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Integrative Care for Irritable Bowel Syndrome

Integrative Care for Irritable Bowel Syndrome
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We medical professionals joke together that 90% of us seem to have Irritable Bowel Syndrome (IBS). Research does show that IBS is linked to lifestyle issues and stress from long work hours, rushed erratic eating habits, and sleep deprivation, in other words the routine experiences of medical training. In a study among medical residents, the likelihood of an IBS diagnosis increased by 30% for every on-call hour that interfered with nighttime sleep. Nurses are also often affected, and those who work rotating night shifts have more IBS diagnoses, and more severe abdominal pain, than nurses with regular working hours.1

But we medical professionals do not suffer alone: IBS affects from 7% to 21% of the world’s population, with the prevalence varying by continent, region, age, and gender. As a distressing chronic condition, IBS reduces quality of life and work productivity, and in the U.S. generates almost 6 million medication prescriptions and an estimated $80 billion per year in direct and indirect healthcare costs. What is this disorder, and what can we do to heal it, or better yet, prevent it?

Over the last few years, the definition of IBS has been refined several times by worldwide consensus; the current standard, known as “Rome III,” is recurrent abdominal pain or discomfort occurring at least 3 days per month, for at least 6 months, associated with two or more of the following: improvement with defecation; onset associated with a change in frequency of stool; onset associated with a change in form or appearance of stool.2 Symptoms include cramping, bloating, constipation, diarrhea and gas, may worsen during menses, and are not explained by tests for anatomic, surgical or other types of bowel problems. IBS is thus a diagnosis of exclusion, without a known specific cause (as of now).

People with IBS are more likely to have other overlapping disorders, such as chronic pelvic pain, painful bladder syndrome, and gastrointestinal (GI) reflux, along with depression and anxiety. Underlying these conditions may be a common cause, such as genetic predisposition or toxic environmental factors. Just as our skin is an interface, separating and protecting our inner world from toxins in the outer environment, the lining of our GI tract, from mouth to anus, is also an interface, and exposed to the environment through what we eat. Stomach acid does a good job sterilizing microorganisms that come in, like bacteria, and the gut’s immune and digestive functions usually work ingeniously well, allowing just needed nutrients to pass through the interface. The microscopic organisms within our intestines, our gut “microbiome,” partners with us in a mutually beneficial relationship, living off what we eat in exchange for providing us with vitamins and inhibiting the overgrowth of harmful bacteria. An imbalance in this interface and its microbiome may well contribute to IBS.

It is likely that our modern mind-body struggle with stress also causes IBS. Chronic stress affects our autonomic nervous system, putting the sympathetic side in overdrive, which inhibits digestion in this flight or fight mode. The parasympathetic side, which promotes digestion, health maintenance, immunity, and self-healing, is suppressed by chronic stress. The gut has an active enteric nervous system or “brain” of its own, capable of direct signaling back and forth to the brain in our head, which is in charge of our mental health. This may explain how and why people who are depressed and anxious are likely to develop IBS, and why those with IBS are likely to develop depression and anxiety beyond what would be expected from the bowel symptoms alone.

IBS may be the first disorder appreciated by Western medicine to be improved by hypnotherapy, a integrative treatment that connects mind and body.3 Studies beginning thirty years ago have demonstrated that progressive relaxation, guided imagery, therapeutic suggestions, and self-hypnosis reduced bowel symptoms and pain substantially, with lasting relief, for adults and children who did not respond to conventional medications, such as antidiarrheals, laxatives, antispasmodics, probiotics and antidepressants. Physical exercise and mindfulness training have also been shown to be effective for IBS.4

From the Eastern medicine perspective, IBS is a liver/spleen disharmony with constriction, blockage and stagnation of Qi (life force energy); treatment with acupuncture and herbs is directed toward these imbalances. When I was an acupuncture student, we noted good results in our IBS symptoms from practicing on each other, even as needling novices. I remember wishing we could needle Ren 8, (Shenque, Spirit Gate) in the center of the umbilicus, since it warms and harmonizes the intestines.5 But this point was off-limits, because needling there risked inadvertent entry into the abdominal cavity. I was amazed when I heard about the new technique of Belly Button Healing developed by Ilchi Lee; it safely focuses on Ren 8, using it as an acupressure point and gateway to the lower abdomen, to circulate Qi energy there and massage, stimulate, and exercise the intestines.

In retrospect I realize that I have been suffering from IBS since I was a little girl; for as long as I can remember I worried that my intermittent pain would recur during important life events. Currently my IBS symptoms are related to the targeted chemotherapeutic agents treating my cancer. Regular practice of Belly-Button Healing with the Healing Life tool has alleviated many symptoms, and I even experience an increase in my usually poor appetite afterward. Belly-Button Healing is benefiting many Body and Brain members who have painful bowel symptoms. By activating and balancing our gut’s brain and autonomic nervous system, it is likely that this method can also prevent IBS in the first place. And it makes you feel great, so give it a try. To find out more go to bellybuttonhealing.com.

Stay well,
Deborah

References

1. Effects of Disturbed Sleep on Gastrointestinal and Somatic Pain
Symptoms in Irritable Bowel Syndrome. A. Patel; S. Hasak; B. Cassell; et al. Aliment Pharmacol Ther. 2016;44(3):246-258.

2. Irritable Bowel Syndrome: A Clinical Review. William D. Chey, MD; Jacob Kurlander, MD; Shanti Eswaran, MD JAMA March 3, 2015 Volume 313, Number 9

3. Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence. Palsson OS. Am J Clin Hypn. 2015; 58(2):134-58.

4. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. Gaylord SA, Palsson OS, Garland EL, et al. Am J Gastroenterol. 2011; 106(9):1678-88.

5. A Manual of Acupuncture, 2nd edition, Deadman, P, Al-Khahfi, M. Published by Journal of Chinese Medicine Publications, East Sussex, UK, 1998.

Written by Deborah Coady, MD
Deborah Coady, MD, is Clinical Assistant Professor of Obstetrics and Gynecology at NYU Langone Medical Center. She devoted a major portion of her medical practice to caring for pelvic pain, and currently writes, lectures, and mentors to promote integrative approaches to pain and chronic illness. As a five-year member of Body and Brain Yoga/Tai Chi, Deborah attributes her success in living with persistent cancer to this practice.
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user
I appreciated the definition of IBS provided in the article along with both the western and eastern medicine perspectives.  The explaination about the Ren 8 accupuncture point as "a place to warm and harmonize the intestines "is fascinating - and helps me understand why the belly button has had such a positive effect on my digestive track. Thanks to Dr Coady for this information.
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user
I have definitely noticed my digestive system going awry as my stress levels rise. Whether it's poor digestion, gas, bloating comma constipation or diarrhea stress has played a major factor in how my gut operates.

Now that I have learned how to take care of my gut and my stress levels with techniques such as belly button healing, intestinal exercise, mindful breathing, etcetera I have noticed a definite regularity in  the way my digestive system and my bowels work.  I wish everybody a healthy gut and a peaceful mind.

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user
Omigosh, you just described the last 3 months of my guts life. Although I would not say my symptoms rise to a clinical level, I have noticed the reflux has diminished noticeably since I started the BBH. The switching back and forth between constipation and diarrhea has been very difficult, but when I started doing BBH 2x/day regularly, even that has slowly responded. Thanks for putting all these confusing symptoms into perspective!
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user
Dr. Coady thank you so much for sharing this information!  I too can recall huge abdominal pains all through childhood.  Of course it improved with regular practice of Body & Brain yoga & tai chi, however, combining the yoga with the Belly Button Healing tool has completely sped up the healing process for those I work with now.  I hope millions of people see this article and take Healing Life Action! 💛🌎🙏✨
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user
In the past, I have experienced a lot of gas, bloating, and GERD. After Intrestine exercises and Belly Button Healing daily, my stomach feels better, my mind calm, and less tension in my body
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