What does your IBS really mean?
If you’re lucky enough not to ever have digestive symptoms then you don’t need to read this. However, most individuals at some point in their life have had some digestive symptoms whether it’s bloating, pain, loose stools or even constipation.
You may have been to the Doctor who diagnoses you with IBS and prescribes some laxatives or anti-cramp medication. Neither you or the Dr know the cause and in fact, the IBS label doesn’t mean anything. The Government guidelines on IBS (NICE) don’t actually mention what IBS can be caused by, just a label given to those with a collection of symptoms and the definition can be applied to anyone with some sort of digestive malfunction.
Don’t settle for a diagnosis of IBS. Try to look more into why you are getting the symptoms you are getting.
The functional approach looks to find out the cause of the issue and there may be many causes which I shall summarise below:
Intolerances: Your body can be reacting to foods you are consuming. The main culprits are gluten, dairy, eggs and soy. You can consume one food and react to it 7 days later so it’s very hard to isolate. Food intolerance testing is quite complex and I only usually recommend one company (Cyrex) as they test many proteins in gluten and also test food cooked and in its raw state.
Low Hydrochloric acid (Hypochlorhydria): low levels of stomach acid which can be caused by ageing, zinc deficiency, stress or other reason may present itself with digestive issues, poor wound healing and indigestion after meals. The use of Apple Cider Vinegar in a little water before meals can help this by helping to improve HCL levels and improve digestion.
Low Bile and Pancreatic Enzymes: Your pancreas may not be working as it should be to produce the enzymes to break down food. Poor bile flow can result in intolerance to fatty food and even gallstones. This can be caused by liver stress such as inflammation, environmental toxins, hormone imbalances.
Constipation: This can be caused by low stomach acid, low levels of fibre in the diet or could be from Small Intestine Bacterial Overgrowth.
Fibre: Most diets are low in fibre but there are some IBS cases where fibre may be making the problem worse. Usually, this is when the gut is inflamed.
Inflammation or Bowel Disease: If the gut is inflamed then you need to work out why and rule out Irritable Bowel Disease. An inflamed gut can also mean lack of absorption so taking a huge pile of supplements may be pointless.
Bacteria Imbalance: Most people have a degree of “dysbiosis” or basically not enough beneficial bacteria balance in the gut. It can present in digestive discomfort bit also can be seen with bad breath, a coated tongue, fatigue. Dysbiosis can be caused by poor diet, high sugar consumption, many rounds of antibiotics and even genetics can play a role.
Small Intestine Bacterial Overgrowth (SIBO): This is a particular type of dysbiosis which normal flora found in the colon makes it’s way into the small bowel, causing symptoms including chronic bloating and gas. You would need to do a breath test to fully understand if this is present and it can be a bit tricky to get rid of… you’d need to use antibiotics and/or herbal antimicrobials and a restrictive diet like a low carb or low FODMAP diet.
Infections: Helicobacter Pylori, Parasites and yeast can all play a role in digestive problems and can be asymptotic. A stool test can pick up active infections.
Stress: This just wreaks havoc on your physiology. The result can lead to any of the above issues.
Leaky Gut: Otherwise known as Intestinal Permeability which can result from any of the above, can cause food intolerances. It can also lead to non-digestive symptoms including links to brain health. A blood test can understand this or even on some stool tests, you can measure zonulin which is a marker in the assessment of leaky gut.
IBS has no single cause and could be many of the Some of these may present together so it’s important to isolate and support in a staged process. In order to understand, I suggest most clients presenting with chronic digestive issues to do a stool test which can rule out most of the above and understand the functioning of the gut.
Depending on the results, I will work through what is known as the 5 R protocol
Remove - remove any infection if present and offending foods
Replace - replace stomach acid enzymes if needed
Reinoculate - promote the balance of bacteria in the gut
Repair - repair the gut lining and reduce inflammation
Rebalance - control stress