The following IBS case study can also be found on the National Institutes of Health website.

Risk factors for irritable bowel syndrome in Turkish population: role of food allergy.

Goals:

The aim of this study was to determine the prevalence of food hypersensitivity
in Turkish patients with irritable bowel syndrome (IBS).

Background:

The IBS is a chronic disease of the gastrointestinal tract characterized by abdominal pain, distension, meteorism and either diarrhea or constipation. The role of diet in the pathogenesis of IBS remains controversial.

Many investigators have shown that individual foods can trigger symptoms in some patients; nevertheless, the percentage of patients that benefit from dietary manipulation ranges from 15% to 67% in different reports.

Study:

Skin prick test to 11 common allergens, total IgE, eosinophilic cationic protein and eosinophil counts were evaluated in 100 patients satisfying the Rome II criteria and compared with 25 healthy controls. The history and physical examination of the groups were recorded
and Beck Depression and Anxiety Inventories were performed.

Results:

One hundred patients were entered into the study with a mean age of 45.63+/-12.91 years.

Of the patients 53 had constipation predominant, 19 had diarrhea predominant, and 28 had alternating type IBS. Skin prick tests positivity were more common among the IBS patients in comparison with controls (25% and 1%, respectively, P<0.05).

Mean IgE values were higher in patients than controls (70.83+/-66.05 and 15.20+/-14.01 IU/mL, respectively, P<0.000). Eosinophilic cationic protein values were also higher in IBS patients than controls (16.75+/-11.28 and 11.56+/-4.72, respectively, P<0.05)

Evaluation of Beck Depression Inventory showed that tendency to depression in patients with IBS was 38% and 4% in controls (P<0.05).

Conclusion:

According to our results, in patients complaining of IBS it is of importance to search for a food component. Clinical improvements can be observed after the introduction of an adequate exclusion diet.

Department of Internal Medicine, Guven Hospital, Ankara, Turkey.

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This study also published at NIH.gov
Image thanks to esltogo.wordpress

So you think that you carry your stress in your abdomen. It's a common belief.

If you have been diagnosed with irritable bowel syndrome (IBS), it is likely that you have been advised to reduce your stress level.

You may have been told to get regular exercise and adequate sleep, and to practice stress reduction techniques such as yoga, meditation, tai chi, deep breathing, journal writing, relaxation therapy, biofeedback, hypnotherapy, or psychotherapy.

All of these practices can indeed improve physical, mental, and emotional health. They provide a host of benefits, from improved personal relationships to enhanced productivity to increased energy and mental clarity, and they just might help with your IBS symptoms.

But chances are they won't cure your IBS.

Most physicians are trained to think of irritable bowel syndrome as stress induced or as a type of psychosomatic disorder. Because there has not been a cure for IBS, it has been framed in a way that suggests that it is more your problem than the physicians. Although some cases of IBS are no doubt related to mental or emotional issues, and stress and anxiety can aggravate IBS (as well as most other medical conditions), they are not the predominant causes of IBS. More often, IBS causes you stress rather than the other way around.

Medicine has a long history of blaming medical conditions with no known organic cause on some form of psychological disturbance, such as stress - only to discover later the organic cause of the problem. One excellent recent example of this is stomach ulcers. While stomach ulcers were once thought to be a stress-induced disorder, it is now well accepted that the bacteria Helicobacter pylori cause them, and that they are treatable.

It is true that stress can make the symptoms of IBS worse, and that your digestive system depends on relaxation to function properly. Occasionally stress is the sole cause of IBS. But far more often it is due to something else. If you still have symptoms when you know that there isn't much stress, then there is more to the problem than stress!

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Image thanks to sime2010.org

Your immune system serves as a guard against foreign invaders. In the case of an allergy, the invaders are called allergens.

The primary weapon that it uses against invaders is the production of antibodies. The antibodies cause reactions that result in the offending allergens being removed from the body.

In many people, foods act as allergens rather than nutrition. This can result in the symptoms of Irritable Bowel Syndrome.

The immune system produces numerous kinds of antibodies, called immunoglobulins. IgE and IgG are acronyms for the two different kinds of antibodies produced by the immune system in allergic reactions to food.

You might be asking why you need to know this...

Conventional allergy testing looks for IgE reactions only. These types of reactions typically occur immediately after contact with or ingestion of the allergen, and in some cases can cause serious, even fatal, health problems. Potential IgE reactions include swelling of the lips and tongue, hives, bloating, abdominal pain, or sudden diarrhea.

These are the reactions that people usually think of when they hear the word allergy. However, IgE reactions can also lead to many other symptoms not traditionally recognized as being caused by food allergies.

The problem with this type of testing is that most food allergies are not IgE reactions, but are rather IgG reactions, which usually show up hours or even days after ingestion of the allergen.

They are generally not nearly as dramatic as the more severe IgE reactions, and usually result in "mere" constipation, diarrhea, bloating, gas and abdominal pain. Both antibodies are important, and food allergy testing should include both or the cause of IBS may be missed.

More information on testing for food allergies.
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Great image thanks to myteethcleaned.com

The article below just came out in the journal Digestive Diseases.

Even though they overemphasize the psycho-social factors, at least they acknowledge the food and antibiotic factors in IBS.

From Karger.com:

Irritable bowel syndrome (IBS) is characterised by abdominal pain and an erratic bowel habit, which depending on the definition used affects 5-10% of the population.

As a typical complex disease, it is likely that the condition will develop when a genetically susceptible individual is exposed to an appropriate environment stimulus.

This bio-psycho-social model assumes that there is no one cause of IBS, but rather that it is the product of complex interactions between host and environment.

Host factors include gender, age and psychological characteristics, while environmental factors include psychosocial stressors, gastrointestinal infections, antibiotics and food.

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Copyright © 2011 S. Karger AG, Basel.

Source
University Hospital, Queen's Medical Centre, Nottingham Digestive Diseases Centre, NIHR Biomedical Research Unit, Nottingham, UK. robin.spiller@nottingham.ac.uk
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Image thanks to blogs.voices.com

Parasites, another cause of IBS symptoms, can cause diarrhea, constipation, gas, bloating, cramps, nausea, poor digestion, fatigue, muscle aches, bleeding, rectal itching, and abdominal pain.

Parasites cannot live without you. You provide them living space and food, but unlike friendly bacteria, parasites do nothing for you in return. They only act against you.

Parasites vary in size from the very tiny, which can be seen only under a microscope, to inches long. Some can find their way into just about any area of the body, but most are found only in the digestive tract. The severity of your symptoms and the amount of damage they cause varies depending on the parasite involved, the number of parasites, and the level of resistance your body has.

Parasites damage the body in a number of ways, by absorbing nutrients that you need and by directly damaging your digestive tract; and, if they are capable of migrating, possibly damaging other areas of your body as well. They often reproduce rapidly and by the thousands, and are easily spread to other people. Unfortunately, a strong population of good bacteria does little to protect you from parasites.

Parasites are more common than generally believed. Although most Americans consider them to be a Third-World problem, they infect millions of Americans - even those who never leave the country or drink from mountain streams (a common source of the parasite Giardia).

We live in a global community. Parasites enter this country every day through the importation of contaminated foods and seemingly innocent products such as clay pottery. It is true that many common parasites are native to the tropics, where it is warm and humid. But the fruits and vegetables we import from these warm countries can be a source of parasitic contamination, affecting every area of the United States.

However, because of the misperception that parasites are not an American problem, they have often been overlooked as a possible cause of digestive illnesses.

Entamoeba hystolytica, a relatively common parasite, infects up to 50 million people worldwide each year, and results in up to 100,000 deaths. In Dhaka, Bangladesh, approximately 50% of children have signs of exposure to this parasite by age five.

Closer to home, one of the largest recorded outbreaks of a waterborne parasitic infestation occurred in Milwaukee, Wisconsin, in 1993. The city's water supply became contaminated with the parasite Cryptosporidium, which causes diarrhea, abdominal cramps, and nausea. Over 400,000 people became ill; 4,000 were hospitalized and over 100 died. Although Milwaukee's water was treated with chlorine, chlorine doesn't kill Cryptosporidium.

The possibility of parasites must be considered when assessing the cause of your IBS. A parasite infection can usually be diagnosed by proper stool testing, and is usually readily treatable.

Information on testing for IBS Triggers here.

Image thanks to toonpool.com