Irritable bowel syndrome (IBS) is common. More common than you might think. Estimates vary depending on the study but it is somewhere in the ballpark of 3-20% of certain populations worldwide. Not only is it common the effects of IBS can have a serious impact on people’s lives. It is the second highest reason that people miss work, following the common cold (1, 2, 3).
If it is so common you might think that we have a clear idea of what irritable bowel syndrome is and what might be causing it. Surprisingly conventional medicine is still lacking a clear picture on IBS and it’s causes and therefore has little meaningful treatment options for the illness (3).
IBS – a ‘trashcan diagnosis’
As it turns out irritable bowel syndrome is defined by a collection of symptoms. Abdominal pain and ‘abnormal bowel habits’ best summarises the syndrome. Constipation, diarrhea, bloating and flatulence are all taken into account when attempting to diagnose IBS (2).
Here’s the rub. Something that you or maybe a loved one might be struggling with. Without a clear definition of what irritable bowel syndrome actually is it is near on impossible to treat.
Another Approach To IBS
Functional medicine is always looking to find and address the root cause. Without that as a core principle we would be where conventional medicine is now, trying to suppress the symptoms.
Because IBS is simply a constellation of symptoms the approach to finding the root cause of one’s digestive symptoms is different every time.
Let’s cover the basics
Clear up the diet!
Many irritable bowel symptoms can stem from consuming food that doesn’t agree with you. It’s crucial, especially when suffering from unpleasant GI distress to run through the 30 day Elimination Challenge.
An article published in the journal of gastroenterology and hepatology looked at some alternatives to the cause of IBS. IgG antibodies (the most common form of antibodies) were proposed as being a trigger for IBS patients indicating adverse food reactions could be at play (5).
Even while we are cleaning up the diet and removing possible toxic foods we can still move onto the next step.
Run a diagnostic test to assess the state of your GI tract.
This is absolutely crucial. I wouldn’t recommend the stool testing that your average doctor can provide. They don’t paint the whole picture and even completely miss serious pathogens all the time!
Not every test is 100% bulletproof. To overcome the failures of an individual test I recommend both a CDSA and a PCR stool testing. That way we are covering our bases.
Clean up your diet by removing all possible/common food irritants and run a comprehensive, functional stool test.
It takes time to get the results from the testing so while we are waiting it’s best to focus in on optimising digestion and minimising digestive symptoms of IBS.
Review and formulate a treatment plan tailored to you.
By this time your results will have come in. The CDSA will determine your good gut flora status and should pick up any dysbiotic bacteria that may be present. Often this can be the root cause of digestive symptoms.
I have run many different CDSA stool tests and have never once seen a clean result.
It is true that my sample population is biased. People are suffering from GI distress and that is why we run the tests, but it does lend its weight to the importance of proper testing.
The CDSA also screens for yeast and fungal overgrowth (often Candida but sometimes other nasties like Rhodotorula and parasitic infections as well.
The PCR testing is a heavy hitting DNA sequencing test that covers your bases on the parasite screening. Essential to run in tandem along with a comprehensive digestive stool analysis (CDSA). Missing a parasite infection that is present would send one off in the wrong direction with very little success.
We need to address the state of imbalance that the testing has revealed. If the test has come back clean and clear then it’s best to focus on food intolerances and possibly environmental disruptors/chemicals that may be throwing your digestive system out of balance.
If the testing has come back with a clear picture of dysbiosis then choices on treatment approaches need to be made.
Here is where one’s particular paradigm comes into play. Do you rely on pharmaceuticals (antibiotics in this case) or have you already tried them with little relief.
In my experience antibiotics are rarely the best choice and personally I reserve them for extreme cases. In cases of bacterial, fungal and even parasitic dysbiosis botanical antimicrobial combinations are very reliable and much less damaging to your microbiota.
Remember the aim of the treatment plan is to bring your gut microbiome back into harmony not smash it to bits so that resistant pathogens can take over.
After treatment there needs to be a focus on rebuilding the gut microbiome and healing the gut. This can be a combination of pre and probiotics that work to feed and seed your gut, soothing herbs and a combination of bone broths, fermented foods and a diet tailored to you as an individual.
This is a mistake that I see far too often. People determine that they have a gut issue, rarely run the proper tests to be sure what they are dealing with and then treat, either with antibiotics or herbal antimicrobials. Then hope to recover their proper digestive function.
Without the repairing and rebuilding phase it’s common for people’s health to regress and the digestive symptoms to return. It’s not always the pathogenic dysbiosis returning, sometimes it can simply be a state of lack. Not having the beneficial microbes present in sufficient quantities can lead to all sorts of unpleasant symptoms (a topic for another article.)
Wrapping it all up
The most important piece is that irritable bowel syndrome is not a clear and concise pathology, it is simply a collection of symptoms that allopathic medicine has little clue on how to approach treating.
Getting to the bottom of what is causing the IBS symptoms is the first half of the battle, then treating and rebuilding is the second half.
If you are struggling with digestive complaints or have overcome them share your story below
References and Resources
- Systematic review: Complementary and alternative medicine in the irritable bowel syndrome
- Irritable bowel syndrome: epidemiology, diagnosis and treatment: an update for health-care practitioners
- The treatment of irritable bowel syndrome
- 30 day Elimination Challenge
- Alternative investigations for irritable bowel syndrome.
- Recommended GI testing – CDSA + PCR