Irritable Bowel - Is it forever?

Irritable bowel syndrome, or irritable bowel disease (IBS or IBD) affects about 13-20% of the Canadian population. Symptoms can include Abdominal Pain, Bloating, Constipation, and/or Diarrhea.

The conventional medicine perspective was that irritable bowel syndrome or irritable bowel disease is a condition that once diagnosed, will result in ongoing suffering for rest of the patient’s life.  Fortunately, as our understanding of the gut microbiome has increased, so has both the conventional and non-conventional treatments & recommendations.
Of course, conventional treatment will still often include medications that mask the symptoms, but do not address the underlying issues. Since I take a more holistic attitude, I believe that IBS/IBD care should be approached with an all-encompassing approach which address Diet, Activity, Stress, Sleep.
Diet
Leaky gut is now showing to be a primary cause for IBS symptoms. Leaky gut can result from a variety factors and although I know I sound like a broken record, it needs a multifaceted approach.
It’s common for practitioners to recommend a low FODMAP diet, which eliminates certain foods that can cause gas & bloating due to the fermentable carbohydrates that can be difficult to digest. This can definitely improve symptoms but can be difficult to follow long-term and does not completely address the underlying issue of leaky gut. This approach alone may have eliminate some big offenders – but it doesn’t necessarily heal the gut lining.
However, there is compelling research that another simple dietary change can greatly improve and even reverse IBS or IBD; a gluten-free diet. Gluten has been shown to cause increased intestinal permeability in ALL individuals (not just those with celiac as was once believed). This increased permeability may effect people differently depending on multiple factors – including how compromised their gut already is.
Activity
Activity and Exercise are extremely important for gut health. Not only does the physical act of moving help keep our bowels moving regularly, but this movement also leads to a cascade of events that releases substances from enzymes, hormones & immune markers that support our gut & overall health.
Stress
Stress in our modern life greatly impacts the health of our gut. These stresses are everywhere, and have become so prevalent (driving in a car, incomplete nutrition, over-exercising), that we often don’t even view them as stressors. Unfortunately, on the inside, our body may be in panic mode.  It is so important to include stress relieving activities in our everyday life. This may different depending on your interests, stress levels or time, however everyone should be doing something to support their stress. For example, this could look like a 5 minute meditation, or an hour long hike in the woods. Or maybe you include a variety of stress relieving activities that change day to day or week to week.
Sleep
Sleep is also vital. Not only does sleep quantity matter but sleep quality also matters. Generally we need 7-9 hours of sleep per night. Things that can affect the quality are stress, exercise (too much or too little), blue light from electronic devices, stimulants (caffeine) or depressants (alcohol), hormone imbalances and many others. If sleep is an issue, you can bet your bowels are paying a price.
Fortunately, the recommendations I have made are all simple things that we can implement in our own lives.  
Of course, some people may still need the additional support of medications or supplements along with the guidance of a professional, however IBS/IBD doesn’t have to rule your life!

References
Bateson, C. (1994). Allergies: Disease in disguise. Summertown, TN: Books Alive.Gastrointestial Society. (n.d.). IBS overview. Retrieved from https://www.badgut.org/information-centre/a-z-digestive-topics/ibs/
Hollon, J., Puppa, E. L., Greenwald, B., Goldberg, E., Guerrerio, A., & Fasano, A. (2015). Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients, 7(3), 1565-76. doi:10.3390/nu7031565
Vazquez-Roque M, et al. (2013). A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function. Gastroenterology. 2013 May;144(5):903-911. doi: 10.1053/j.gastro.2013.01.049. Epub 2013 Jan 25.
Verdu E.F., et al. (2009). Between celiac disease and irritable bowel syndrome: the “no man’s land” of gluten sensitivity. Am J Gastroenterol. 2009 Jun:104(6):1587-1594. doi: 10.1038/ajg.2009.188.
Wolf, R. (2013). Science bite: Gluten-free diet in Irritable Bowel Syndrome. Retrieved from https://robbwolf.com/2013/05/17/science-bite-gluten-free-diet-irritable-bowel-disease/