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Irritable bowel syndrome

irritable bowel syndrome - IBSThis chronic condition is a combination of attacks of diarrhoea and intermittent constipation. It can involve disturbance of muscular movement in the large intestine. The cause of irritable bowel syndrome (IBS) is unknown but the disorder can be aggravated by stress, and may be linked to sensitivity to particular foods. Other symptoms of IBS include abdominal cramps, bloating, and passage of mucus with the faeces.

Irritable bowel syndrome (IBS) is characterised by recurrent irritation and inflammation of the large intestine (bowel), resulting in abdominal bloating and pain that is relieved by bowel movements.  A functional disorder with no evidence of accompanying structural defect in the intestines, IBS is one of the most common gastro-intestinal disorders.

Frequent signs and symptoms of IBS:

  • Cramp-like pain in the middle or to the side of the lower abdomen
  • Pain usually relieved by bowel movements
  • Loose of more frequent painful bowel movements
  • Diarrhoea and constipation, usually alternating
  • Symptoms of upset stomach, flatulence, nausea, loss of appetite
  • Headache, backache
  • Rectal pain
  • Fatigue
  • Varying degrees of anxiety or depression
  • Excessive secretion of colonic mucus
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Causes of IBS:

(it is important to consult a doctor for a proper diagnosis of IBS so that any other conditions can be ruled out)
  • Disturbed bacterial balance as a result of antibiotic or antacid usage.  Antibiotics wipe out the friendly as well as unfriendly bacteria, disturbing normal gut ecology.  Antacids decrease hydrochloric acid in the stomach – which is necessary for proper digestion and also destroys unfriendly bacteria in the stomach.
  • Laxative abuse.  Laxatives are irritants that work by triggering forceful contractions (peristalsis) of the intestines in the body’s efforts to purge these offending substances.  Laxative abuse can damage the intestinal lining and result in poor absorption of nutrients.
  • Stress and emotional conflict that results in anxiety or depression.  Stress disrupts the secretion of the body’s digestive factors (hydrochloric acid and pancreatic enzymes).  IBS attacks are often preceded by significant stress, obsessive worry about everyday problems, marital tension, fear of loss or death of a loved one.
  • Food allergy.  Approximately two thirds of patients with IBS have at least one food allergy.  Most common allergens are wheat and dairy products.
  • Dietary factors.  Excessive consumption of tea, coffee, carbonated drinks, and sugar.  Excessive consumption of refined sugar may be the most important contributing fact to IBS.  A diet high in sugar quickly raises blood glucose levels, causing a sharp decrease in intestinal peristalsis (rhythmic contraction of the intestines that propels food through the digestive tract).  Since sugar is primarily digested in the first sections of the small intestine, this portion of the digestive tract is constantly ordered to stop contracting and eventually becomes atonic (paralysed).  When partially digested food sits in the small intestine, bacteria have an abnormally long time to feed, resulting in bacterial overgrowth, leading to bloating and flatulence.

Risk increases with:

  • Stress: disrupts digestive secretions
  • Disease-promoting diet: a diet based on high intake of red meat (saturated fat), processed foods, hydrogenated fats and sugar, with little consumption of fresh vegetables, legumes, fruits, nuts, seeds and whole grains which promote gut health – fibre, vitamins, minerals, antioxidants and essential fatty acids.
  • Drug therapy: in addition to antibiotics, which wipe out good gut bacteria, numerous commonly used drugs irritate the intestinal lining, eg laxatives, non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen.
  • Excess alcohol consumption: alcohol is an irritant that increases gut permeability to toxins and potentially allergenic foods.  In addition, alcohol increases the adrenal gland’s secretion of stress hormones, including cortisol, which disrupt digestive hormones.
  • Smoking: nicotine stimulates the adrenal glands to secrete stress hormones.
  • Fatigue, over-work:  both significantly increase stress.
  • Poor physical fitness:  physical exercise reduces cortisol (stress hormone) levels and increases levels of mood-elevating beta-endorphins, thus decreasing anxiety and tension.
  • Other family members with IBS:  family members typically share eating patterns and may also share behavioural patterns, ie reacting to stressful situations by shutting off the production of digestive factors.

IBS Preventative measures:

  • Avoid caffeine, alcohol, carbonated beverages, and simple sugars (refined foods)
  • Get adequate sleep.  Poor sleep quality correlates with an increase in both the severity and frequency of IBS symptoms.
  • Don’t smoke
  • Choose a health-promoting diet rich in whole, unprocessed, preferably organic goods, especially plant foods (fruits, vegetables, whole grains, beans, nuts – especially walnuts), and cold water fish (salmon, mackerel etc)
  • Increase dietary fibre from fruit and vegetable sources – wheat and other grains are among the most commonly implicated foods in malabsorption and allergic conditions.  In IBS, a condition in which the intestines are irritated and highly susceptible to potentially allergenic proteins leaking into the general circulation, food allergy is frequently a significant factor.
  • Identify and eliminate allergenic foods.  Approximately two-thirds of people with IBS have at least one food allergy – related allergy symptoms include palpitations, fatigue, excessive sweating, and headaches.  Most common are dairy products so replace with goats milk and cheese and avoid products from a cow.  

Nutritional supplements:

  • Probiotics:  Friendly bacteria are needed to repopulate the intestines.  Probiotics perform numerous functions essential for intestinal health including metabolizing nutrients, vitamins, drugs, hormones and carcinogens; synthesizing food for intestinal cells; preventing unfriendly organisms from attaching to and colonizing the mucosal lining of the digestive tract; and stimulating normal immune responses.  Probiotics compete with, thereby preventing colonization of the overgrowth of normally benign organisms such as candida albicans.
  • Fibre:  use fibre derived from fruit and vegetable sources, not potentially allergenic grains.
  • L-glutamine:  a major metabolic fuel for the intestinal cells, maintains the villi – the absorptive surface through which we absorb nutrients
  • B Complex:  needed for proper muscle tone in the gastro-intestinal tract.
  • NAG (N-acetylglucosamine):  a major constituent of the intestinal lining and of the barrier layer that protects the intestinal lining from digestive enzymes and other potentially damaging intestinal contents.
  • Digestive enzymes (with pancreatin):  To aid in protein digestion and prevention of leaky gut syndrome.  Also aids in reducing inflammation

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