Irritable bowel syndrome – also known as IBS – is one of the most common diseases in the Western world. According to a new study from the University of Sheffield, England, many IBS patients lack vitamin D, and vitamin D supplements can alleviate symptoms like abdominal bloating, stomach cramps, diarrhea, and constipation. This is because vitamin D has a number of functions that are relevant for the digestion. Science generally knows very little about what triggers IBS, but it is accepted that disturbances in the intestinal microflora, food intolerance, and stress may contribute to the problem.
IBS affects the colon and typically causes symptoms like pain and upset stomach, stomach rumble, flatulence, and alternating stool consistency that shifts between diarrhea and constipation. In between, the patient may experience periods without pain and with fewer symptoms. The IBS diagnosis is based on anamnesis that complies with the Rome III criteria. IBS affects around 10-20 percent of people in the Western world and is more frequent with women. The disease impairs quality of life, causes absence from work, and is a large burden to the public healthcare system.
Have your vitamin D levels measured if you suffer from IBS
Researchers from the University of Sheffield have looked closer at the link between vitamin D and IBS, a disease that affects one in five citizens in Great Britain. By reviewing seven published studies, the scientists found that around 75% of IBS patients are vitamin D-deficient. They also observed that around 70% of the patients were less troubled by rumbling and cramps in the stomach and had fewer problems with diarrhea and constipation when they were given supplements of vitamin D. However, vitamin D supplementation had the most significant impact on the patients’ quality of life. Although more research is needed, the scientists already recommend measuring blood levels of vitamin D in IBS patients. If they are low in vitamin D, supplementation is advised. The new study from the University of Sheffield is published in the European Journal of Clinical Nutrition.
Vitamin D in the blood is measured as 25-hydroxy-vitamin D. The official threshold level is 50 ng/ml, but many experts believe that this is insufficient and suggest 75-100 ng/ml for optimal disease prevention.
Vitamin D controls many functions – also in the intestine
Vitamin D is like a hormone that can activate and influence a host of different cells and organ systems. It is commonly known that vitamin D is important for our bones, and it also helps control our mood, immune defense, nervous system, and intestinal flora. Vitamin D helps the immune system fight harmful bacteria and toxins, including those from the food we eat. And vitamin D prevents the immune system from overreacting and causing chronic inflammation.
Lack of vitamin D increases the risk of inflammation in the gut
Earlier research that is published in the World Journal of Gastroenterology reveals that IBS is associated with mild intestinal inflammation, and this type of inflammation may cause molecular changes and gastrointestinal symptoms.
Vitamin D deficiency is already linked to an increased risk of inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, and it is even associated with bowel cancer.
Overlap between IBS and food intolerance
Many of the symptoms you see with IBS, lactose intolerance, and gluten intolerance (celiac disease) are identical. People with lactose intolerance are unable to break down lactose (milk sugar) because they lack an enzyme called lactase. The unpleasant symptoms typically occur somewhere between 30 minutes and two hours after ingesting dairy products. 70% of the world’s population is lactose intolerant and is able to get along perfectly fine without dairy products. People with the condition should of course try to exclude dairy products and other foods with lactose from their diets.
Celiac disease is an autoimmune disease that causes foamy diarrhea and many other symptoms. The condition is untreatable and requires complete abstinence from foods that contain gluten.
Both lactose intolerance and celiac disease are triggered by a single (not the same, though) factor, whereas IBS is more complicated. It is possible to suffer from IBS, lactose intolerance and/or gluten intolerance at the same time. What is less commonly known is that the immune defense can react to milk protein such as casein and whey protein, and that other parts of the immune system may react to gluten (non-celiac gluten intolerance).
If the immune system overreacts to protein in different types of food, it may cause poor digestion and chronic inflammation in the bowel and other parts of the body.
Special blood tests can reveal if the IgG antibodies of the immune defense react to milk protein, gluten, and other foods.
Histamine intolerance, which often goes unnoticed, may also cause the same symptoms as those seen with IBS. Histamine is a neurotransmitter, which the body produces. Bacteria can also produce histamine, and the compound is even found in different foods. As a rule of the thumb, the longer food has ripened or been in storage, the more histamine it contains. Red wine, vinegar, cheese, pickled herring, sauerkraut, and salami contain a lot of histamine. We have in our intestine an enzyme called DAO (diamine oxidase) that breaks down histamine. If we are deficient in this enzyme, we may experience digestive problems, headache, and other symptoms.
In any case, the overlap between IBS and different forms of food intolerance is a clinical dilemma that serves to show how big a role our diet plays.
|10-20 percent of people in the Western countries suffer from IBS. In Asia, the disease only affects around 6-11 percent. It appears that a lot is controlled by what you eat.|
Avoid stress and get plenty of sleep and exercise
The body is designed to respond to stress with a fight-or-flight reaction. This causes blood to gush from the intestines to the brain, the heart, and the muscles in order to prime us for optimal physical and mental performance. However, we humans are not meant to be in a condition of stress for prolonged periods, as this condition is extremely energy-demanding and gives lower priority to our digestive system. Many people with IBS are more or less stressed and need to relax and take more time, especially in the morning where it is only natural to have a bowel movement.
We primarily digest our food when we sleep, so it is vital to get enough rest. We also need exercise and some sort of physical outlet for stress. Long walks are particularly good for our intestines.
Vitamin D-supplements could ease painful IBS symptoms. Latest news –The University of Sheffield. 25 January 2018
Vitamin D-supplements could ease painful IBS symptoms. ScienceDaily. 25 January 2018
Emanuele Sinagra et al. Inflammation in irritable bowel syndrome: myth or new treatment target. World J Gastroenterol. 2016
Archita Makharia et al. The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma Nutrients 2015
Madden JA, Hunter JO E review of the role of the gut microflora in irritable bowel syndrome and the effects of probiotics. Br. J Nutr. 2002
Ane Bodil Søgaard, Karen Østergaard, Troels V Østergaard. Mælk og Sundhed. Books on Demand
Pernille Lund. Immunforsvarets nye ABC. Hovedland 2012
Helmut Schmutz. Fødevareintolerans (Histaminintolerans). HSH, 3001, Mauerbac
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