanding your gut’s delicate balance

General Healthcare

  7 Minutes

The human gut is a complex ecosystem, home to trillions of microorganisms that play an important role in our digestive health. When the delicate balance of this ecosystem is disrupted, it can lead to gastrointestinal issues, including Irritable Bowel Syndrome (IBS). This common digestive disorder affects an estimated 8% of the South African population, equating to around 4.6 million people.
IBS is a chronic condition characterised by recurring abdominal pain and changes in bowel habits which interfere with your daily activities, work productivity and social life. Despite its prevalence, IBS remains a challenging condition to understand and manage, often leaving people who are affected feeling frustrated and seeking answers.

What is IBS?

IBS is a functional gastrointestinal disorder, which means it affects how your gut works without any visible signs of damage or disease. It’s characterised by recurring abdominal pain and changes in bowel habits, like diarrhoea, constipation, or both.

These symptoms can have a major effect on your quality of life, affecting work, social activities, and overall well-being.

Symptoms of IBS

While symptoms can vary depending on the type of IBS, some common ones include:

  • Abdominal pain or discomfort
  • Changes in bowel habits (diarrhoea, constipation, or both)
  • Bloating
  • Gas
  • Urgency to use the toilet
  • Feeling of incomplete evacuation

Some people with IBS also experience non-gut related symptoms like headaches, sleep disturbances, anxiety, or depression.

Types of IBS

IBS isn’t a one-size-fits-all condition. There are three main types, each with its own pattern of symptoms:

  • IBS with constipation (IBS-C): Stools are often hard or lumpy, and often difficult or painful to pass.
  • IBS with diarrhoea (IBS-D): Loose,watery and/or urgent stools are more common.
  • IBS with mixed bowel habits (IBS-M): This type alternates between constipation and diarrhoea.

Some experts also recognise a fourth type, unclassified IBS (IBS-U), where symptoms don’t fit neatly into the other categories.

Diagnosing IBS

Diagnosing IBS can be tricky as there’s no single definitive test. Doctors use a combination of methods:

  • Symptom review: They’ll look for a specific pattern in your symptoms including sudden weight loss, blood in the stool and a recent change in bowel habits.
  • Medical history: This includes family history and recent infections.
  • Physical exam: To check for abdominal tenderness or bloating.
  • Exclusion of other conditions: Blood tests, stool tests, and sometimes other procedures like colonoscopy may be used to rule out other diseases.

IBS is an exclusionary diagnosis, meaning it’s diagnosed when other potential causes have been ruled out.

Causes of IBS: The microbiome connection

While the exact cause of IBS remains unclear, evidence points to an imbalance in the gut microbiome as a potential key factor. The gut microbiome is the community of trillions of healthy microorganisms living in our digestive tract. When this community becomes imbalanced it can lead to IBS symptoms. This is a condition known as dysbiosis.

Dysbiosis can occur due to various factors, including:

  • Infections
  • Stress
  • Dietary changes e.g. insufficient fibre, excess sugar and processed foods
  • Medicines such as antibiotics or long term antacid use
  • Antibiotic use

When dysbiosis occurs, it can trigger a cascade of events in the gut. The immune system may become activated, leading to low-grade inflammation. Dysbiosis affects gut motility (how food moves through the digestive system), increases gut sensitivity, and alters gut-brain communication, all of which are hallmarks of IBS.

The power of fermented foods and a healthy microbiome

The power of fermented foods and a healthy microbiome

Given the link between gut microbiome imbalance and IBS, it’s not surprising that restoring microbial balance can help manage symptoms. One way to do this is to incorporate fermented foods into your diet.

Fermented foods like kimchi, kombucha, tempeh, miso, amasi (maas), amahewu, live culture yoghurt, and sauerkraut are rich in beneficial bacteria and their byproducts. These foods can help in several ways:

  • They provide prebiotics, which feed the good bacteria in your gut.
  • They introduce new beneficial microbes to your gut ecosystem.
  • They contain substances that can protect your gut lining and support your immune system.

While more research is needed, some studies suggest that regularly consuming fermented foods may help alleviate IBS symptoms and support overall gut health.

Lactic acid bacteria and lactic acid: Gut-friendly allies

Lactic acid bacteria, e.g. lactobacillus are used in the production of many fermented foods. These bacteria produce a key substance known as lactic acid. The lactic acid in fermented foods is the reason for their characteristic sour taste. It’s the presence of lactic acid in fermented foods which contributes to their health benefits. Lactic acid benefits the gut in several ways:

  • They help maintain a healthy pH in the gut, creating an environment that favours beneficial bacteria.
  • Some strains have been shown to reduce abdominal pain and improve overall IBS symptoms.
  • They may help strengthen the gut barrier, reducing gut permeability (often referred to as leaky gut).

A study using a combination of Lactobacilli strains found significant improvements in global IBS symptoms and reduced stool frequency in patients with diarrhoea-predominant IBS.

Butyrate: The gut’s favourite fuel

Butyrate is a short-chain fatty acid produced when certain gut bacteria consume dietary fibre. It’s a crucial energy source for the cells lining your colon and plays a vital role in gut health. Recent research has explored the potential benefits of butyrate supplementation in IBS:

  • It may help reduce abdominal pain and discomfort.
  • It can improve bowel habits, helping to normalise both diarrhoea and constipation.
  • It supports the gut barrier function, reducing gut permeability.

Interestingly research has shown that the body can covert lactic acid into butyrate further explaining why fermented foods are so beneficial for us.

Managing IBS: A holistic approach

IBS can be challenging to live with, but understanding its connection to the gut microbiome opens up new avenues for management strategies that support a healthy, diverse gut ecosystem and help alleviate symptoms.

  • Incorporate fermented foods into your diet
  • Use a prebiotic and probiotic supplement
  • Make sure you eat enough fibre to support butyrate production
  • Keep a food diary to identify trigger foods
  • Manage stress through relaxation techniques or cognitive behavioural therapy
  • During flare ups try the root vegetable and pumpkin diet. This simple eating plan can be followed for up to 10 days to help your gut rebalance and recover.

A,Vogel Molkosan: A prebiotic powerhouse for IBS management

For people looking for long-term management of IBS symptoms, A.Vogel Molkosan is a solution. This natural whey concentrate, rich in L+ lactic acid, acts as a prebiotic to support a healthy gut microbiome.

A.Vogel Molkosan 200mlA.Vogel Molkosan works by:

  • Providing food for beneficial gut bacteria
  • Creating an environment that discourages harmful bacteria and yeasts
  • Supporting the production of butyrate.

 
A.Vogel Molkosan prepares the gut environment to support existing beneficial flora and stimulate the growth of new bacteria.

To incorporate A.Vogel Molkosan into your IBS management routine take a teaspoon or tablespoon in a glass of water 20 minutes before meals. Mix the A.Vogel Molkosan with fruit juice or add it to a smoothie if you find the taste challenging.

Use it daily and year-round for ongoing digestive health support. A.Vogel Molkosan is suitable for adults and children over 6 years old, and can even be used by those with lactose intolerance. When combined with dietary changes, stress management techniques, and other IBS treatments, A.Vogel Molkosan is a valuable tool in the long-term management of this challenging condition.

A.Vogel Gastronol: A homeopathic solution for acute IBS symptoms

For people experiencing acute IBS symptoms, A.Vogel’s Gastronol tablets offer a targeted homeopathic approach. This remedy is specifically formulated to address common digestive discomforts associated with IBS.

A.Vogel Gastronol 200tabs
  • Nux vomica and Colocynthis: These ingredients help counteract digestive system cramps and diarrhoea, two hallmark symptoms of IBS.
  • Aesculus hippocastanum, Argentum nitricum, Alumina, Bryonia, and Nux vomica: This combination addresses indigestion, abdominal distention, and flatulence, which are often experienced during IBS flare-ups.
  • Bryonia and Nux vomica: These components also assist in relieving the sensation of digestive fullness, a common complaint among IBS sufferers.

 
When acute symptoms arise, A.Vogel Gastronol can be taken every 15-30 minutes, with the dosage adjusted based on age. For adults and children over 12, the recommended dose is 2 to 3 tablets. As symptoms improve, the frequency can be reduced, with a maximum of 5 doses per 24 hours. For children 6-12 years the dosage is 1 tablet 3-5 times daily.

The tablets are designed to be chewed or dissolved in the mouth, allowing for quick absorption and rapid relief. This makes A.Vogel Gastronol a convenient option for managing sudden IBS attacks, helping to alleviate discomfort and reduce the duration of acute episodes. It’s important to note that while A.Vogel Gastronol can provide relief for acute symptoms, it should be used as part of a comprehensive IBS management plan.

IBS is a complex condition, and what works for one person may not work for another. Always consult with a healthcare professional before making big changes to your diet or starting new supplements. They can help you develop a personalised management plan that addresses your specific symptoms and needs.

Conclusion

IBS is a complex and chronic condition that affects millions of South Africans. Understanding its connection to the gut microbiome provides us with a roadmap to effective management. Nurturing the diverse community of microbes in our gut by incorporating fermented foods, managing stress, and identifying trigger foods, helps to restore balance to our internal ecosystem.

IBS management is not about finding a quick fix, but rather about developing a holistic, long-term approach tailored to your individual needs. With patience, persistence, and the right strategies, you can improve symptoms and regain control over your digestive health.

References and additional reading:

  1. Chong, P.P. et al. (2019) The microbiome and irritable bowel syndrome – a review on the pathophysiology, current research and future therapy, Frontiers. Available at: https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2019.01136/full
  2. Gallimore, I. (2024) Fermented Foods: Can They Help Your Ibs?, Tummy MOT. Available at: https://tummymot.com/tips/fermented-foods-can-they-help-your-ibs
  3. Irritable bowel syndrome (2024) Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016
  4. Irritable bowel syndrome (IBS) (no date) Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/irritable-bowel-syndrome-ibs