What is Irritable Bowel Syndrome (IBS)?


Irritable Bowel Syndrome (IBS) is a functional disorder of the Large Intestine (Colon)  that can cause cramps, bloating, gas, pain, diarrhea, or constipation.

People with IBS-D will have diarrhea on a regular basis with occasional or no constipation, while people with IBS-C have regular constipation and with only rare diarrhea. The abdominal pain is often compared to menstrual cramp pain, while some will describe a kind of stabbing pain. Severe bloating is very very common. And then some people will have both C and D, in which case some days they will be constipated, and other days, have diarrhea.

Unlike other gut disorders, IBS is a functional disorder, or a syndrome. There are no known changes to the tissues of the colon, unlike  Ulcerative Colitis, Diverticulitis, and Crohn’s Disease. There is also, unlike say diarrhea from food poisoning or dysentery, no infectious agent. This is why IBS is called a Syndrome.


What is a Syndrome in Western Medicine?

So how can my gut be so miserable when there are no actual changes to the intestines, and no infectious disease? IBS is like having a tension headache in your gut. One of my teachers asks, “are you a teeth grinder or a gut grinder? Irritable bowel syndrome is a kind of nervous system disorder, like tension headaches.


The Role of the Fight or Flight Stress Response in IBS

It seems to affect people, women far more than men, who carry their stress in their gut. The body keeps the score. IBS Constipation, in my view, is more associated with the Fight and Freeze aspects of the nervous system and IBS-Diarrhea with the flight aspect. Disorders of the internal organs from the nervous system are disorders of function, not structure.


Irritable Bowel Syndrome is a Functional Disorder

Functional Disorders are when normal process of the body do not function as they should. There is no infection, no structural cause, no injury.

Diarrhea from food poisoning is an infectious disease, like the flu. Stuctural defects occur in response to appendicitis, or colon cancer. Functional disorders, on the other hand,  are disorders in which your body is rebelling and refusing to function normally. The cause of functional disorders is the nervous system.


BioMed Anatomy & Physiology of IBS

The Mayo Clinic website, describe the effects of IBS succinctly:

“The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food from your stomach through your intestinal tract to your rectum.

If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal, causing gas, bloating and diarrhea. Or the opposite may occur, with weak intestinal contractions slowing food passage and leading to hard, dry stools.

Abnormalities in your gastrointestinal nervous system also may play a role, causing you to experience greater than normal discomfort when your abdomen stretches from gas or stool.

Poorly coordinated signals between the brain and the intestines can make your body overreact to the changes that normally occur in the digestive process. This overreaction can cause pain, diarrhea or constipation.”

The question that arises is what causes an individuals intestinal wall muscles to malfunction? And what disrupts the gastrointestinal nervous system to misfire.

The cause is the nervous system, whether habitual or situationally disrupted. Habitual disruption comes with specific bodymind types, the nervous type or the hyperintense type. We can also be responding to situation, like high level of unusal external stressors at work or with family. This is now called the “Gut-Brain Connection”

See this article of mine on the topic, or this book by Dr. Michael Gershon, M.D.


Irritable Bowel Syndrome (IBS) in Chinese Medicine and Acupuncture Theory

Chinese medicine cuts to the root of the nervous system basis of IBS, by describing the Gut-Brain connection root of IBS. We describe the flow and extraction of food through the gut as the “Qi mechanism.” Qi is life force, the difference between a live organism and a dead one. To be alive is to have everything in your body moving, from the extraction and movement of the Qi of the Air into hemoglobin, to the extraction of micronutrients from food and drink into the blood stream.

When this movement of Qi is flawless, you eat, you feel good afterwards, and later you go to the bathroom and have a well formed stool. When the movement is effected by stress, frustation, anxiety, you can end up with IBS, or GERD, or gastritis, or even Ulcerative Colitis and Diverticulitis.


Fight or Flight in Chinese Medicine: The Mind Leads the Qi

Chinese Medicine uses the term Shen, or Mind, Heart, Consciousness to describe how excessive unregulated emotional stress damages the body. We say “the Mind leads the Qi.” Its simple to see the differences in a human or animal body when angry, sad, joyful, terrified, sexually aroused, in love. We can tell just by looking. This IS the nervous system acting on our body and its tissues. This is how the sympathetic and parasympatheic nervous system works. 

Being in love wont cause IBS, and neither will happiness or joy. IBS is a specific fight or flight response associated with hyperintensity, perfectionism, anxiety, fear.

Indeed, Chinese Medicine say that Anger causes the Qi to rise and or to contract. Note, the movement of Qi thru the gut is downward. So raising the Qi causes constipation, as does increased tension around the colon. On the other hand Chinese Medicine describes how “fear makes the Qi descend.” It differentiates diarrhea type Irritable Bowel Syndrome from constipation type as having more of an anxiety/fear type basis.


Its Not “All in Your Head”

This DOES NOT mean “its all in your head”. But what it does mean is its how your particular nervous system responds to stressors and conditioning. It describes how you may be internalizing life’s stressors and difficult emotions like fear and frustration.

The good news is that Acupuncture and Chinese Herbs will give you immediate relief! Acupuncture is a direct intervention on the nervous system. It “rebalances” your Gut Brain connection. And Chinese herbs are safe, plant based drug medicines that relax and repair the functioning of the colon.

The Root of Irritable Bowel Syndrome in Chinese Medicine: Liver-Spleen Disharmony

The root of Irritable Bowel Syndrome in traditional Chinese Medicine is what is called a “Liver-Spleen Disharmony.” Don’t worry, there is nothing wrong with your physical Liver or Spleen.

But the ancient Chinese described harmonious function of the digestive tract in terms of the relationship between the Liver and Gall Bladder and the Pancreas and Stomach, along with the intestines, and the short-hand name for this system is the harmonious function of the Liver and Spleen.

When the Liver Qi gets tense it over-controls, and when the Spleen Qi gets weak it fails to do its job. When both happen this is a perfect storm that creates various gut issues, including Irritable Bowel Syndrome.


The Liver Qi in Chinese Medicine and Acupuncture–Stagnated by Frustration

The Liver in Chinese medicine has the job of maintaining the free flow of Qi through the entire body, and when it fails in this role, due to excessive stress or due to a Pitta personality type, then the energy of the Liver, being aggressive, attacks its neighbor, the Spleen (whose job is intricately involved with extraction of nutrients in the gut) and disrupts it, and the intestinal function.

And when the Liver Qi stagnates it leads to tension anywhere in the body, which can weaken intestinal contractions leading to constipation. This is the piece of Irritable Bowel Syndrome that relates to stress, especially associated with frustration or intensity.


The Spleen Qi in Chinese Medicine and Acupuncture–Weakened by Worry

Worry is meditating on what you dont want to happen. Its in the larger category of Fear, and is a tendency related to anxiety. Catastrophizing is something anxious folk do, and we can learn to not do it with simple cognitive therapies and mindfulness practice. And it weakens the Spleen Qi, which is an overarching term for the extraction and movement of food thru the gut.

And one of the functions of the Spleen Qi is to keep things from falling down. The Spleen is associated with the Zhong Qi/Upright Qi. If anxiety and fear is consistent or strong enough it will lead to diarrhea, because “fear makes the Qi descend.”

The damage done by strong fear to the gut is dramatic.  Dogs and Kids pee in their pants when frightened. Its common in English to say, “i was so scared i was sh*tting my pants, or peeing in my pants. That’s how our nervous system works. Because, its the same movement of Qi that enabled me to jump backwards 7 feet at the Grand Canyon to avoid getting bitten by a large rattlesnake.


TCM Diet Therapy for Irritable Bowel Syndrome in a Nutshell

Poor diet can also weaken the Spleen Qi. Everything from overeating itself, from too many heavy foods like meat and dairy, overdoing alcohol, sugars and sweets.

A diet heavy in cold, or raw food, like salads and smoothies, and the compulsive over-drinking of water, especially refrigerated water, weakens digestive function. This is not the cause of IBS, but can certainly combine with the nervous system piece, and has to be dealt with during treatment.

Likewise, underconsumption of lightly cooked Green Vegetables can be an aggravating factor. “Rice for energy, protien for stregnth, and VEGETABLES TO KEEP EVERYTHING CLEAN” is an ancient adage. Vegetables can cleanse pathological damp heat from the body, and have a tonic, cleansing effect.


How Quickly Will My Irritable Bowel Syndrome Improve?

The good news is IBS is actually fairly easy to treat. Over the past 30 years I have treated hundreds of cases with extremely good, quick results.

I treat IBS with a combination of Acupuncture, Chinese Herbal Medicine, Ayurvedic Herbal Medicine, and both Chinese and Ayurvedic diet therapy, depending on the case.

I have people come in once a week for three weeks, during which time we can get the treatment started and I can develop a careful and clear understanding of your case. Each case is different, but there are overlapping similarities.

Acupuncture Treatment of IBS

The acupuncture piece of the treatment is designed to “relax the Liver Qi” so that it stops producing damp heat and stops interfering with the healthy “spleen and stomach” function. The acupuncture is not at all painful and is actually very very relaxing and leaves you feeling refreshed, as after a profoundly deep sleep.

I also often use moxibustion to warm and strengthen the acupuncture channels relating to the Spleen and Stomach function and to strengthen the large intestine if weak.

After the first 3 visits, then I like to see you twice a month for 3 months. In severe cases I may need to see you once a week for 4 weeks and then twice a month.

Most people have a full recovery back to pain-free, normal bowel movements from anywhere between 6 weeks and 3 months,  provided they are conscientious about taking their herbs twice a day, and being careful with their diet.

Healing is a process, not a pill. Dealing with the nervous system piece though meditation, therapy, tai qi, or yoga helps a great great deal.

Some patients continue with acupuncture treatment once a month or once in 6 weeks for an additional 6 months, both for their Irritable Bowel Syndrome treatment, but also as part of their general health routine, what some patients call a ‘tune-up.”

Chinese Herbal Therapy for IBS

Your herbal therapy treatment for Irritable Bowel Syndrome may include both Ayurvedic and Chinese Herbal Medicines if constipation, and if diarrhea strictly Chinese medicine. This is based on my clinical experience and what I have found to work best in the fastest time frame.

I have a variety of formulas that I use based on your unique gamut of symptoms, ranging from Ginger and Codonopsis to Blue Poppy brand Perilla and Mentha to Triphala and Boswellia.


Diet for IBS

Clean and Light with Digestive Herbs and Spices

Diet therapy involves at least three months of a clean and light diet free of sugar, which includes alcohol beverages, with very little yeasted foods, and lots of cooked vegetables, soups, small amounts of flesh foods, simple light grains like rice, and ample mild digestive spices like fennel, ginger, cumin, cardamon, asafetida, long pepper, and coriander.

I also use herbal beverage teas that are great tasting and make a big difference with gas, bloating, and burning.

What I really like is when the patient takes ownership of their dietary changes, and thinks of it as a change in their life rather than some kind of depriving. You don’t have to give up alcohol, spicy hot food, or sweets for the rest of your life.

But you do have to ‘fast” from them for 3-6 months, and you may find that you will want to have less of these things once you recover. Usually that is because you have replaced them with other things more satisfying.

Tailored to Your Ayurvedic Dosha

For patients interested I like to tailor the diet to the Ayurvedic dosha of the individual, both to the primary and secondary dosha. So even if we use a diet that pacifies Vata or Pitta, we have to adapt it to the individual’s constitution.

A Vata elevation in a Kapha type is dealt with differently than in a Pitta type. And a dual Vata-Pitta elevation in a Vata type is different than in a Pitta type.

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