What Is Irritable Bowel Syndrome (IBS)?
Irritable Bowel Syndrome (IBS) is a common disorder that impacts 15-20%1 of the U.S. population. It is an under-diagnosed,1 under-managed, and often frustrating condition, that often reoccurs over time. Only a small portion of IBS sufferers seek medical attention or even know that IBS can be managed. Irritable Bowel Syndrome (IBS) is a disorder in which the bowel is irritated and does not function properly. IBS is usually associated with the disruption in the gut mucosal barrier and an impaired ability to digest and absorb food nutrients. People who have IBS often experience distressful symptoms such as abdominal pain, discomfort or cramping, bloating or gas, diarrhea, constipation, or bouts of diarrhea interrupted by constipation, urgency of bowel movement, sense of an incomplete bowel movement and pain during bowel movement. Some of these symptoms can be severe or unbearable. IBS is the second leading cause of absenteeism, after the common cold.2 Important new knowledge and new products for IBS in the past 10 years have created new options to manage IBS.
What Causes IBS?
In the absence of a known organic cause, it is thought that IBS is associated with the disruption in the lining of the gut (gut mucosal barrier) and reversible, localized, low-grade immune activation,3 which results in impaired ability to digest and absorb food nutrients. Intestinal malabsorption triggers IBS symptoms, often after a meal.
If IBS is suspected, consult with a physician about confirming IBS and then developing a program to manage it.4 IBS can be triggered by food, stress, environment, infections, and genetic predisposition.5
What Are The Symptoms of IBS?
In addition to impacting the digestion and absorption of food nutrients, the symptoms of IBS include, at varying times, some or all of the following†:
- Abdominal pain, discomfort, or cramping
- Bloating or gas
- Diarrhea, constipation, or bouts of diarrhea interrupted by constipation
- Urgency of bowel movement
- The sense of an incomplete bowel movement
- Pain during bowel movement
IBS symptoms can usually be sensed below the navel, in the belly.
Where Do the Symptoms of IBS Occur in the Digestive System?
The symptoms of IBS often occur within 90 minutes of meals.6 This reflects the time it takes for the food to reach the small intestine.4 Recent scientific and clinical evidence suggests the small intestine is the site of the disruption in the lining of the gut (gut mucosal barrier) and reversible, localized, low-grade immune activation,3 and where transit time can also be disrupted. Thus, food can move too fast or too slow, causing diarrhea, constipation or both. This is also the site where abdominal pain originates, probably from irritated nerve endings in the gut or from trapped gas.
IBgard® is designed to deliver its ingredients in the small intestine – the site of the gut mucosal barrier disruption.
The most widely used physician recommended approaches to managing IBS are:
Physicians often recommend gradually increasing fiber intake, starting with 2-3 grams per day. Fiber may reduce the constipation caused by IBS, because it makes the stool softer and easier to pass. Fiber is found in foods such as whole-grain breads and cereals, beans, fruits, and vegetables.
Physicians may also recommend exclusionary IBS diets such as excluding or reducing high fat foods, sugars, caffeine, and alcohol. Diet alone may not be practicable to manage your IBS long term, but it should be part of your overall IBS program implemented with your physician.
Physicians may recommend common stress management tools including regular exercise, taking time to relax, and getting an adequate amount of sleep every night.
Physicians may either prescribe medications or recommend over-the-counter products to manage IBS. Commonly prescribed and recommended products can include laxatives, anti-diarrheals, and antispasmodics. Almost all currently offered medications can have side effects, so always consult a physician for any resulting side effects, or if the product is not providing relief from symptoms.
Physicians now increasingly recommend IBgard, a medical food specially formulated for the dietary management of IBS. IBgard capsules contain individually triple-coated, sustained-release microspheres of Ultramen®, an ultrapurified peppermint oil, along with fiber and amino acids (from gelatin protein). IBgard has been shown in peer-reviewed publications, to be effective in managing IBS symptoms.§7 Since food is a common trigger, physicians now recommend IBgard be taken 30 minutes before meals.
The Distinctive Nutritional Requirements for People Who Have IBS
People with IBS usually suffer from diarrhea, constipation or both. These conditions reflect the movement of food through the GI tract that is either too fast or too slow. This irregular movement can cause poor digestion, malabsorption of nutrients and loss of electrolytes. IBS is associated with growth of bad bacteria and excess mucus in the gut, which can disrupt the absorption of essential nutrients. IBS is also associated with low absorption of certain sugars, and healthcare professionals recommend restricting sugars, gradually increasing fiber in the diet, starting with 2-3 grams per day.
IBgard is specifically formulated to meet the distinctive nutritional requirements of IBS that cannot be met with dietary modification alone. IBgard supplies microspheres of peppermint oil to the small intestine, which helps to manage the symptoms of IBS and thereby enables proper digestion of food and enhanced absorption of nutrients.
Over 90% of nutrient digestion and absorption takes place in the small intestine.8 With IBS, this digestive and absorptive process is disrupted in several ways. The bile acid flow is disrupted as part of the IBS cascade of disruption.9 Peppermint oil (primary component: l-Menthol) helps restore secretory function such as bile flow.10 The German Commission E monograph for peppermint oil lists its use as an anti-spasmodic for bile ducts.11 This and other known activities of peppermint oil are helpful in digestion and absorption.
By improving gut health in the first place, IBgard helps prevent nutritional problems later.
1 Hungin, A. P S, L. Chang, G. R. Locke, E. H. Dennis, and V. Barghout. 2005. “Irritable Bowel Syndrome in the United States: Prevalence, Symptom Patterns and Impact.” Alimentary Pharmacology and Therapeutics 21 (11): 1365–75. doi:10.1111/j.1365-2036.2005.02463.x.
2 Cash, Brooks, Sean Sullivan, and Victoria Barghout. 2005. The American Journal of Managed Care 11 (1 Suppl): S7-16. doi:2834 [pii].
3 González-Castro, Ana M, Cristina Martínez, Eloísa Salvo-Romero, Marina Fortea, Cristina Pardo-Camacho, Teresa Pérez-Berezo, Carmen Alonso-Cotoner, Javier Santos, and María Vicario. 2016. “Mucosal Pathobiology and Molecular Signature of Epithelial Barrier Dysfunction in the Small Intestine in Irritable Bowel Syndrome.” Journal of Gastroenterology and Hepatology, 53–63. doi:10.1111/jgh.13417.
4 Drossman, Douglas A., Lin Chang, Susan Schneck, Carlar Blackman, William F. Norton, and Nancy J. Norton. 2009. “A Focus Group Assessment of Patient Perspectives on Irritable Bowel Syndrome and Illness Severity.” Digestive Diseases and Sciences 54 (7): 1532–41. doi:10.1007/s10620-009-0792-6.
5 Holtmann, Gerald J, Alexander C Ford, and Nicholas J Talley. 2016. “Pathophysiology of Irritable Bowel Syndrome.” The Lancet Gastroenterology & Hepatology 1 (2). Elsevier: 133–46. doi:10.1016/S2468-1253(16)30023-1.
6Ragnarsson, Gudmundur, and Göran Bodemar. 1998. “Pain Is Temporally Related to Eating but Not to Defaecation in the Irritable Bowel Syndrome (IBS): Patients’ Description of Diarrhoea, Constipation and Symptom Variation during a Prospective 6-Week Study.” European Journal of Gastroenterology and Hepathology 10 (5): 415–21.
7 Cash, Brooks D., Michael S. Epstein, and Syed M. Shah. 2016. “A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms.” Digestive Diseases and Sciences 61 (2). Springer US: 560–71. doi:10.1007/s10620-015-3858-7.
8 Dr. Ananya Mandal, supra fn. 79.
9 Kamath, P.S. et al., abnormal gallbladder motility in irritable bowel syndrome: evidence for target-organ defect. Am J Physiol 260:G815-G819, 1991.
10 Zong, L. et al., Preliminary experimental research on the mechanism of liver bile secretion stimulated by peppermint oil. J Dig Dis. 2011 Aug: 12(4):295-301.
11 Balakrishnan, A., Therapeutic uses of peppermint—A review. J Pharm Sci & Res. Vol. 7(7), 2015, 474-476.
The IBgard® Difference