Some types of anti-depressants when prescribed at a low dose have been found to offer relief to some people with IBS even when depression is not a feature. Although the exact mechanisms involved are not completely understood, it is believed that altering serotonin levels can have a positive effect on the digestive system. Before we look at why, we should clarify what IBS actually is.



What is IBS?

IBS or irritable bowel syndrome is a complex disorder which manifests itself in a combination of symptoms affecting the digestive tract such as diarrhoea, constipation or both along with abdominal pain, bloating, a sense of urgency to pass a bowel movement particularly in the morning or twenty minutes or so after eating, straining, and a feeling that the bowels haven't emptied properly after performing a bowel movement. Not everyone of course will experience all of these symptoms and for some the symptoms might be mild and only a slight inconvenience whereas for others they can be so debilitating that they significantly reduce quality of life.

What can cause IBS?

No one knows exactly what causes IBS because there appears to be many different factors that can contribute to the development of IBS in some people. For example, IBS can be triggered by diet and food intolerances, some people develop IBS after a particularly stressful even in their lives and others have found that their IBS started after a gastrointestinal infection or even after taking a course of antibiotics. However, many researchers believe that the root cause of IBS symptoms lies in the Enteric Nervous System (ENS) which has a direct connection with the brain, and the role that serotonin has to play.

Serotonin and the gut

Serotonin is an extremely important neurotransmitter involved in brain function, basically it is the "feel good" chemical in our brains. However most of the serotonin actually resides in the gut. Serotonin helps to regulate our moods, appetite, sleep, and pain sensitivity and plays an important role in motility, the process of propelling the contents of the gut through the digestive tract and towards the anus. This shows just how much the brain and the gut are inter-linked. Indeed, IBS is thought to be a malfunction in brain-gut communication.

We already know that serotonin affects the nerves in the gut and that it helps to control peristalsis so if we have low levels of serotonin in the gut then this process is likely to be more sluggish, which of course can result in constipation. If, on the other hand, the levels are high, then this process is likely to be speeded up resulting in diarrhoea. Many people with IBS have been found to have altered levels of serotonin depending on whether their IBS was diarrhoea or constipation predominant.

What this also suggests of course is that as the brain and the gut are connected, anything that has an impact on the brain may also have an impact on the digestive system, such as intense stress or anxiety. If this is the case then perhaps by treating the underlying anxiety and finding ways of avoiding stress whilst also treating the symptoms of IBS itself it is possible to find relief from IBS and improve quality of life.

Stress is already known to exacerbate the symptoms of IBS, probably because any type of stress can also be felt in the gut. You only need to imagine the nervous feelings in the pit of your stomach you experience before an important exam or a driving test for example, to see how stress can affect the digestive system.

Tips for coping with IBS

As IBS is a long term disorder that is likely to last a lifetime then it makes sense to make long term changes in order to find ways of coping with IBS on a day to day basis. This inevitably will involve both dietary and lifestyle modifications.

Try eliminating any foods or drinks from the diet that irritate the digestive tract and/or worsen the symptoms of IBS and increase the amount of soluble fibre in the diet. It is absolutely vital to drink plenty of fluids to help keep the digestive system working efficiently.

Find ways of reducing the amount of stress in your life. Make sure you indulge in regular exercise as this helps keep the bowels healthy and is also good for your state of mind. Even a half hour walk several times a week can do wonders for your mental health and at the same time help to ease IBS symptoms. Perhaps try learning some relaxation techniques like breathing exercises, or take up yoga or practice meditation. The most important thing is that you enjoy what you do.

Finally, mealtimes should be stress free as much as possible. Take time over your meals and avoid the temptation to skip meals or to eat too much at one sitting. The ultimate key here is balance.