Irritable bowel syndrome (IBS) impacts 18-25% of Canadians, one of the highest prevalence globally. Symptoms can include bloating, irregular bowel movements, gas, pain, fatigue, and more. IBS is diagnosed based on the “Rome Criteria”, where a person experiences abdominal pain or discomfort, and to 2 more of the following:
- A change in frequency of stool (i.e. more often, or less often)
- Feels better after passing a bowel movement
- A change in the form of stool (constipation, diarrhea or mixed)
Often, IBS comes with additional symptoms that are not related to the gut. This can include anxiety, depression, fatigue, and more. A diagnosis can take up to 4 years, often with little effective treatment options, conventionally. This can feel disheartening and frustrating.
Today I want to discuss functional approaches to IBS. Finding the root cause is key to finding the right solution.
Functional Causes of IBS
Stomach acid and digestive enzymes are key for breaking down the foods you eat. If you have low stomach acid levels and/or digestive enzymes, your body has a hard time effectively breaking down food. This food (larger than it should be) then moves into the small, and large intestine and may cause a number of problems. It can either irritate the lining, or feed the gut microbiome directly in an uncontrolled manner, leading to gas, bloating, and pain. Supporting digestive power can be one effective strategy for IBS.
H. pylori is a stomach bacterial infection. It is a common cause of lowering stomach acid levels and leading to overgrowth of a number of strains in your microbiome – both good and bad. Certain subtypes of H.pylori can increase your risk of developing stomach ulcers. Screening for H. pylori can be challenging, I’ve seen many H.pylori breath tests give false-negative results. For this reason, we do DNA based stool testing. It’s a highly sensitive way to test for digestive infections.
A food sensitivity is delayed hypersensitivity reaction – anywhere from 24-72hours after eating a particular food. This delay can make it challenging to pinpoint what foods you may be reacting to. In contrast, a food allergy is an immediate reaction, often resulting in respiratory or skin symptoms.
There are certain foods that commonly cause inflammation and irritate the gut lining. The most common I see are dairy and gluten. There are two ways to test for food sensitivity. The first is a food elimination-challenge diet, where you remove specific food groups for a period of time, and then strategically add them back in and note any symptoms. The second is a food sensitivity blood test. This measures elevated antibodies in the body, which are reacting to particular foods you are eating. Both methods have pros and cons and should be discussed with your naturopathic doctor.
There are different types of microbiome imbalances. You can have too much, too little, or a microbiome in the wrong place. “SIBO” or Small intestinal bacterial overgrowth is the number one cause of IBS. This is a condition where your microbiome has moved from the large colon into the small colon. I talk about this in detail here. An imbalance microbiome can also lead to bloating, discomfort, and irregular bowel movements.
How do I know which one is causing my IBS?
As you can see, there can be a number of different things going on, with a diagnosis of “IBS”. A systematic approach to identifying the root cause is key to figuring out which treatment plan will work best for you. Acubalance has a range of functional tests to facilitate this process. This includes food sensitivity, SIBO, and comprehensive microbiome and intestinal health analysis. Treatment should focus on not only treating the underlying cause but preventing future recurrence.
If you’d like to learn more, let’s chat. Schedule a free 15-minute phone call to learn more.
Dr. Ashley Damm,
Naturopathic Doctor – Vancouver BC