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Irritable Bowel Syndrome (IBS) is a highly prevalent gastrointestinal disorder that reduces patients’ quality of life and imposes a significant economic burden to the healthcare system. It affects between 6–18% of people worldwide and is characterized by the presence of a cluster of symptoms and signs including cramping, increased gas, abdominal pain, altered bowel habits, food intolerance, and bloating. For some people, IBS involves incontinence or a feeling of incomplete evacuation. Some patients have no abdominal pain in the morning, and get stomachaches in the afternoon. Others go for two weeks without pain, and then have a day of crippling pain. These effects of IBS may cause you to feel you're not living life to the fullest, leading to discouragement or depression. What causes Irritable Bowel Syndrome (IBS)? The exact cause of Irritable Bowel HEALTH MATTERS Irritable Bowel Syndrome (IBS) Syndrome (IBS) is unknown. It is believed to be due to a number of factors including alteration in the gastrointestinal (GI) tract motility, increased sensitivity to pain, and food intolerances. It is twice as common in women as men and can last over a period of months or even years. Food Intolerance and IBS The role of food intolerance in Irritable Bowel Syndrome is not yet clearly understood, but many people have more severe symptoms when they eat certain foods. Depending on how much of the offending food you eat, and how much lactase enzyme your body can produce, symptoms can be mild or severe, and include nausea, cramping, gas, bloating, and diarrhoea. Why Stress triggers IBS Symptoms Stress is the body's reaction to any change that requires an adjustment or response. The body reacts to these changes with By Kepha Nyanumba physical, mental, and emotional responses. An estimated 40 to 60 percent of those with IBS have anxiety or depression. Stress and major life traumas, such as a breakup, loss of a close family member, or a family member leaving home, are all known to worsen the symptoms associated with IBS. This happens because the body’s goal is to maintain homeostasis, or a steady state of being. After a stress response, fluctuating hormones are meant to return to normal levels. However, when people experience chronic stress and anxiety, their bodies can’t achieve homeostasis. This is often the case when a person has IBS. Stress causes the release of many hormones, including corticotropin-releasing factor (CRF). This hormone is linked to the gut’s healthy bacteria, which maintains bowel function. The extra CRF also activates your body’s immune response. While that may sound like a good thing, immune activity can have adverse effects, as is the case when a person has a strong allergic response to a healthy food. Exercise is one of the most important things you can do to combat stress. The benefits are strongest when you exercise regularly. People who exercise regularly are less likely to experience anxiety than those who don’t exercise One way to handle stress is to write things down. While recording what you’re stressed about is one approach, another is jotting down what you’re grateful for. Gratitude may help relieve stress and anxiety by focusing your thoughts on what’s positive in your life. Participate in an Irritable Bowel Syndrome support group. Social support from others can be a key factor in managing stress and controlling IBS symptoms. Not all stressors are within your control, but you can control some of them. Take control over the parts of your life causing you stress that you can change. One way to do this may be to say “no” more often. This is especially true if you find yourself taking on responsibilities more than you can handle. Being selective about what you take on and saying no to things that will unnecessarily add to your load can reduce your stress levels. Adopt journaling as a means to identify how your methods of managing stress are improving and ideally how your symptoms are getting better. NOTE: While stress can be a contributing factor to Irritable Bowel Syndrome, it usually isn’t the sole factor. Focusing on stress reduction, as well as taking medications and managing your diet to lower risk of symptom triggers, can help you reduce IBS symptoms whenever possible. Nutrition Management of IBS Dietary modification should be the firstline of treatment in the management of IBS. There are several types of foods in particular that often trigger IBS symptoms and signs. Avoid culprit foods. Fatty foods aggravate symptoms in many people with IBS. Fats slow down the digestive tract, gumming up the works in an already irregular system. Milk can also trigger symptoms in people with IBS who are lactose intolerant. Reduce or eliminate trans-fatty acids, found in commercially baked goods, such as cookies, crackers etc. Many studies show that probiotics help relieve symptoms of IBS, including abdominal pain, gas, and constipation. Eating a healthy diet that includes mainly fruits, vegetables, and whole grains plays a key role in the management of gastritis. If gas is a problem, you may want to limit the intake of gas forming foods. Probiotics and IBS Probiotics are microorganisms that can help the symptoms of IBS by regulating motility, constipation, and diarrhea. Research is beginning to support a potential role for probiotics in IBS, with variability depending on the use of different probiotic strains, their ability to adhere to and colonize in the GI tract, and the number of colony-forming units an individual ingests. Prebiotics and probiotics are helpful to Irritable Bowel Syndrome patients but they should not be used as a first-line defence. Instead, it’s important to get to the root of food sensitivities that may trigger symptoms. Kepha Nyanumba is a Consultant Nutritionist working with Crystal Health Consultants Limited. You can commune with him on this or related matters vide email at: Kephanyanumba@gmail.com, follow him on twitter: @knyanumba or Blog: kephanyanumba.blogspot. com. While stress can be a contributing factor to Irritable Bowel Syndrome, it usually isn’t the sole factor. Focusing on stress reduction, as well as taking medications and managing your diet to lower risk of symptom triggers, can help you reduce IBS symptoms whenever possible. Chronic stress can cause your intestinal bacteria to be imbalanced, a condition known as dysbiosis. According to studies stress-induced dysbiosis may play a key role in a person developing IBS. Strategies for Coping with Stress Make effort to sleep at least six to eight hours a night. Getting plenty of sleep can provide you with the energy you need to go through your day. 84 MAL36/20 ISSUE