Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is the most common disease diagnosed by gastroenterologists. It is also one of the most common disorders seen by primary care physicians. IBS is the most common functional gastrointestinal (GI) disorder, which means no physical cause can be found to explain the symptoms. The symptoms of IBS include abdominal pain, frequent diarrhea, constipation, or gas and bloating. Conventional medicine focuses on managing the symptoms, while Functional medicine seeks to find the root causes of the IBS and address each of them.
When I went to medical school, I learned that people with irritable bowel syndrome have a psychosomatic condition. The science has evolved since then and now we know that there are several drivers of the irritable bowel syndrome:
1. Stress
Stress – there is a link between higher stress levels and increased rates of IBS. The reason is your brain and your gut are connected via the vagus nerve. Thus stress might contribute to the development, or worsening, of IBS symptoms by increasing or decreasing activity within the autonomic nervous system. Therefore, this causes your colon to contract too much or too little (causing constipation or diarrhea).
2. Increased intestinal permeability (“leaky gut).
Increased intestinal permeability (“leaky gut). The digestive tract lining has a 1 layer cells with tight junctions that works as a barrier to prevent undigested food particles, microbes, toxins, and other undesirable substances from entering the body. This means that, if the intestinal wall lining becomes damaged, the tight junctions open, allowing these food particles, microbes, and toxins to enter the body. Therefore, the immune system responds to defend the body from these invaders, and inflammation can result. Fortunately, leaky gut syndrome can be treated using a functional medicine 5R approach and an individualized elimination diet. See below.
3. Dysbiosis or imbalance in the gut microbiome.
Dysbiosis or imbalance in the gut microbiome. There is a large collection of microbes that live inside of the gut that weighs about 3 pounds. Thus, when these bugs get out the balance, you can get symptoms such as bloating, constipation and irritable bowel disease. We can get these bacteria back in balance and get our gut healthy. We do this by tending to it properly: eating the right foods including fiber, taking the right nutrients, such as pre-biotics and probiotics.
4. Small intestinal bacterial overgrowth
Small intestinal bacterial overgrowth is another condition that manifests with digestive issues such as gas, bloating, heartburn. As a consequence, many patients tell me they feel “pregnant” throughout the day due to the abdomen distention. In SIBO certain bacteria migrates from the large intestine into the small intestine, and they ferment the food that you are eating. Because of this, there are symptoms of gas and bloating throughout the day. As a consequence, this condition needs to be diagnosed with a specific test called Breath test and treated with a non-absorbable antibiotic called Rifaximin or herbal anti-microbials.
5. Food sensitivities
Food sensitivities are another hidden cause of abdominal pain, heartburn and bloating which overlap with IBS symptoms. Certain food groups like gluten, dairy and processed foods can irritate the lining of the gut in susceptible individuals. An elimination diet can help with this. This means that people usually start with an elimination of common food triggers such as gluten, dairy, corn, soy, sugar for a minimum of 4 weeks. You can also do a blood test that looks at your individual food sensitivities, and this test can be ordered by a functional medicine doctor.
6. An overgrowth of yeast (Candida)
An overgrowth of yeast (Candida) which results from overuse of antibiotics can create extra constipation, diarrhea, gas and bloating. Yeast overgrowth occurs when the balance of your gut flora is disrupted. It can be diagnosed with a comprehensive stool test.
Strategies
Some of the strategies I use with my patients involve the Functional Medicine 5 R approach which aim to:
- Remove the foods that you might be sensitive to, identify and treat the bacteria, parasites or yeast that might contribute to the dysbiosis or imbalance in the gut flora.
- Replace what is missing, such as digestive enzymes and acids required for proper digestion.
- Repair the gut lining with different supplements and foods.
- Repopulate the digestive tract with the good bacteria, probiotics.
- Rebalance your stress, sleep, hormones.
We individualize the above steps based on each person’s symptoms and testing results.
By identifying the foods that you are sensitive to and changing your diet, treating infections in the digestive tract, healing the gut lining and taking the right supplements and probiotics you can fix your irritable bowel.
I am witnessing this transformation with my patients on a regular basis. Working with a functional medicine practitioner will help you pinpoint your imbalances and create an individualized plan for your gut healing.