In my previous blog on irritable bowel syndrome (IBS) I shared a new study published December 2015 in the British Medical Journal Open Gastroenterology which demonstrated that many patients with IBS are vitamin D deficient. In addition to vitamin D supplementation I suggested considering saccharomyces boulardii since it has been tested for clinical efficacy in many gastrointestinal conditions including IBS.

There was another interesting study also published December 2015 in Frontiers in Neuroscience that shed some interesting light on irritable bowel syndrome. Biopsies of patients with IBS were taken and for the first time it was demonstrated that the nerves in their gut wall poorly responded to a cocktail of inflammatory substances. This contradicts the theory that IBS patients have an oversensitive gut.

In this study researchers examined the reaction of biopsy samples from IBS patients and healthy volunteers to electrical stimulation and nicotine. Both methods are well-established for testing the responsiveness of the enteric nerves. As a result both groups responded similarly so the theory of nerve sensitization can be ruled out.

Researchers suggested one possible cause of symptoms in some IBS patients is the increased release of neurotransmitters which can play a role in inflammatory processes.

The researchers then gave a cocktail of inflammatory substances which contained histamine proteases serotonin and TNF-alpha to simulate the gut wall. The results were surprising; they were exactly the opposite of what the researchers expected. The nerves of the IBS patients reacted much less to the inflammatory substances than did the biopsy samples of the healthy volunteers. Therefore the researchers concluded that IBS patients actually have reduced sensitivity in the gut wall which may actually be a protective mechanism to help prevent overstimulation.

To confirm this result researchers exposed the enteric nerves to irritation for several hours. As a result the nerves down-regulated the reaction. With that being said it still remains unclear how this desensitization of the nerves causes the actual symptoms.

Additional nutrient support to be considered for IBS

Perilla frutescens also known as Chinese basil this herb is a member of the mint family.

Perilla frutescens demonstrates antispasmodic prokinetic (stimulating GI motility) and anti-inflammatory effects which help normalize and promote healthy bowel function and help reduce GI symptoms. 

Saccharomyces cerevisiae CNCM I-3856 is a specific patented probiotic strain that has been shown to help improve gastrointestinal comfort and intestinal flora. Clinical trials have demonstrated that this strain survives transit through the gastrointestinal tract has anti-inflammatory properties and reduces the perception of intestinal pain. It has been shown to reduce digestive discomfort after four weeks of consumption. 

Glutamine has been well touted for its role in the gut where it promotes the health and function of the mucosal cells for healing and repair. Glutamine is the main fuel of the enterocytes (cells of the intestinal lining) and thus is essential in intestinal barrier function. This nutrient may be of great importance to IBS patients as increased intestinal permeability is commonly seen in this condition.

Finally there are several diagnostic considerations which may be of great benefit in order to help devise an overall treatment plan for the IBS patient. Such testing options include a comprehensive digestive stool analysis organic acid testing and food antibody testing.

By: Michael Jurgelewicz DC DACBN DCBCN