Irritable Bowel Syndrome (IBS) is a complex and often misunderstood gastrointestinal condition that significantly impacts the quality of life for those affected. With symptoms ranging from abdominal pain to unpredictable bowel movements, managing IBS can be challenging. This article explores the science behind IBS, its potential causes, and how Traditional Chinese Medicine (TCM) offers holistic approaches to alleviate symptoms and restore balance.

What is Irritable Bowel Syndrome (IBS) and how does it affect me?

Irritable Bowel Syndrome (IBS) is a common, chronic disorder affecting the large intestine. It is characterised by a group of symptoms that typically occur together, including repeated pain in the abdomen and changes in bowel movements, which may be diarrhoea, constipation, or both.

Causes for Irritable Bowel Syndrome (IBS)

Though the exact cause of IBS is not known, several factors are believed to play a role:

Abnormal Gastrointestinal Tract Movements: Problems with how the muscles in the intestines move can cause either too rapid or too slow transit of food, leading to diarrhoea or constipation.
Hypersensitivity: Increased sensitivity of the intestines can lead to pain or discomfort.
Brain-Gut Interaction: The communication between the brain and the gut may be impaired, affecting bowel function and pain sensitivity.
Inflammation: Some people with IBS have increased numbers of immune cells in their intestines, suggesting inflammation may play a role.
Severe Infections: IBS can develop after a severe bout of diarrhoea (gastroenteritis) caused by bacteria or viruses.
Changes in Microflora: The microflora in the gut of people with IBS may differ from those in healthy individuals.
Genetics: A family history of IBS might increase the risk of developing the condition.
Mental Health Issues: Anxiety, depression, and other mental health issues are common in IBS patients, though it's unclear whether they cause IBS or are a result of it.

What are the symptoms of Irritable Bowel Syndrome (IBS)?

Symptops of Irritable Bowel Syndrome (IBS) | Common TCM

Symptoms of IBS include:

Abdominal Pain and Cramping: Often relieved by bowel movements.
Bloating and Gas: A feeling of fullness or swelling in the abdomen.
Diarrhoea (IBS-D): Frequent, loose, watery stools.
Constipation (IBS-C): Infrequent, hard, or lumpy stools.
Diarrhoea and Constipation (IBS-M): Alternating bouts of diarrhoea and constipation.
Mucus in the Stool: Presence of white or clear mucus in stools.
Changes in Bowel Habits: Unpredictable bowel movements.

Available treatments and self-help tips for IBS

With dietary changes, medication, lifestyle changes and psychological therapies, IBS is highly manageable. Below are some treatments and self-help tips that can help:

Dietary changes: Supplementing with fibre can be helpful for constipation by increasing roughage in the stools. A low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet could help reduce bloating and distention in the gut. Avoiding trigger foods such as gluten, dairy, caffeine and high-fat foods could also reduce gastric discomfort.
Medications: Anti-diarrheal medications for controlling diarrhoea and laxatives for constipation. Antispasmodics to reduce abdominal pain and cramping. Probiotics can be useful for balancing the gut microbiome and low doses of antidepressants to relieve pain and treat underlying depression or anxiety.
Lifestyle changes: Physical activity is helpful in regulating overall digestive health. Stress management techniques like mindfulness meditation or yoga can help reduce the symptoms of stress. Adequate and good quality sleep is important for overall health and well-being.
Psychological therapies: Cognitive Behavioural therapy (CBT) can help you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. Gut-Directed Hypnotherapy can help control symptoms through relaxation techniques.

Evidence-Based TCM Approaches for Managing Irritable Bowel Syndrome (IBS)

In Traditional Chinese Medicine (TCM), although there isn’t a disease that translates to IBS, its associated symptoms can be likened to 便秘(Bian Mi), 腹痛(Fu Tong), 泄泻(Xie Xie), 痞满(Pi Man) etc. Commonly seen patterns of disharmony that present in those afflicted with the above-mentioned TCM diseases are: “Food Stagnation, Spleen Deficiency, Liver Qi Stagnation, Damp-Heat, Blood-stasis, Liver-Stomach Imbalance” etc. Although IBS consists of a melting pot of all the TCM diseases mentioned above, the patterns of disharmony identified allow a skilled TCM practitioner to slowly but surely unravel the puzzle that is IBS for the best TCM treatment.

TCM believes that a disease can be split into many different patterns of disharmonies at different stages of the same disease. This means that as the situation evolves, different patterns of disharmony start appearing and thus the formula or treatment method has to change to suit the pattern. Thus, a comprehensive consultation is necessary to elucidate the pattern of disharmony for effective management of IBS using TCM.

Herbal Medicine

Functional issues related to digestion have always been a staple for TCM. There is a saying in the TCM community that if the 脾胃(Pronounced Pi Wei) i.e. Gut health is weak, many illnesses will arise. Through the lens of a TCM practitioner, IBS is seen as a chronic imbalance in the function of the digestive system. Hence herbal formulae that have an effect on the gut have been used in the management of IBS.

According to a population-based cross-sectional study done in Taiwan, 白术 Bai Zhu, 厚朴 Hou Pu, 陈皮 Chen Pi and 丹参 Dan Shen were among the most commonly used herbs for the management of IBS. Popular formulae for the management of IBS include 加味逍遥散Jia Wei Xiao Yao (JWXY) decoction 半夏泻心汤 Ban Xia Xie Xin (BXXX) decoction 香砂六君子汤 Xiang Sha Liu Jun (XSLJ) decoction[1]. JWXY decoction has been shown to be effective in regulating abnormal gastric motility and electrical activity in the muscles in IBS patients with functional dyspepsia[2]. BXXX decoction was found to effectively relieve IBS symptoms while providing benefits to functional dyspepsia and stomach ulcer symptoms[3]. XSLJ decoction was used often to alleviate allergy related conditions, functional abdominal pain and produced improvements in functional dyspepsia symptoms compared with prokinetic agents[4].

Acupuncture

Another great TCM treatment to consider in acupuncture in Singapore. Acupuncture, the act of inserting fine needles into specific acupoints on the body, has long been used for the management of gastrointestinal disorders, proving to be a vital complementary therapy for IBS. Not only is it proven to be a safe and convenient way to manage digestive issues, it also comes with few side effects. A meta-analysis reviewing the efficacy of acupuncture for IBS found that patients reported greater benefits from acupuncture than from pharmacological therapies[5]. Commonly used acupoints for alleviating digestive discomfort include 足三里(Zu San Li) 太冲(Tai Chong) 合谷(He Gu) 中脘(Zhong Wan) 天枢(Tian Shu) 大横(Da Heng) etc. 太冲(Tai Chong) and 合谷(He Gu) are especially effective at relieving IBS triggered by stress and anxiety while the others are effective in managing symptoms like bloating,abdominal pain, poor appetite,diarrhoea and constipation.

A study done to discover the effects of acupuncture on diarrhoea dominant IBS found that the acupuncture stimulation improved the IBS symptom severity and anxiety of IBS-D patients by activating the related functional connections[6]. Acupuncture stimulation negatively activated the functional connections between different regions of the brain, which were decreased compared with those of the control group[7]. The acupoints used in the study were 百会(Bai Hui), 印堂(Yin Tang), 太冲(Tai Chong), 足三里(Zu San Li), 三阴交(San Yin Jiao), 天枢(Tian Shu), and 上巨虚(Shang Ju Xu).

How Many Sessions Do I Need?

IBS is a commonly treated condition. While it can be a chronic event, most cases experience a reduction in the frequency, severity and a positive prognosis. At Common TCM, your physician will review your medical history and determine the optimal frequency of visits based on the duration of the condition and the severity of symptoms that may affect the prognosis. A course of treatment usually entails weekly sessions for a 3 month period. Upon completion, depending on how the symptoms have abated, a follow-up treatment plan taking into account other factors (e.g. any upcoming major stressors/travel) will be suggested.

Who is this suitable for?

Treatment is suitable for anyone, however certain acupoints are contraindicated during pregnancy, so inform your physician if you may be pregnant. A personalised consultation with the physician from a good TCM clinic in Singapore will be necessary to determine the treatments chosen. IBS management requires a physician who thoroughly understands the triggers to your condition whether it is food-related or emotion-dependant. Thus, a physical consultation is the best way to review your well-being status, stress levels to help personalise your healthcare journey.

Finally, do your research and seek advice from reputable professionals at a TCM clinic in Singapore for an elevated healing experience. For more information, visit our website to learn more about our treatments and physicians or to book an appointment. Your well-being is our priority, and we are here to support you on your journey towards better health.

[1]

https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1201240/full

[2]

https://onlinelibrary.wiley.com/doi/10.1002/ptr.2920

[3]

https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1130257/full

[4]

https://pubmed.ncbi.nlm.nih.gov/23304226/

[5]

https://pubmed.ncbi.nlm.nih.gov/22488079/

[6]

https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2020.608688/full