IRRITABLE BOWEL SYNDROME, IBS, MUCOSAL COLITIS, treatment, symptoms, medicinal herbs, essential oils, complementary treatment

When a disease has many different names it means that the disorders associated with it are varied, not always characteristic and that its description is therefore a bit vague.

This is the case of the IRRITABLE BOWEL SYNDROME ( or IBS), this "functional" (or functioning) disorder of the colon is common and widespread in all populations.

Specialists estimate that at least 20% of people will suffer from IBS one day or another and that 5% suffer from this digestive disorder chronically; to characterize it we use the regular presence of a certain number of symptoms (ROME criteria).

<< According to the Rome III criteria an irritable bowel syndrome is established only in the presence of pain or abdominal discomfort lasting at least 12 weeks in the last 12 months (the 12 weeks of pain not to be consecutive). This pain must correspond to at least two of the following three criteria:

- Be relieved at the time of defecation.
- Be associated with a change in the frequency of defecation. (defined as a frequency greater than 3 times per day, or less than 3 times per week).
- Be associated with an abnormal change in stool consistency (too hard or too soft).

SYMPTOMS AND PHYSICAL DISORDERS OF IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome is a functional disorder but its manifestations are in fact very physical:

- Digestive pain with cramp or colic in the lower abdomen to the right or left more rarely in the middle or back.

- These pains, which seem to come from the large intestine, are accompanied by intestinal gas with meteorism (increase in the volume of the visible or felt abdomen); these pains diminish or disappear after evacuation of intestinal gases or after defecation.

- The need to defecate can be urgent (pressing).

- This disorder is accompanied by either diarrhea or constipation.

- When there is constipation it is often associated with mucosal colitis (a lot of mucus in the feces), and the foecal matters take the form of small balls in the middle of a liquid more or less tinted.

Pains and transit disorders are sometimes accompanied by migraines, slight urinary problems and an increase of the gastro-colic reflex: when one eat (especially in the middle of the day), an abundant meal, too fast and a meal containing a lot of fat, it provoke intestinal contractions and the urgent need to defecate.

The symptoms of the irritable bowel are essentially diurnal, they disappear when sleeping.

They are accompanied neither by fever nor by blood or digested blood (almost black feces), but sometimes by chronic fatigue.

They are more common among women.

They begin quite often following an infectious gastroenteritis (bacterial or viral) which is a classical trigger of this disorder, more rarely of psychological stress, often we find no cause.

Stress, worries, nervousness accentuate the symptoms of irritable bowel.
The irritable bowel syndrome or functional colitis, often evolves by episodes of a few days, weeks or months in the most serious cases.
The symptoms may disappear completely for several months and re-emerge as a result of stress or food overload.
Irritable bowel syndrome can subside and disappear completely in a few years (5 to 7 years) especially when it has been triggered by an episode of infectious gastroenteritis.

CAUSES OF IRRITABLE BOWEL SYNDROME

The causes and pathological mechanisms responsible for this "disease" are not well known:

- but we know that the digestive system has a complex mechanisms of regulation and that it is deeply disturbed in this affection,

- that there are important interactions between organs (stomach, liver, pancreas, intestines),

- that the neurological regulation of digestion is autonomous (unconscious) but also very influenced by the brain and therefore our "mood"
,
- the defense cells of the body are very present in the colon and they are able to secrete very powerful pro-inflammatory substances,

- that the colon (or large intestine) naturally contains many bacteria and yeasts that have a positive role in the transformation of feces but which can also proliferate abnormally especially when the digestion of food is incomplete,

- that our enzymatic equipment may be deficient preventing the digestion of certain foods (example milk lactose),

- or that we may be "allergic" or "intolerant" to certain components of the diet (eg cereal gluten),

- and that people suffering from irritable colon often have a hypersensitivity of their colon to the presence of intestinal gas that distends its walls.

Treatments of the irritable colon (traditional or by medicinal plants or essential oils) and dietetics try to act at these different levels..

WARNING !!

Before talking about functional disorders (so relatively benign) we must eliminate other more serious causes of colitis (malignant or benign tumor, Crohn's disease, ulcerative colitis, parasitosis etc.) and therefore consult a doctor when intestinal disorders persist or are accompanied by fever, bleeding, are present even at night, or occur after 50 years

FOOD MUST BE MONITORED WHEN LIVING WITH INTESTINAL DISORDERS

We must ensure that we are not intolerant to certain groups of foods that are tested successively by removing them from the diet.

- LACTOSE is eliminated as much as possible for 2 weeks by eliminating milk (fresh or powdered) and foods containing it even processed milk (yoghurt, cheese, butter, pastry, ice cream, etc.); you can also do a lactose tolerance test.

- Tolerance to GLUTEN is tested by removing for 2 weeks all foods containing it (mainly bread and wheat flour dishes, pasta and pizza, wheat semolina), they are replaced by rice which is well accepted in the majority of inflammatory digestive disorders.

- FRUCTOSE can also be involved: honey, soda drink (coca-cola, pepsi-cola etc.), very sweety fruits.

- Almonds are sometimes sources of digestive disorders: nuts, hazelnuts, almonds, macadamia, para nuts ... as well as peanuts (peanuts).

- SOME FOODS PROMOTE INTESTINAL GASES which aggravates the situation when the bowel is irritable:
- starchy foods (beans, lentils, peas, beans),
- cabbage and green vegetables that contain a lot of cellulose (salad, spinach for example),
- foods containing fermentable carbohydrates (eg fructans, mannans) or related substances (examples: mannitol, sorbitol) gas sources (onions, Jerusalem artichokes, jerusalem turnip, pears, apple pectin, chicory, vegetable gums used in industrial feed (example: xanthan gum).
The acronym (FODMAP) summarize the list of these edible substances that increase intestinal gas and aggravate irritable bowel syndrome.

Better to avoid too much substances that activate bowel movement or are irritating to the stomach such as caffeine, nicotine, alcoholic beverages, pepper, pepper.

Avoid abundant fatty meals

LIMITING THE QUANTITY OF FOOD: if the digestive system is overloaded, or does not work well, some of the undigested food is found in the large intestine where they will be transformed by the microflora, very abundant and varied.
- In a person whose bowel is not irritable, there will be an increase of intestinal gas, a small diarrhea, or a temporary increase of feces, without any significant disturbances.
- In a person whose bowel is irritable, the increase in the volume of the large intestine by the gases will cause a strong motor activity of the colon (cramp, various pains) with either imperious diarrhea or constipation (by inefficiency of bowel movements) with mucusal production.

DIETARY FIBRES TO REGULATE BOWEL CONTRACTIONS

The bowel contractions allow the feces to be compacted and move towards the rectal bulb.
If the contractions are disordered they become ineffective (hence constipation) or speed up the evacuation rate (hence the diarrhea).
The vegetable "fibres" (soluble or insoluble) contained in the diet allow the feces to have a certain firmness, and they regulate the bowel contractions.
Insoluble "fibres" (eg wheat bran, green vegetable cellulose) are effective but can "irritate" the digestive walls especially when the intestine is already inflamed and thus aggravate the situation in case of irritable bowel syndrome.
Soluble "fibres" (present in oats (flake, porridge, bread), almonds, algae, various seeds , many edible roots especially cooked (carrots, turnips, potatoes, sweet potatoes, yams) are much less aggressive and "soft" but can sometimes be accompanied by a production of intestinal gas.
It is nevertheless these soluble dietary fibres that are recommended in case of irritable bowel syndrome.

Bowel contractions are limited with antispasmodics (ex: spasfon, debridate), agent which decreases intestinal movement (loperamid type), which reduces the pain related to colic and the sudden urge to defecate.
It is quite effective in the short term, but it does not solve the problem in the long run leading sometimes to secondary constipation with increased intestinal fermentations

When ballooning, flatulence and signs of fermentations dominate the picture one can try to limit the bacterial development with an antibiotic treatment for 10 to 15 days, if possible by using antibiotics which remain contained in the intestine and are therefore weakly absorbed

In order to lower tthe bowel "hypersensitivity" , antidepressants are often prescribed at lower doses than when treating a true depression.
It is now estimated that the digestive tract is so innervated and contains enough nerve cells to be considered as a "second brain"

People with functional bowel disorders are often anxious, stressed or easily anxious, hence the possible use of anxiolytics during short periods..

- Inflammation and irritation of the colon are treated by digestive "dressings" like "smecta" or "bedelix".
- When constipation is the main symptom, mild mucilaginous or ballast laxatives are used.

There is no stereotyped treatment of intestinal functional disorders, it must be adapted to the personality of the patient, the type of disorder (constipation or diarrhea), the importance of stress, the existence or not of food intolerance, and must be adapted to changing disorders over time.

MEDICINAL PLANTS AND FUNCTIONAL COLITIS

Several medicinal plants have interesting to mitigate the symptoms of the irritable bowel

- TURMERIC anti-inflammatory and protective of the digestive mucosa: 1g of powder twice a day in a glass of water or regularly incorporate turmeric powder in the dishes (but careful with curry sometimes too spicy).

- MYRTILLE, BLUEBERRIES, CRANBERRIES : antidiarrheal and against infections associated with collibacillus, in the form of extracts, juice, powder or ethanolic tincture.

- FENNEL , CORIANDER , MINT , STAR ANISE or BADIANE OF CHINA antispasmodic digestive

- VALERIAN ROOT , CALIFORNIA POPPY or eschscholtzia to calm and mitigate the effects of stress and anxiety in the form of extracts or ethanolic tincture.

- ROSEMARY , ARTICHOKE , sapwood of TILIA (linden) , to regulate the flow of bile, necessary to digest fatty substances ; the sapwood of linden acts on the sphincter of oddi which regulates the entry of bile in the dudénum, but it is also antispasmodic on the digestive tract.

- The German Chamomile , Matricaria recutita, this small plant whose flowers are used in infusion throughout the world for its antispasmodic, calming and anti-inflammatory virtues, gives good results in case of irritable bowel syndrome dominated by colic cramps, constipation with mucosal colitis.
It is less effective when there is diarrhea and signs of fermentation.
It is better to use the chamomile of herbalist's shop, of pharmacy .

- KINKELIBA or QUINQUELIBA , Combretum micranthum, whose leaf is widely used in West Africa as an infusion, an herbal tea, has regulatory properties on liver activity and bile ducts, its polyphenol content alleviates intestinal disorders.

- VEGETABLE CHARCOAL (in capsules) in cure of one to two weeks absorbing the intestinal gases and decreasing the proliferation of microorganisms in the large intestine.

- PSYLLIUM SEEDS to regulate intestinal transit.

- The flowers, leaves, fruits of many species of Hibiscus for their emollient, softening, mucilaginous and slightly laxative properties: Hibiscus Rosa-sinensis flower (tropical decorative flower), hibiscus tilliaceus flower (purau or burau of Polynesia), leaves of Hibiscus Manihot (South Pacific Cabbage), Okra (Hibiscus esculentus).
Flowers in filtered decoction if possible, Leaves of cabbage and okra after a short cooking.

- Malva species (mallow) botanically very close to Hibiscus and found in temperate countries: Malva alcea leaf, flower; Malva neglecta, round-leaved mallow, leaf, flower; Malva sylvestris , flower; Althoea officinalis, Althoea rosea marshmallow, hollyhock, flowers, leaves and roots.
The flowers, leaves or roots are used for their mucilage examples: 5 g of dry root or 20 g of fresh root in 1/2 liter of water, decoction, filtration to be consumed in two times.
The leaves are rather to use in case of diarrhea: a handful of leaves in 1/2 liter of water, decoction, to drink during the day.

ESSENTIAL OILS AND IRRITABLE INTESTINE SYNDROME

The most interesting essential oils to reduce functional colitis:

- especially PEPPERMINT ESSENTIAL OIL in gastroresistant capsule: analgesic, antispasmodic and antiseptic,

- additionally the essential oils of CORIANDER, CLOVE, CINNAMON bark, THYME if possible in gastroresistant conditioning so that the essential oil reaches the large intestine .

COMPLEMENTARY TREATMENTS

Other complementary treatments should not be neglected:

- GREEN CLAY by mouth in two doses (morning and evening) for its anti-inflammatory, protective effect on the digestive mucosa and antiputrid effect , stop or decrease the dosage in half in case of secondary constipation.

- PHYSICAL EXERCISE .

- PSYCHOTHERAPY, mental and physical YOGA.

- MAGNESIUM supplementation sometimes gives good results (300 to 500 mg per day).
If you are lucky enough to live near an unpolluted sea (and you do not have high blood pressure) you can try a glass of sea water morning and evening for a week and then a drink per day.

- A PERIODIC FASTING is sometimes very effective to calm the intestinal"inflammation or irritation" : just do not eat for a day (while drinking a little more than normal), once every 15 days or a times per week.
The human organism is perfectly adapted to face a fast of several days, it draws on reserves, and a fast of a day does not pose any problem in a person in general good health (not in an insulin-dependent diabetic naturally).
The digestive system is resting for 24 hours.
The use of fasting as a therapeutic has gone out of fashion in our western civilization where we are encouraged to eat several times a day, but many studies (in animals) show that the limitation of food intake (while keeping a dietary balance) increases the lifespan and strengthens the immune system.

We will detail the plants and essential oils that we think are most useful to reduce the symptoms of irritable bowel

PSYLLIUM SEEDS AND IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome may be alleviated by taking psyllium seeds: blond psyllium (Plantago ovata) or black psyllium (Plantago psyllium, Plantago indica).
The seed is rich in non-digestible mucilage that increases its volume in the intestine.
It acts at several levels:
- by increasing the volume of materials in the colon (against constipation)
- by absorbing excess water (against diarrhea)
- by perhaps attenuating the inflammation of the colon mucosa
- It also seems to decrease the absorption of cholesterol.

EXAMPLE OF DOSAGE:

WHOLE SEED: About two tablespoons two to three times a day, in a glass of cold water and it is better (but not mandatory) to wait an hour while they swell.

POWDER grinded seeds (eg metamucil): Easier to use and more often effective one to two tablespoons two to three times a day in water or fruit juice .
In any case think to drink enough in the day.
Stop of course in case of increased digestive disorders (this is not the desired effect!)

PEPPER MINT ESSENTIAL OIL Mentha spicata AND IRRITABLE BOWEL SYNDROME

Some of the symptoms of irritable bowel are related to an hypersensitivity of the large intestine (colon), which is inflamed, irritated, exudes many mucous fluid and contracts abnormally and in a disordered manner with consequences:
- pain related to spasm,
- a pseudo-diarrhea,
- constipation because the contractions of the colon are partly ineffective
- and in some cases nauseating fermentations.

PEPPER MINT ESSENTIAL OIL is a contact anesthetic, an antispasmodic of smooth muscle fibers, has antibacterial properties and is not too aggressive for the digestive mucosa.
The use of the essential oil of mentha piperita (peppermint) is therefore one of the ways explored to reduce or heal this digestive disorder.
How to use the essential oil of peppermint?
If the essential oil is absorbed orally in drops it does not reach the colon because it is absorbed in the stomach and duodenum, passes into the bloodstream and is eliminated by breathing, in the urine or metabolized at liver level.
A fraction too weak to be effective is found in the terminal intestine and the large intestine.
Therefore, it is necessary to use a package that is resistant to digestive enzymes and is tight enough to reach the jejunum and proximal colon.
The preparation must be "enteric", gastro-resistant.
If the capsule disintegrates too quickly in the stomach, this may cause, in some people, regurgitation or digestive burns.

DOSAGE of enteric (gastro-resistant) peppermint capsules Mentha piperita with menthol and menthone.
I do not recommend this treatment in children under 12 years and even advise to wait 18 years.
As most often in internal aromatherapy, this treatment is not recommended for pregnant women or breastfeeding women .
Dosage: 0.2 to 0.4 ml (approximately 6 to 12 drops) of peppermint essential oil per gastro-resistant capsule 1 to 3 times daily to be taken 1/2 hour BEFORE the meal (otherwise the capsule is destroyed in the stomach), in cure of 2 to 3 weeks.
The dosage is flexible because it is necessary to start with a small dosage to check that there is no intolerance (type of gastric burning sensation for example).
If irritable bowel symptoms persist (but subside) treatment can be prolonged to 2 or 3 months by gradually reducing the number of capsules, and choosing the time of day when it is the most effective (quite often late in the morning).
In case of intolerance, regurgitation, pyrosis, digestive burn, stop or suspend the treatment.