Irritable bowel syndrome is a diagnosis only to be considered when all other reasons for the symptoms have been ruled out.

The characteristics of IBS are persistent and recurrent abdominal pains, usually gripping but sometimes with sharp or cutting episodes, bloating, irregular bowel habits with diarrhoea or constipation, flatulence and associated nausea, and lethargy. All or some of these symptoms may be present. Some authorities would also consider the passage of mucus as being a potential sign of irritable bowel but excess mucus and therefore the passage of it is, in my mind, an association of inflammation or other pathology and should not, therefore, be considered part of an irritable bowel syndrome. There is no inflammation in IBS.

There is no doubt that stress is a principal factor in IBS. Stress chemical or catecholamines, the most common of which is adrenaline, cause blood to move from non-essential organs to the heart, lung, brain and muscles in preparation for ‘flight or fight’. The bowel loses some of its blood flow and in extreme cases a lack of oxygen will cause the bowel to contract and the individual will defecate. For those under a persistent level of stress, a small reduction in blood and therefore oxygen will lead to mild cramping as seen in IBS. Some consideration must be given to IBS being associated with a low-fibre diet because this prevents the bowel muscle from exercising and therefore it cramps more easily. Some studies have shown that increasing the fibre content may actually make IBS worse, so the jury is out on that possible cause.

A weakened hydrochloric acid production or pancreatic enzyme flow may also result in IBS by leaving undigested foods that may trigger some form of mild and transient inflammation.

More likely is a food allergy or intolerance, infestation of yeast, fungi or parasites and the inevitable disturbance of the normal bowel flora. The unwanted organisms cause the production of chemicals that trigger cramping, and a poor-quality normal bowel flora leading to an overgrowth of these unwanted organisms.

All IBS sufferers must consider counselling and a relaxation technique. Yoga, Qi Gong, Tai Chi and meditation are all prerequisites to eliminating the underlying cause of the problem even if a physical reason is found. For those who disbelieve this, please have one session of hypnotherapy to ensure that there is no underlying and subconscious anxiety.

If IBS is diagnosed, a course of capryllic acid (an extract from coconut) and grapefruit seed should be taken in combination. The maximum recommended dose on the product you buy is a guideline for prescribing.

A high dose of a purified Acidophilus (yoghurt bacteria) should be taken at a maximum dose as recommended on the packaging.

Avoid eating a lot of meat or dairy produce. Cut out greasy, spicy and sweet foods. During attacks of discomfort eat well-steamed vegetables, rice, potatoes and other soft foods such as bananas.

If the diet is low in fibre increase this with fruit and vegetables at each meal but stop if the discomfort worsens.

Keep a journal and note bad days. Note accurately the foods and drinks you take in and the levels of stress you are under. See if there is any pattern, which may be delayed by 48hr, and try avoiding the possible triggers.

Try 500mg of bromelaine before meals three times a day.

Bach flower remedies Cerato, Gorse and Vervain can be taken.

Consider a suitable blood test for food allergy or see a nutritionist who uses a bioresonance technique to isolate intolerances. Applied kinesiology is an alternative choice.

Consider a trial with a pancreatic extract or hydrochloric acid supplement, again as recommended on the product. Simple noninvasive hydrochloric acid and pancreatic enzyme-level tests are available.

Shiatsu and basic body massage may be very relieving by addressing the excess of adrenaline in the system and working on the lymphatic system and acupuncture meridians. Techniques of abdominal massage associated with manual lymphatic drainage can be instantly relieving and regular massage treatments can reduce the severity of symptoms.

Herbal treatments such as those in Ayurvedic, Tibetan and Chinese medicine are all helpful when prescribed by a specialist.

Homeopathic remedies should be chosen on the basis of the symptoms. Pay attention to the homeopathic remedies Natrum carbonicum, Magnesia phosphorica, Carbo vegetabilis, Argentum nitricum and Ignatia.

Enteric-coated peppermint oil (the oil is enclosed in a capsule that bypasses the strong acids and alkalis of the stomach and small intestine, thus reaching the colon where the spasm most commonly occurs) can be used. This has a strong antispasmodic action and will act to relieve, although probably not cure, the problem.

Two teaspoonsful of chamomile, one teaspoonful of rosemary and one of sage in an infusion taken every 2hr will also act as an excellent antispasmodic.