Irritable Bowel Syndrome Key Points
Have you been diagnosed with Irritable Bowel Syndrome (IBS) or suspect you may have it, then read on..
As anyone with Irritable Bowel Syndrome already knows, IBS is a condition that can severely limit what you can eat, what you can do, and can strike at any time! Symptoms include bloating, abdominal pain, and funky pooh.
Many people with IBS have suffered for years, and can end up eating a very restrictive diet that makes eating out and socializing very difficult difficult. They are dragged down by brain fog, fatigue and anxiety about their condition and what they can and can not eat.
The Diagnosis Criteria
Let’s start by discussing how an IBS diagnosis is usually given and the usefulness, or lack thereof, of the diagnosis.
The Rome IV Criteria is commonly used to diagnose IBS – as you can see the inclusion criteria are quite general..
Rome IV Criteria
Recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.
In reality, an IBS diagnosis is often given by a medical doctor by a process of exclusion. Which simply means that other gut conditions are first ruled out, and then if the cause can’t be identified, then it is given the label of IBS.
As the underlying cause isn’t known, the only option is then to treat only the symptoms using drugs or surgery, or you may be told there is nothing that can be done, or to eat more fiber or Metamucil. This isn’t doing anything to treat the underlying causes and drivers of your gut health issues..
And so an IBS diagnosis is is NOT the final answer. It tells you absolutely nothing about the underlying causes of your gut distress – more detective work is needed (and this can be done by yourself or with a Nutritionist/Naturopath practitioner such as myself).
If you take one thing away from this post, I want it to be the hope and understanding that it’s possible to improve your IBS.
You can increase the range of foods you can eat.
It is possible to lessen the constant worry about your digestion and improve your well-being and quality of life, and return to some degree of normality.
What is causing my IBS?
As a Functional Medicine practitioner, I aim to get to the root cause of health issues.
This is important!
By finding the root causes, we can weed out health issues for good. Imagine you are pulling a tough weed out of your garden. The weed breaks and leaves the roots behind. By addressing only the symptoms, it’s as if you are pulling this weed out of your garden. When the roots remain, the weed will grow back. It’s better to remove the weed by it’s roots.
Did you know that there is one underlying cause that the latest research shows us is behind 60% of cases of IBS? Yes, 60% !
This is bacterial overgrowth of the small intestine or small intestinal bacterial overgrowth (SIBO), and your doctor probably hasn’t even heard of it! This isn’t an invention of alt-medicine Naturopaths and Nutritionists. We can test for its presence using lab testing, see improvements when it’s treated, and there are over 2,000 research papers on SIBO.
There are other possible causes of IBS, although SIBO is the most common. I will only list the other potential causes here as I do encourage you to work with a practitioner to identify and treat the causes of your condition
- Parasites, and bacterial or yeast overgrowths. Stool testing is available through the GI Map and GI 360 tests. Very limited testing for parasites is available under Medicare in Australia.
- Impaired digestion. Low stomach acid, digestive enzymes and poor fat digestion
- Slow or fast food transit time through the gut. Can cause diarrhea or lead to a bacterial overgrowth.
- Gluten disorders including Celiac disease.
- Psychological and emotional stress and vagus nerve impairment
- Carbohydrate maldigestion including fructose, lactose and sucrose
- Food sensitivities. These are not true allergies but low-grade reactions to foods that may not be seen until hours or days after eating
The Low-FODMAP diet can be effective at reducing symptoms but it should only be used for a month or two as it may lead to nutrient deficiencies and may have negative effects on the beneficial bacteria in our gut (as it lacks fibre).
Also, reducing symptoms is very different from having a cure. When we treat only the symptoms, the symptoms will worsen again when we relax the diet/treatment. We are only avoiding the problem for a period of time. When we address the underlying causes, then the issue is fixed or at least significantly improved, for good and is less likely to return.
My Gut Freedom Formula flagship program starts with a detailed assessment of your gut issue so that we can have an effective plan for treatment.
Small intestinal bacterial overgrowth (SIBO)
We normally have about 1.5kg (3 lbs) of bacteria, about 500 species, in our gut. Usually, most of these bacteria live in our large intestine and our small intestine is relatively sterile.
But bacteria can also take-over in our small intestine where they aren’t supposed to be, a condition known as SIBO. There are many causes of SIBO which you can work with a practitioner to identify.
These bacteria in the small intestine ferment food producing gas and causing bloating, belching, nausea, as well as diarrhoea or constipation or an alternation between the two.
If SIBO is found, anti-biotics are an option. But many people prefer an approach that is less damaging to the gut bacteria. This approach involves dietary and habit change, and targeted supplements.
A successful approach should always look at the underlying cause of SIBO itself. For instance, a build of methane producing bacteria, associated with constipation, may have been caused by a slow transit time of food (how long it takes to pass through the gut). If that’s the case, steps should be taken to speed up the digestive process, else SIBO is likely to return.
In many people, food poisoning was the trigger for the development of SIBO.
Remember that time years ago when you were travelling and got sick after eating something? SIBO can develop in the days, weeks or even months following infection..
The toxins released during an infection may have damaged nerves in the gut. Now, when you are stressed, there is an abnormal muscular contraction of the bowel causing digestive discomfort. In this case, the brain can then become overly sensitive to signals of pain or bloating sent from the gut, and it feels like your gut has become overly reactive.
Testing Option: Lactulose or Glucose SIBO Breath Test
What if I’ve looked at these causes, and I still have IBS?
In some cases even after a thorough professional assessment and lab testing it isn’t possible to identify the underlying cause. Whilst identifying the root causes allows for more precise treatments, we can still improve gut issues where these causes haven’t been identified!
This is because unlike medications, changing our diet or lifestyle exert their effect on many facets of gut health, including the balance of bacteria, inflammation and digestion. E.g. probiotics can help reduce leaky gut, find a new balance of gut bacteria, and reduce the number of parasites = many effects from one intervention! So they are beneficial even when the root cause hasn’t been identified.
Some people also find gut-centred hypnosis, working on the gut-brain connection, and the Dynamic Neural Retraining system to be supportive during this process, particularly if they spend the majority of their day in fight-or-flight mode or have unresolved psychological trauma.
My program for fixing gut issues, the Gut Freedom Formula, therefore combines assessment of your personal causes of your gut issues, and a plan based on the findings, with a diet and lifestyle formula interventions.
What do I do next?
For a more detailed overview of the steps to fix your gut health, have a look at this article.
By taking steps such as these, and seeking out the underlying causes of IBS, you can really improve your health and finally overcome your digestive issues.