Irritable bowel syndrome (IBS) is a disharmony that affects nearly one in five people in America and it is the number one reason reason people are referred to gastrointestinal specialists.  Nearly 70% of those afflicted are female between the ages of 20-45.  It’s a troubling pattern that can be overwhelming and reduce quality of life.  Fortunately, it is highly treatable with Holistic Nutrition and Chinese Medicine.  

Let’s look at IBS from both Western medical perspective first

IBS, sometimes called ‘spastic colon’ is a rather broad term used to describe a number of symptoms that cause disharmony in the large intestine (or colon).  It is considered a ‘functional’ disease – meaning the Large and Small Intestines aren’t functioning correctly.

Symptoms include:

  • irregular bowel habits
  • loose stools
  • constipation
  • alternating diarrhea and constipation
  • cramping
  • gas and bloating
  • infrequent stools that are hard and painful
  • mucus in the stools

IBS is a little tricky, and not considered a ‘disease’ per se.  Why?  Upon examination of the bowel, the doctor usually finds nothing wrong, no inflammation, and no evident signs of disease unlike in ulcerative colitis or inflammatory bowel disease, which IBS is often confused with.  The inflammatory patterns would include bleeding in the stools, physical damage to the colon, cancer or other serious bowel patterns.

What causes IBS from a Western medical view?  

They don’t know – and to date, they say there is no cure.  It is often viewed as a mild annoyance or a disabling experience.  In extreme cases, a person may be unable to go to social events, to go out to a job, or to travel even short distances.  What they do recognize is that IBS often arises after times of extreme stress.   Western medicine usually lumps IBS into into 2 categories:

  • Diarrhea-predominant IBS – occurs immediately after waking up or right after eating and can include symptoms of bowel urgency or incontinence, gas, mucus in the stools and bloating.
  • Constipation-predominant IBS – sometimes labeled ‘spastic colon’ this pattern varies from constipation to diarrhea, there will be pain in some or all of the colon, gas, bloating, nausea and mucus in the stools.  Pain and symptoms are often relieved are having a bowel movement.

Western medicine treatment usually include anti-diarrhea and/or anti-spasmodic medicines, dietary changes and stress reduction.

Chinese Medicine’s view on IBS

IBS is very responsive to Chinese medicine, herbs,  nutrition and lifestyle recommendations.  Although I might have 5 people walk into our office with a western diagnosis of IBS, it is likely that all 5 will leave with different treatment plans and recommendations. Why? Chinese medicine views each individual as a whole, complex being taking in to account both the psychological and physiological aspects of the client’s life.   The trick is using the clues to find the pattern and then treating both the symptom (diarrhea, gas, etc) and the root (Spleen Yang deficiency for example).

Let’s look at the common Chinese medicine patterns differentiation, signs and symptoms.

Damp Heat in the Large Intestine – This pattern of IBS presents with abdominal pain and diarrhea with  urgency and a burning sensation  The bowels are usually explosive and have a strong odor.  The person will feel relieved after having a bowel movement (a sign of excess). There may also be a slight fever, low grade infection (that may or may not appear in lab work), a stuffy sensation in the chest. Pressure on the abdomen would create pain.  Pulse will be full and surging, and the tongue will have a yellow coating.  Treatment focuses on clearing and removing damp and heat.  People with this pattern often indulge in very heating foods like too many spices, greasy fried foods and alcohol.  The person may also have a habit of eating too quickly or while upset.

Spleen Qi Deficiency – How is the Spleen involved in bowel problems?  In Chinese medicine the Spleen hold different functions and roles that in western medicine and its primary jobs are to govern digestion – big difference.  This form of IBS presents predominantly with fatigue, weakness of limbs, lethargy, gas and bloating. The pattern may come and go, becoming worse in times of overwork or stress. Pressure on the abdomen would relieve pain. There may also be prolapse including hemorrhoids which are considered a weakening of the Spleen Qi.  Bowel movements will often leave them feeling more exhausted. The tongue will be swollen and puffy, with or without a coat and the pulse will feel a bit weak.  Treatment is focused on strengthening the Spleen and building Qi.

Spleen Dampness – Spleen dampness is what happens when Spleen Qi deficiency is unchecked and foods that encourage damp (greasy, fried, processed, and sugary foods) are eaten excessively.  All the symptoms of Spleen Qi deficiency are present: the exhaustion, the weakness, etc. the addition is mucus, heavy or muzzy headedness, nausea or vomiting of phlegm, sinus congestion and stools with phlegm.  There may also be an inability or a sensation of inability to complete bowel movements.  Here the pulse becomes slippery and the tongue will be swollen and have a glossy coat.  This pattern often arises from eating too many sweets and rich foods and excess worry. Treatment focuses on draining damp and tonifying qi.  Darn those milkshakes and donuts.

Spleen and Kidney Yang Deficiency or Excess Cold–Yin and Yang are dynamic opposites that described and define each other.  Yang functions in the body create warmth and the ‘fire’ that transforms fluids and food into substances and energy the body needs.  When this Yang function is weak, slow, tired and withdrawn. This disharmony will be similar to Spleen qi deficiency and damp except patterns of coldness will appear in the body including: pale complexion, apathy,  low libido, back ache, frequent urination or urinary incontinence. Pressure on the abdomen would relieve pain and warm the center. The tongue will be swollen, possibly pale, and depleted in the back and the pulse will feel weak and flooding, especially on the left proximal position. Treatment here would focus on building Kidney and Spleen Yang.  Time to warm up, no running around with your belly or back uncovered.

Liver Qi Stagnation–The ‘hot and bothered’ pattern.  The Liver is easily bothered by habituated emotions (meaning they are running amok) which will create stagnation including frustration, anger, resentment and stress. Men and women are both affected but because of Liver’s role in the menstrual cycle, this pattern of IBS will often show symptoms around the cycle. Stools may be pellet like and difficult to move and then become loose around a women’s cycle. Symptoms also include acid reflux, GERD, cramping that is relieved once the bowels move, irritability, depression and mood swings.  This pattern is very easily disturbed by stress, emotions and being to ‘tightly wound’–it shows up in women with menstrual difficulties.   The pulses would display a tense nature and the tongue may be slightly red or constricted around the edges.  Treatment would focus on relieving stagnation and harmonizing the liver.  Time to exercise and practice those breathing skills.

Liver Invading Spleen (Wood Invades Earth) – Any organ disharmony left unchecked will eventually influence an organ that it interacts with.  In this pattern Liver Qi stagnation becomes excessive and overbearing and invades the Spleen.  There will be symptoms of Liver Qi stagnation along with pain along the ribs, tightness of breath, and fluctuation from exhaustion to angst and frustration.   Treatment in this pattern would focus on harmonizing the Liver and Spleen.  The tongue might be puffy, swollen and red along the edges. The pulse could vary from constrained and tight to weak.

Damp heat in the Gall Bladder – Damp heat in the Gall Bladder arises from eating excess greasy, fried and fatty foods, too many rich meats and oils and sweets.  Women in their 40’s are particularly vulnerable to this pattern and it often combines with autoimmune disorders, allergies or food sensitivities–hyperactive histamine responses. This pattern will express as explosive bowels that may have a green tint and are foul smelling.  There is a sense of urgency, in severe cases there may even be fecal incontinence. The tongue will have a slick, greasy coating perhaps unilaterally.  The pulse will be overblown and slippery.

As you can see, Irritable Bowel Syndrome is a complex disharmony in western and Chinese medicine.  It is essential that the practitioner use appropriate methods of assessment (tongue, pulse, asking, listening, palpation) so that acupressure point usage, palpation, accurate food and herbal, and lifestyle recommendations fit the client’s pattern.

If all this seems overwhelming and burdensome, don’t worry – there are several simple recommendations that will help get you on the right path to dealing with IBS now.

  • Have regular eating times – If you could do one thing to improve your digestion – this would be the first thing I would recommend. The system really loves it when it knows you are going to regularly feed your body.  Often times just getting a client to eat 3 meals at regular times a day makes a huge difference.
  • Sit down, chew your food and eat slowly – Sit down, chew your food, turn off the tv, eat with people you like. Your ability to digest increases when you are calm and relaxed. When you aren’t the Liver qi stagnates and fails to create ‘free and easy flow of Qi and fluids.’ Meaning you get belching, acid reflux, bloating, etc.  Digestion begins in the mouth with chewing.  Any client that I’ve seen with digestive issues that has taken on the commitment to slow down, sit down and chew their food has seen improvement in their digestion–whether they have GERD, ulcers, IBS or just a little gas and bloating. 
  • Avoid spicy foods – Too many spicy and hot pungent foods like garlic and hot peppers and ginger can aggravate the heat patterns of IBS.
  • Don’t chill the Spleen – Too many raw or cold foods quells the digestive fire, so if you fit into a Spleen or yang pattern be cautious with cold.
  • Avoid food triggers – This means you need to take the time to learn your pattern. If wheat and gluten are a trigger for you, limit them in your diet for a while, if onions and tomatoes bother you, back off of them.  Watch out for dairy, fried foods, meats and fats I have a client currently who can eat almost all onions except the yellow and red onions – hmmmm…odd sensitivity to have. To a whole family of foods – okay, but that she can eat any other type of onion is unusual.  I’ve recommended she try organic-the idea being that yellow onions are a heavily sprayed pesticide crop here in Idaho.  And, of course, pesticides and chemicals irritate the digestive system.
  • Simplify your foods – Whatever your pattern of IBS, symptoms will improve and abate with simple foods – especially the winter squash family (pumpkin, spaghetti squash). Add in easy to digest broth based soups with vegetables and rice. I often recommend clients have baby food and applesauce on hand, especially if they don’t enjoy cooking for themselves.
  • Increase fiber – This is a balancing trick.  Some doctors don’t recommend fiber–but fiber actually helps to regulate the bowels, the trick is finding the fibrous foods that are energetically appropriate to treat your pattern of IBS.  Pumpkin might be perfect…
  • Don’t eat late – Liver works on cleaning the blood in the late evening so late night meals weigh down the system. Spleen and Stomach are at their peak and able to digest food best in the morning. Eating late places a huge burden on the Gall Bladder and Liver….ugh….  Read more about the Nutrient Qi Cycle.
  • Manage stress – Qigong, yoga, T’ai Chi, meditation and exercise.  Learn how you manifest stress and learn ways to manage it.
  • Get in for Amma and to get the right herbs and recommendations to settle your pattern.

If you suffer from IBS try implementing a few of these recommendations and get in to get a clear assessment and specific recommendations for your pattern.

Be well!