Irritable Bowel Syndrome & Fructose Malabsorption
Irritable bowel syndrome (IBS) and digestive complaints are difficult to treat from a Western medical perspective. Sufferers will commonly seek the help of complementary alternative health practitioners and solutions, in particular Chinese herbal medicine and acupuncture.
The conventional treatment options are usually based on symptomatic relief medications including: laxatives, antispasmodics, anti-diarrheas and antidepressants. Another treatment that appears to provide evidence-based relief of symptoms of IBS, in particular abdominal pain, is the application of the FODMAPs diet. It has been established that a high percentage of IBS sufferers also have fructose malabsorption (FM). By reducing fructose intake, this diet assists with symptom management, even with IBS patients who do not have a positive FM diagnosis. The FODMAPs * diet restricts intake of particular carbohydrates that are either not absorbed properly or creates discomfort during digestion. Evidence has not established whether FM has developed because of IBS or has been a causative factor. In a clinical setting it is not uncommon for IBS sufferers to not only be diagnosed with FM but also present with sensitivities to gluten (with a negative celiac diagnosis) or particular preservatives. Often not only a FODMAPs diet will be used, but further restrictions are implemented such as avoiding gluten and processed food. Although this may assist patients by avoiding unpleasant digestive symptoms, it is socially very restrictive and difficult to maintain.
Traditional Chinese Medicine Perspective (TCM)
From a TCM perspective, food sensitivities or intolerances such as FM or gluten sensitivity are indicative of an internal disharmony. A common TCM pattern is stagnancy within the liver Qi or a depletion of Qi in the stomach and spleen. Such patterns lead to digestive sensitivities and constitutional weakness. If this pattern is left untreated it may potentially cause or exacerbate IBS symptoms with associated food intolerances. However, applying the TCM treatments of acupuncture and in particular Chinese herbal medicine can rectify internal imbalances thereby effectively treating IBS and associated symptoms. TCM can play a key role in the treatment of IBS. It can assist with symptom management but also provide a treatment strategy that will encourage remission or at least work on a preventable basis. Currently exciting research is being carried out testing the effectiveness of TCM and the treatment of IBS. One study in particular will be incorporating TCM patterns such as Liver Qi stagnation. These studies will definitely be a “space to watch” in promoting TCM as a viable treatment option.
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* FODMAPs Fermentable oligosaccharide, diaccharides, monosaccharides and polyols