Focus on diet, stress, sleep, exercise to improve IBS

Irritable bowel syndrome, or IBS, is an extremely common medical condition and the prevalence of IBS in the United States is among the highest in the world.

Bowel inflammation is a known risk factor for IBS. Reducing bowel inflammation can alleviate the symptoms of IBS. One dietary compound, butyric acid, has profound anti-inflammatory actions in the bowel and may play a key role in both the prevention and treatment of IBS.

While IBS is not a fatal medical condition, it does affect about 15% of the world population. It is also twice as common in women than men. There is no blood test or imaging study that confirms IBS. The diagnosis rests on the symptoms. These symptoms include long-standing abdominal pain with constipation and/or diarrhea (but sometimes neither).

IBS is strongly associated with depression and anxiety, chronic fatigue syndrome and fibromyalgia. The root causes of IBS are not well defined. Some believe bacteria-based inflammation in the bowels lead to motility issues, pain and food sensitivities. IBS can mimic other, more serious bowel illnesses such as celiac disease, early ulcerative colitis and Crohn's disease, microscopic colitis and even colon cancer. There seems to be a genetic component but it is not strong.

There are many treatments for IBS. Some are dietary - probiotics, fiber, diet - and may result in cures. Others focus on medications that only reduce the symptoms of IBS.

Butyric acid is a four-carbon, fatty-acid molecule. In the bowels, specific bacteria will produce butyric acid as a result of digestion. The importance of butyric acid to the health of the bowels cannot be understated. It is essential to the functioning of the bowels' immune system. Butyric acid encourages the production a set of immune cells that regulate how the bowels' immune system reacts. Low levels of butyric acid results in low levels of these regulatory cells. The immune system overreacts, resulting in inflammation.

Butyric acid also inhibits the production of inflammatory molecules, again limiting levels of inflammation. It is also used by the bowel wall cells, ensuring integrity of the bowel wall. Low levels of butyric acid ultimately result in bowel wall damage and, once more, inflammation.

There are many medical studies demonstrating the importance of butyric acid in the treatment of IBS and inflammatory bowel diseases like ulcerative colitis and Crohn's disease.

Probiotics containing butyric acid-producing bacteria can be beneficial. These bacteria consume fiber and one of the byproducts is butyric acid. Foods that result in butyric acid are garlic and onions, apples, carrots and oat bran. Good dietary sources of butyric acid itself are clarified butter, ghee, parmesan cheese and sauerkraut. Butyric acid also can be found as a dietary supplement.

IBS does not have to be a permanent condition. In many respects it is the direct result of lifestyle rather than the inevitable result of bad genes. Changing one's diet, reducing stress, getting quality sleep and exercise all contribute to the health of the bowel. A healthy bowel is resistant to developing IBS.

• Dr. Patrick Massey is president of ALT-MED Medical and Physical Therapy, 1544 Nerge Road, Elk Grove Village.