EVERYTHING YOU NEED TO KNOW ABOUT IRRITABLE BOWEL SYNDROME

Picture this: You’re leaning over in your chair, clutching your gut, eyes closed, teeth clenched, as your gut aches and swirls with discomfort. Sounds pretty miserable, right? Well for those who suffer from Irritable Bowel Syndrome (IBS), this is their reality.

IBS is a common digestive disorder affecting two out of ten people living in the UK, with women being twice as likely as men to be diagnosed.[1] With no widely accepted cause or treatment plan, it can be tricky to effectively treat or manage symptoms.

The truth is, many of us have experienced the above scenario at some point. So how do you know if it’s just a quick stomach bug or something more serious? What should you do if you think you might have IBS? Then if you do, how is it treated? We’ll answer all these questions and more below.

What is Irritable Bowel Syndrome?

IBS is often referred to as a functional digestive disorder. This is because the gastrointestinal tract shows no damage, but still isn’t functioning properly. IBS isn’t just uncomfortable and at times, embarrassing. It also causes diarrhea, constipation, cramps, and bloating. On top of this, for many, IBS is a lifetime problem.[2]

Many in the medical community refer to IBS as a “diagnosis of exclusion”. This means it’s often not diagnosed until other diagnoses have been ruled out. So once you’ve had lab work, testing, and even procedures done that haven’t nailed down another diagnosis, you may get diagnosed with IBS.

Because IBS is notoriously difficult to diagnose and treat, conventional medical practitioners are often left putting bandaids on the symptoms, while the root cause is unaddressed. With functional medicine, we recognize that this is a gut health issue where the underlying cause needs to be discovered for the patient to experience a true relief of symptoms.

Symptoms of Irritable Bowel Syndrome

Irritable bowel syndrome causes a host of symptoms that include:[3]

Diarrhea
Constipation
Gas
Bloating
Cramping
Nausea
Fatigue
Feeling sick
Backache
Mucus in stool
Loss of appetite

When talking about the symptoms of IBS, I find it important to note a few symptoms that are NOT signs of IBS. If you find yourself experiencing any of these symptoms, it’s important to bring these to your medical provider’s attention.

Some of the symptoms NOT associated with IBS include:

Fever
Pain that wakes you at night
Weight loss
Vomiting
Black, tarry stools
Blood in stools
Lump or swelling in your abdomen

What Are the First Signs of Irritable Bowel Syndrome?

I’m often asked, what are the first signs of IBS? The straight answer to that is, any of the above symptoms. The way in which you experience symptoms may vary from the next. Although, abdominal discomfort or pain are considered hallmark symptoms of IBS.

Causes of Irritable Bowel Syndrome

Finding the root cause of IBS isn’t simple or quick, but I find it to be essential in getting my patients the relief they deserve. There are a number of causes of IBS that need to be looked into to ensure a proper treatment plan is made.

Small Intestinal Bacterial Overgrowth (SIBO)

SIBO occurs when the delicate balance of bacteria that should be in our small intestines is altered. This is how SIBO leads to IBS. When you have SIBO, you’ll have difficulty absorbing nutrients your body needs and your digestion is also altered.

Astonishingly, a study found that almost 80% of those with IBS also have SIBO. And almost half of those people had an improvement in their symptoms once SIBO was treated.[4 ]

Gut Permeability

Many refer to gut permeability as leaky gut. Leaky gut occurs when the cells lining the inside of your intestines become permeable through damage or breakage. This allows bacterial toxins and undigested food particles to leak into your bloodstream. Once leaked, your body triggers an inflammatory response as your immune system attacks against the foreign invaders.

Gut permeability is caused by stress, chronic disease, toxins, medications, infection, and poor diet or lack of nutrients. In fact, many disease processes begin with intestinal permeability which leads to inflammation which then causes chronic disease.

One study found low levels of a protein that regulates gut permeability in people with IBS who have diarrhea or constipation.[5] This proves that leaky gut is very much associated with IBS.

Gut Infection

Gut infections can occur because of yeast overgrowth, parasites, or bacteria. Our modern diets and lifestyles have left many with poor gut health, which leads to an increased risk for infection – because so much of your immune system is housed within your gut.[6] This gives pathogens the ability to bypass or overpower the immune defenses in your gut.

Gut Dysbiosis

Gut dysbiosis is an alteration in the normal composition of bacteria that live in your gut. A subset of people with IBS also experience gut dysbiosis. Unfortunately, there’s no microbial ‘signature’ identified yet which could act as a biomarker for IBS.[7]

Food Allergies or Sensitivities

Many of the symptoms of food sensitivities and IBS are similar, which can make it difficult to correctly diagnose what the cause is without doing an elimination diet from gluten. Some food intolerances I see in my IBS patients include:

Dairy
Eggs
Corn
Soy
Yeast
Peanuts

Food intolerances and allergies are often an underlying cause of IBS.[8]

Stress

Stress, especially chronic stress, increases your risk of developing IBS. This is due to the gut-brain connection. When you’re stressed, it affects your gut. And vice versa. When your gut health is out of whack, it sends signals to your brain that affect your stress levels.[9]

Because of this interrelation of gut health to brain health, it’s no surprise that if your emotional needs aren’t met, the co-occurring physical symptoms you’re experiencing also go unaddressed.[10] It’s vital to look at the total picture and treat the body as a unit that functions together, not as individual, separate compartments.

Diagnosing Irritable Bowel Syndrome

Although IBS is often referred to as a diagnosis of exclusion, there are some criteria that need to be met for a diagnosis. This includes recurrent abdominal pain or discomfort at least three days per month in the last three months associated with two or more of the following:[11]

Improvement with bowel movements
Onset associated with a change in frequency of stool
Onset associated with a change in form or appearance of stool

The above criteria should be experienced for the last three months with symptoms onset at least six months prior to diagnosis. For those who suffer from the symptoms of IBS, this means it’s a waiting game for a diagnosis. But that doesn’t have to mean you need to suffer in silence. Seek out a functional medicine practitioner to begin finding the root cause of your symptoms.

Treatment of Irritable Bowel Syndrome

When treating IBS, I like to choose a treatment plan based on your unique symptoms and causes. This is because there isn’t a one size fits all approach that treats every case of IBS, every time. Keeping this in mind, here are some of the ways in which I treat IBS.

Diet for Irritable Bowel Syndrome

First, I recommend eliminating processed foods from your diet. This means anything packaged, processed, or not in its natural form. The reason is that it helps to eliminate toxins from your diet and reduce inflammation. In addition, the diet I recommend is the Paleo diet.

The foods in a Paleo diet include:

Organic, free-range meats
Eggs
Organic fruits and vegetables
Nuts and seeds
Healthy fats and oils
Fresh herbs and spices

Foods to avoid on the Paleo diet include:

Processed foods
Sugar
Artificial sweeteners
Gluten
Dairy
Legumes

I often utilise Cyrex arrays (laboratory testing) to get a deep look at any food intolerances you may have. This helps to ensure you’re not eating any foods that may be contributing to your IBS. It’s important to remember that many food intolerances are the result of SIBO, increased gut permeability, and gut infections. Hence why it’s so important to take a multi-faceted approach to treat IBS.

Low-FODMAP Diet for Irritable Bowel Syndrome

Another diet I recommend for some patients is a low-FODMAP diet. This diet restricts fermentable oligosaccharide, disaccharide, monosaccharide, and polyols in the diet. These are carbohydrates that are poorly absorbed and instead ferment in our guts causing gas and bloating.

Some foods high in FODMAPs to avoid include:

Beans
Apples
Onions
Wheat
Garlic
Dairy
Mushrooms

Research shows a low-FODMAPs diet is effective in the short-term treatment of IBS.[12] Although it’s important to note that this diet doesn’t address the underlying causes of IBS and is highly bio-individual. A low-FODMAP diet helps relieve symptoms very quickly but can reduce the diversity of microbes in your gut if followed long-term.

Peppermint Oil for Irritable Bowel Syndrome

Peppermint oil is helpful for treating IBS due to the active ingredient L-menthol. L-menthol decreases bloating and pain. In addition, it also increases stool consistency and frequency. A recent study found it an effective treatment for the symptoms of IBS, including pain.[13]

Peppermint comes in capsules, essential oils, and extracts. It’s important to purchase from a reputable manufacturer selling 100% pure peppermint oil.

Stress Management for Irritable Bowel Syndrome

Managing your stress is vital to whole-body health. When you focus on taking time out of your day to reduce your stress level and bring awareness to what you’re feeling, you’ll feel more relaxed, calmer, and have a clearer head.

A few of my favorite ways to manage stress include:

Mindfulness-Based Supported Therapy (MBST)

This therapy is focused on the five components of presence, listening, empathy, compassion, and boundary awareness. MBST is proven to reduce stress and anxiety, as well as contributing to spiritual growth.[14]

Yoga

The practice of yoga has a big impact on reducing stress, anxiety, and depression.[15] You can do yoga in the comfort of your own home with some meditative music or find a group session near you.

Deep Relaxation

Many people find it difficult to truly relax. With our modern, busy lifestyles and constant bombardment with information, it’s crucial to find time to deeply relax and start anew.

Some suggestions for ways to gain deep relaxation include:

Mindful meditation
Guided imagery
Warm bath
Slow, deep breaths
Journaling
Stretching
Tai Chi
Massage

Turn your phone on silent, shut off the television, and avoid distractions while relaxing. This ensures you get the most out of your session.

Probiotics for Irritable Bowel Syndrome

Since intestinal dysbiosis, gut infections, and SIBO alter your gut microbiota, it’s essential to rebalance. You can do this through the use of probiotics. Probiotics help balance out gut bacteria, calm intestinal inflammation, improve motility, reduce immune activation, and reduce gut permeability.[16]

I suggest using only soil-based organisms, finding the specific strain most useful at relieving your specific symptoms. Your functional medicine practitioner will help you decide which probiotic is best for your unique needs.

Soluble Fibre for Irritable Bowel Syndrome

Not all fibers are created equal. I suggest a soluble fibre like Partially Hydrolyzed Guar Gum (PHGG) as it’s a natural fibre and is proven safe and effective at promoting gut health.[17] It’s easy on your gut, while still providing the many health benefits of traditional dietary fibre. PHGG is especially beneficial to someone on a low-FODMAP diet because it is low in FODMAPs.

Are You Suffering From Irritable Bowel Syndrome?

If you or someone you know is suffering from IBS, it’s important to find a functional medicine practitioner to find and treat the root cause of the issue. As you’ve read, IBS isn’t a simple one size fits all diagnosis. It’s specific to each individual and should be treated as such.

I believe the best way to treat IBS is with a whole-body approach. This is why it’s important to talk to your functional medicine practitioner when you’re experiencing these types of symptoms. If you’re in the Preston, Chorley or Blackburn areas and are experiencing the symptoms of IBS, click here to contact me. I look forward to helping you on your journey to whole-body health!

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