What Is IBS?

Irritable Bowel Syndrome is one of the most common digestive disorders in the US, with up to 20% of people who suffer from IBS symptoms and consequences.

Woman with stomachache, bathroom in background

 IBS Causes

Leaky gut - the cells that line our digestive tract need to be bound tightly together like brick and mortar.  A variety of reasons can cause some of the "mortar" to loosen or crumble. These cells then become like bricks loosely stacked which allows small proteins to pass though the digestive lining and end up in our bloodstream. This can cause all-over body symptoms like brain fog, rashes, itching, joint pain, muscle pain, or fatigue.

 Gut dysbiosis -  an imbalance in the microbial diversity our digestive system requires to function optimally. This can be an overgrowth of bacteria, or fungal (yeast). A microbial overgrowth imbalance doesn't typically go away, even with strict dietary changes. These issues needs to be treated with anti-microbial and/or anti-fungal medication, which can natural or pharmaceutical.

Food Sensitivity - This can be a combination of food allergy, food intolerance, and leaky gut mentioned above. Food sensitivities can be address through a testing panel such as the Alcat Food Sensitivity Test, or through an elimination diet.  

IBS Symptoms 

Abdominal discomfort - this can range from a dull ache to sharp pains. With IBS, the stomach discomfort and pain is often relieved by having a bowel movement. It is also common to feel as if you have not completely finished your bowel movement.

Diarrhea - often this is intermittent, but it’s more common to have diarrhea after eating. This can happen immediately after eating and up to several days after eating trigger foods.

Constipation - hard,  difficult to pass stool. You may goes days without being able to have a bowel movement (but you shouldn’t!). You may experience increasing abdominal pain and bloating until you are able to have a bowel movement. It's also possible to have symptoms that alternate between diarrhea and constipation

Bloating - This is worse after eating, esp after eating trigger foods. Bloating may get better after a bowel movement. Experiencing stomach distention and pain is common. This may or may not be followed by flatulence.

Typically the above symptoms would be present for at least 3 out of the last 6 months, not necessarily every single day.

IBS Pain

From my own experience, and what I've seen with my patients, IBS is about 50% physical pain related, and 50% suffering from the consequences. ~ Dr. Mayatte

Physical

The pain most often associated with IBS is recurrent abdominal pain or cramps. This often occurs with bloating, distension, or tension in the belly. Abdominal pain may be worse before a bowel movement, with looser and more frequent stools.  This type of abdominal pain is most often decreased after a bowel movement.

 Emotional

The other type of pain associated with IBS is much less talked about which is the emotional pain. IBS is invisible to others, making it difficult to deal with in social, family, and work situations. The topic of bowel function is taboo in our culture. So, not only is it an invisible disorder, but it's inappropriate to talk about in ANY situation. Even among family members in a private setting it's taboo.

IBS is rarely addressed well in allopathic medicine. Your doctor may tell you your labs are fine and there is nothing wrong. Or they may tell you that drugs are the only treatment. Often patients have gone to many doctors, been tested for every gastrointestinal illness under the sun, and the answer has always been, its IBS... find ways to "manage it".

IBS Treatment

There are a variety of treatments for IBS. These can range from dietary changes, supplements, lifestyle, and pharmaceuticals. What I've found is the majority of patients benefit the most and the quickest with a combination of treatments.

Diet - dietary changes for treating IBS don't have to be a permanent lifestyle change. While it is important in life to be able to eat the foods you love and not have to limit yourself in social situations this may have to change temporarily. I have found working with patients that it is usually necessary to make short-term changes to what you eat. This is to reduce symptoms, and allows the digestive lining to heal. There isn't a set time frame of how long this takes. How long to follow a specific diet is different for each person.  I base this on how long they have had their symptoms, how they react to reintroducing foods, and what other stress is going on in their life.

 Diet options: 

  • Specific Carbohydrate Diet - One of my top choices for control IBS symptoms and getting your life and health back. One of the more restrictive in terms of food choices, but it does have stages that you can move through depending on what symptoms you are having.

  • FODMAPs- less restrictive than the SCD diet above and can work quite well for some people. 

  • Gluten-free - This is avoiding foods with gluten. While targeted towards those with Celiac, many non-celiac find they feel better avoiding gluten. Although this is a good place to start, many people with IBS have underlying issues that may mean they need to avoid more than gluten to control symptoms and allow the digestive lining to heal.  

  • Elimination diet - this involves elimination of specific foods identified from a food sensitivity panel test. Or you can remove the most common foods associated with IBS symptoms. Specific foods are avoided for 4-6 weeks and then re-introduced into the diet one at a time. This option is often a good place to start as some people do have a reduction in symptoms.

Supplements - There are a variety of supplements that can help relieve symptoms and heal the digestive tract. These include:

  • Curcumin

  • Berberine

  • Probiotics

  • Fiber

  • Anti-microbials

  • GI anti-inflammatories

  • Digestive aids

  • L-glutamine

  • Melatonin

In my practice I use supplements (and/or medications) to relieve symptoms, treat overgrowth syndromes, repair damage, and prevent future imbalances and issues. These are prescribed on a case-by-case basis, based on each individuals symptoms and overall health picture.

 Lifestyle - This includes exercise, sleep & stress management, eating habits.

  •  Exercise - increasing activity to 30 min/ 5 days a week. This can even be spread throughout the day, which is even better than 1 session of activity, and being sedentary the rest of the day.

  • Sleep - Getting 8-9 hours of sleep per night. This allows your body time to repair & reset. Sleep is like a natural anti-inflammatory and stress reducer.

  • Stress management

    • Mediation - This can sound like a stupid suggestion to a pain problem, and it may take some time before you notice it being helpful. There's a lot of suffering involved with IBS, often from childhood or later. Meditation can help deal with the suffering aspect. Even with meditating for around 10 minutes a day can change perception. When a flare up happens meditation can make a difference in your perspective and stress level during the flare up.

  • Eating habits

    • Allowing 3-4 hours between meals to give the digestive system time to process foods and rest.

    • Eating in a calm, enjoyable environment, not at your desk while trying to cram lunch into work tasks.

    • Water fasts one day a week to allow the digestive system to rest, repair and reset. Fasting has been shown to improve IBS symptoms.

Question about IBS? Something more you’d like to know? Let me know in the comments below.