Irritable bowel syndrome (IBS)

The digestive tract in short

Digestion starts in the mouth. Chewing breaks ingested food into smaller pieces, and help the digestive enzymes in the saliva, to mix with the food and start breaking down the starch.

The oesophagus is a tube of about 30 centimetres and connects the mouth to the stomach. Food moves down the oesophagus to the stomach through a process called peristalsis. The oesophagus muscles contract and expand in a wave-like sequence, from top to bottom, to force the food towards the stomach.

In the stomach serious digestion takes place. More enzymes, secreted by the stomach lining, begin the digestion of fat and protein. The stomach content become a grayish mass and is completely acidified by the time the stomach has finished its work.

The stomach slowly passes its contents through peristalsis into the small intestine. Pancreatic enzymes complete the digestion in this area. The gallbladder releases bile acid into the small intestine. This acts as a detergent that allows the food materials - consisting of fat, protein, starches and indigestible fibre - to mix. In this way enzymes can come in better contact with the food. The enzymes break everything down to the smallest molecules possible. The small intestine is almost 6 m long and is lined with villi. Villi are small finger-like protrusions on the intestine walls surfaces that make the actual surface of the small intestine enormous and allow complete absorption of the digested nutrients. In the lower one-third of the small intestine water is absorbed, so the material that leaves the small intestine is undigested food material that is moist, but not watery. It takes 3 to 5 hours for the food to be digested and passed through the small intestine section. Food components, bile and water are absorbed though the villi into blood vessels that transports them to the liver for further processing.

The large intestine, or colon, is the last 1.2 meters of the digestive tract or large intestine. It is a hollow tube-like organ made up of muscle structure that moves digestive food and waste along by wavelike motion known as peristalsis. The primary function of the colon is to absorb water, electrolytes and some vitamins, as well as preparing and storing faecal waste prior to elimination. The colon is one of the most important organs for elimination of toxins and waste. If bowel movements are not regular, the waste products and toxins accumulate and can compromise our health. Good health is as much a function of our ability to get rid of unwanted compounds, as it is of the quality of the food we eat.

The colon consists of 5 distinct parts: the ascending colon, the large junction, the transverse colon, the descending colon and the rectum, which empties through the anus.

IBS is primarily an illness of the colon.

Terminology

Nutritional intervention

What is dietary fibre?
Dietary fibre is the indigestible part of plant-based foods. It passes through the stomach and small intestine without being digested.

How does fibre work?
Fibre is like a brush with selective bristle that, in addition to moving things along, can selectively bind unwanted materials and remove them from the system.

Insoluble fibre (wheat bran) is the water carrier that helps to produce regularity. It gives stools consistency. They are found in high-fibre cereals, grains, most vegetables, legumes, potatoes and sweet potatoes.

Soluble fibre, like pectin, gums, oats etc, are the best at selective absorption. Soluble fibre also binds cholesterol and fats in our diets and helps to carry it through our system.

The two most important functions of fibre are firstly to add bulk to the stool, making it firm and less watery and therefore easier to move, and secondly, to bind with unwanted material.

How much fibre is enough?
For optimal bowel function you would need 25 - 40g of fibre per day.

How to improve IBS symptoms

• Ensure a high intake of WATER-HOLDING fibre, to attain stool softness.
  • OATS - Jungle, Tiger, Pioneer, Pinhead oats, Jungle Oat Bran
  • LEGUMES WITHOUT HUSKS - spilt peas, split lentils, Soya, VitaMince, VegieMince
  • FINELY GROUND WHEAT BRAN - brown bread, All Bran Flakes, Hi Fibre Bran, Pronutro
    It is recommended that at least one of the above three fibres are eaten at every meal.
• Exclude all ROUGHAGE that is not digested and contributes 'lumps' to the stool
  Roughage is that part of food that is not digested and remains hard and lumpy throughout the small and large intestine (colon).
• Keep the fat content of all meals as low as possible
  Keeping the fat content low will ensure proper digestion of all proteins, carbohydrates and fats and thereby prevent lumps of undigested food remaining in the faeces. Avoid all high-fat food, take-aways and fast foods.
• Avoid caffeine e.g. tea, coffee, Coke, Diet Coke, Pepsi etc.
  Caffeine is a general central nervous system stimulant and stimulates peristaltic motion. A sudden rush of caffeine can "kick start" peristaltic motion and can cause IBS to flare-up.
• Consume small meals at regular intervals throughout the day
• Drink enough water => 6 to 10 glasses per day
  Without water, the water holding fibre would not work properly. Since fibre is the substance that binds water, it will 'dry out' the intestinal tract if you do not drink enough water. In the absence of water the stool will be dry and hard but with enough water the stool will be soft and consistent.
• Stay active
  Regular exercise provides two major benefits:
  • Exercise dramatically improves regularity
  • Exercise reduces the emotional stress that can lead to flair-ups.
• Replenish Friendly bacteria
  An excess of unfriendly bacteria (more accurately, an upset in the natural micro flora balance) in the large intestine will cause diarrhoea. Antibiotics and food poisoning easily upsets this balance. How can a person re-establish a normal intestinal microbiological balance again?

  The best way to increase the friendly bacteria count is by simply taking probiotic supplements containing Lactobacillus acidophilus and Bifidobacteria bifidum cultures.