The Pulse | Thursday, June 20, 2019
Medical and Naturopathy Responses Critical to IBS Care
Irritable Bowel Syndrome, or IBS, can be a frustrating and embarrassing illness. The treatment of it shouldn’t have to be.
Alison Egeland, ND, works in naturopathy at Attune Functional Medicine in Broomfield, Colo. For patients suffering with IBS, she believes a two-fold approach can really make all the difference for patients: addressing the medical responses to IBS, and looking at it from a naturopathic perspective as well.
The Inside Tract sat down with Egeland to discuss why naturopathy should be a huge component of IBS treatment, and how GI professionals can be better advocates for their patients when it comes to holistic care.
SGNA: What are some common misconceptions about IBS?
Alison Egeland (AE): I think many people still consider IBS a “mystery diagnosis” and that doctors really don’t know what is wrong. The truth is, there are multiple factors involved in IBS and the underlying cause can be different for each person. For example, one person may have IBS as a result of previous food poisoning, while another person may have IBS as a result of severe physical or emotional trauma.
SGNA: Why do you think so many people remain undiagnosed with IBS?
AE: I’m sure there are a number of reasons – some people are probably too embarrassed to talk with their doctor while others are self-treating with over-the-counter medications or supplements. Unfortunately, for some people, IBS is their new “norm” and they just live with it.
SGNA: What can GI nurses and associates do to be better advocates for patients with IBS?
AE: A careful history is key. Listening to a patient’s story can provide a lot of clues about potential causes for their IBS.
SGNA: Your session at Annual Course 2019 focused on both medical and naturopathy responses to IBS. Why do you think management of IBS should involve both?
AE: I think that both conventional and naturopathic medicine have strengths for helping patients with IBS. Many patients respond well to the conventional treatment for IBS, but for patients that continue to struggle in spite of treatment, it is important to investigate other causes.
An area where naturopathic medicine can be especially beneficial is environmental medicine. There are a number of chronic infections and toxic exposures such as chemicals and mold that can contribute to the underlying cause for IBS. I have found that specialized testing and personalized treatment are paramount in the more complex patients.
SGNA: Anything else you’d like to add?
AE: Naturopathic doctors are trained to address the “foundations of health” in all patients to make sure we’re not missing something essential. Factors like stress, sleep and nutrition can have a profound impact on a person’s health when they are out of balance.
While these things seem very basic, there are physiological mechanisms that can contribute to conditions like IBS. For example, chronic stress impacts cortisol, mast cells, digestion, the migrating motor complex and immune function which all play roles in IBS. Sleep and circadian patterns are also important – there is a higher prevalence of IBS in shift workers. Interestingly, there are a number of studies showing that the sleep hormone melatonin improves IBS symptoms.
Diet is also extremely important. Nutrient deficiencies such as vitamin D, vitamin A and zinc are linked with an increase in intestinal permeability. We also have to consider food quality and digestibility. Food that is highly processed or full of chemical pesticides or preservatives can disrupt the delicate balance of bacteria and other microbes in our GI tract. Seemingly healthy foods such as dairy, beans and whole grains can be difficult for many people to digest. A detailed patient history is critical for identifying these important diet and lifestyle factors.
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