Does Ayurveda Really Treat IBS?

Only a decade or two ago, Irritable Bowel Syndrome or IBS was a condition unfamiliar to most Indians. Prevalence rates were rather low and awareness about such a condition was even lower. That situation has changed dramatically in recent years, with IBS believed to affect over 250 million Indians, often going undiagnosed. This is troubling as IBS can severely affect quality of life causing a wide range of discomforting symptoms like abdominal pain, bloating, gas, diarrhea, or constipation. When undiagnosed and not treated properly it can increase the risk of malnutrition and other complications. Even when treatment for IBS is provided, it is often ineffective. This has made natural treatment options much sought after, and Ayurved seems like the best bet. But, how effective is Ayurvedic medicine for IBS? Can we really find an IBS cure in Ayurved?

While Ayurved may not cure IBS, it gives us plenty of natural treatment options and recommendations that have proven efficacy in the management of IBS. Using these natural methods can restore quality of life and ensure that IBS symptoms are vanquished without the need for lifelong medical treatments. In fact, many of the Ayurvedic recommendations for IBS that have proven benefits are closely aligned with current diet and lifestyle guidelines for IBS in mainstream health care systems.

Ayurvedic Diet for IBS

Digestion is regarded as central to human health in Ayurved and dietary imbalances are said to be at the root of all diseases. This is certainly true when it comes to IBS and there are a few general recommendations that can help most IBS patients:

• Follow the dinacharya or Ayurvedic daily routine, and if not practical, adhere as closely to it as possible, particularly with regard to meal times. Meals should not be skipped and meal timings should remain fixed to support your body’s biological clock and to match the natural ebb and flow of energy in nature. This practice is supported by research, which shows that irregular meal intake is associated with higher prevalence of IBS. 
• Cutting out processed foods and increasing whole food consumption is a necessary step in the Ayurvedic treatment of IBS. It is also supported by most conventional health care practitioners, as processed foods are generally devoid of fiber and nutrition. High fiber diets are believed to lower the risk of certain IBS symptoms like constipation. For this reason, increased fiber intake from fruits, vegetables, and whole grains is recommended, but should be done gradually.
• Foods like chocolate, alcoholic and caffeinated beverages, sodas, and dairy products should be avoided. Some healthy whole foods can also contribute to gas buildup and should therefore be avoided or limited. These can include beans or legumes, cabbage, cauliflower, and broccoli. High fat foods like red meats and cheese can also trigger IBS symptoms in some patients and should be avoided.
• Moderation and balance cannot be emphasized enough in Ayurved and this is not just in the context of food choices or food groups, but also in terms of meal sizes. Overeating is regarded as a major contributor to conditions the exacerbate IBS and it is advisable to avoid large meals, instead ensuring adequate nutrition through smaller and more frequent meals at fixed times.
• Herbs and spices play an important role in Ayurved, helping correct underlying dosha imbalances, ama buildup, and weakened ojas to treat IBS naturally. With therapeutic benefits including anti-inflammatory, analgesic, and antioxidant properties, herbs like sunth, dhaniya, kutaj, and saunf are also important ingredients in any Ayurvedic medicine for irritable bowel syndrome.

Ayurvedic Lifestyle for IBS

Ayurved has always followed a holistic approach to health care and this includes lifestyle choices, not just diet and nutrition or medication. Ayurvedic IBS lifestyle recommendations call for 2 major changes:

Exercise: Increase physical activity by taking up yoga or any other mild to moderate intensity exercise routine. Yoga is of course most beneficial as specific asanas can alleviate digestive discomfort and other IBS symptoms. This recommendation for physical activity in IBS patients has now gained greater support, with studies finding that increased physical activity can promote improvements in intestinal function, reducing gastrointestinal symptoms. Exercise also promotes improvements in circulation, cardiorespiratory function, and triggers the release of endorphins and other hormones that help improve mental health and feelings of wellbeing.

De-Stress: Mental and emotional stress are regarded as major triggers for IBS in Ayurved and should be dealt with appropriately. Meditative practices like mindfulness, as well as pranayama or breathing exercises, and other relaxation therapies should be taken up to lower stress levels and promote mental health. Today, stress management is regarded as vital for IBS control, as intense uncontrolled emotions can trigger colon spasms in IBS patients. 

Personalized Treatments for IBS

Prior to modern advances in genetics, Ayurved was the only medical science to truly recognize the uniqueness of the individual and recommend personalized treatments. These recommendations are based on the concept of natural energies or doshas that define the fluctuations of nature and the individual’s physical and mental traits. As every individual has a unique prakriti or dosha balance, in cases where patients do not respond positively to generalized treatments (as described above), more personalized treatments are necessary. This could include diet and lifestyle changes that are based on dosha characteristics specifically. 

In addition, to considerations of prakriti, many patients also benefit from low-FODMAP or gluten-free diets. However, such dietary and lifestyle advice should be sought from a professional and experienced Ayurvedic physician or dietitian to avoid dietary deficiencies and malnutrition, as many foods that are high FODMAP foods or contain gluten are also important and healthy sources of nutrition.

References:

• Kapur OP, Shah S. Irritable bowel syndrome in Indian patients. [Last retrieved on 2010 Jun 26]. Available from: https://www.bhj.org.in/journal/special_issue_tb/DPII_13.HTM
• Cozma-Petruţ, Anamaria et al. “Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!.” World journal of gastroenterology vol. 23,21 (2017): 3771-3783. doi:10.3748/wjg.v23.i21.3771
• Guo, Yu-Bin et al. “Association between Diet and Lifestyle Habits and Irritable Bowel Syndrome: A Case-Control Study.” Gut and liver vol. 9,5 (2015): 649-56. doi:10.5009/gnl13437
• Johannesson, Elisabet et al. “Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects.” World journal of gastroenterology vol. 21,2 (2015): 600-8. doi:10.3748/wjg.v21.i2.600
• Qin, Hong-Yan et al. “Impact of psychological stress on irritable bowel syndrome.” World journal of gastroenterology vol. 20,39 (2014): 14126-31. doi:10.3748/wjg.v20.i39.14126
• Kavuri, Vijaya et al. “Irritable Bowel Syndrome: Yoga as Remedial Therapy.” Evidence-based complementary and alternative medicine : eCAM vol. 2015 (2015): 398156. doi:10.1155/2015/398156
• Altobelli, Emma et al. “Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis.” Nutrients vol. 9,9 940. 26 Aug. 2017, doi:10.3390/nu9090940

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