Updated 10 August 2017

Getting to the root of bowel pain

Whether or not you suffer from IBS, ulcerative colitis or Crohn's: take note of the fact that a number of factors could protect against, or worsen, these forms of bowel disease.

Problems associated with bowel disease such as irritable bowel syndrome (IBS), ulcerative colitis, and Crohn's disease seem to be increasing at an alarming rate – at least judging by the number of questions readers ask me about these bowel conditions.

Recent articles in the July Edition of the Medical Chronicle have highlighted a number of factors that can either protect against, or worsen bowel disease.

Factors influencing inflammatory bowel disease
Inflammatory bowel disease includes ulcerative colitis and Crohn's disease.

The Medical Chronicle reports that researchers at the Christchurch School of Medicine and Hospital in New Zealand have identified a number of environmental factors that may either prevent or exacerbate the development of these inflammatory conditions that affect the bowel.

a) Protective influences

  • Breastfeeding – Adults who were breastfed during infancy for longer than three months had a 30-40% lower incidence of ulcerative colitis or Crohn's disease. This is just another reason why it is important for mothers to breastfeed their babies.
  • Vegetable intake – Veggies, particularly from home gardens, also reduced the incidence of bowel disease by 30-40%. Vegetables with their rich content of dietary fibre, phytonutrients, beta-carotene, vitamin C, minerals and other protective nutrients, would be expected to exert a positive effect on bowel health. The fact that home vegetable gardens were also associated with a lower incidence of bowel disease indicates that freshly harvested vegetables that possibly have not been exposed to excessive amounts of artificial fertilisers, pesticides and herbicides, are a better option than commercially produced vegetables. If you don't have your own vegetable garden (something that is becoming increasingly difficult to maintain when so many people live in flats) then at least try to purchase fresh vegetables from your green grocer. If possible, buy organically grown vegetables.

b) Negative influences
The following factors increased the incidence of bowel disease between 1,7 and 6,8 times:

  • Genetics – Participants in the New Zealand study with a family history of inflammatory bowel disease were much more likely to also develop such conditions. If you come from a family with a history of bowel disease, make sure that you start taking steps to protect your digestive system, such as the correct diet rich in fibre and protective nutrients, plenty of exercise and avoiding stress, as early in life as possible.
  • Cigarette smoking – Yet another good reason why you should quit.
  • Repeated antibiotic treatment – Subjects, who received four or more courses of antibiotics per year as teenagers, were much more likely to develop ulcerative colitis.

While it is impossible to control your genetic makeup and difficult to control how many antibiotic treatments you may have received during adolescence, especially if you are someone who is prone to respiratory infections, no one need be exposed to the dangers of smoking.

By never starting to smoke or by quitting as soon as possible, you may be able to prevent the development of ulcerative colitis and Crohn's disease.

IBS and the psyche
The July Edition of the Medical Chronicle also features an interesting article on studies that investigated how psychological treatments, such as cognitive behavioural therapy and hypnotherapy, can be used to alleviate the symptoms of IBS.

It has long been known that psychological factors like stress, anxiety and depression, can worsen the symptoms of IBS.

According to Dr E Mayer, Professor of Medicine, Physiology and Psychiatry, at the University of California in Los Angeles, "there are intricate ties between the digestive tract and other major body systems".

Prof Mayer also pointed out that the use of psychological therapy can contribute to the effective treatment of IBS.

Cognitive behavioural therapy
American studies have found that a psychological therapy, known as cognitive behavioural therapy, "may be quite effective in treating the symptoms of IBS unresponsive to standard medications and dietary agents".

A study conducted at the University of Buffalo, New York, found that an abbreviated four-session behavioural treatment programme, which involved little contact with therapists, because the patients learned how to control their own behaviour with a self-study workbook, produced an improvement in IBS symptoms in up to 73% of the participants.

By teaching themselves methods of controlling emotional reactions to stress, patients improved their quality of life, learned to cope more effectively with stress situations and reduced the symptoms of IBS.

Another study carried out in Sweden with patients who received hypnotherapy directed at their digestive tract (deep relaxation and suggestions such as visualising a well-functioning digestive tract) for one hour a week for 12 weeks, showed that these patients were less anxious and depressed and had fewer IBS symptoms for up to one year.

If you suffer from IBS and find that taking medications and making dietary changes do not address your problem, it may be a good idea to ask the doctor who is treating you to refer you to a clinical psychologist who specialises either in behavioural therapy or hypnotherapy.

The gastro-intestinal tract is a complex system that can easily be influenced by a variety of factors.

Patients suffering from any one of the above-mentioned bowel diseases need to consult a clinical dietician to assist them with the correct diet for their condition, and also either institute lifestyle changes like stopping smoking, or consult a psychologist to help them learn to cope with the reactions of their gastro-intestinal tract. – (Dr Ingrid van Heerden, DietDoc, August 2006)

(Medical Chronicle (July 2006). More than just genetics: Lifestyle choices impact on GI health. Medical Chronicle, p. 40; & Studies find cognitive therapy benefits IBS, p.58)

Read more:
The real reason for IBS
My constant nag of pain


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