Irritable bowel syndrome is an extremely common functional digestive disorder that can be difficult to treat. It is widely diagnosed and affects approximately 1 in 5 of us.
Unless you work in healthcare, discussing your bowel habits with anyone can be a real source of discomfort. We don’t talk bowels in the UK, so if you’re reading this and you’re British, imagine that I am whispering that IBS affects your large intestine (colon) and symptoms include abdominal pain, cramping, bloating, gas, constipation and diarrhoea. You may even have a sudden urge to have a bowel movement even if you’ve just been to the loo. If you have IBS, you know that the symptoms can be constant, painful and have an impact on your quality of life.
What is it?
IBS is known as a functional digestive disorder. This means that there is an issue with the way that the bowel functions with no underlying structural abnormalities. To diagnose IBS, your doctor will conduct tests to rule out other conditions such as Crohn’s, colitis or coeliac disease.
What causes it?
IBS is multifactorial in nature and person specific; it is affected by a combination of lifestyle, dietary and emotional factors, which are in essence different for everyone, making causation difficult to determine. Because IBS is not a single disease with a single cause, but rather, a complex collection of symptoms, it has several possible causes.
Thankfully there is a growing body of evidence in the functional medicine community that links the gut microbiome and many aspects of health including IBS, autoimmune disease, heart disease, thyroid health and more. And given that we’re talking about the digestive system, it’s not surprising that there is also evidence that links the microbiome with IBS.
Functional medicine practitioner, Chris Kresser posits that IBS is directly related to gut imbalance or dysbiosis signposting us to research which indicates that those with IBS tend to have decreased levels of good bacteria in their colon.
Small intestinal bacterial overgrowth or SIBO has been implicated in up to 80% of people with IBS. SIBO is a subset of gut dysbiosis in which the small intestines harbour an abnormal number of bacteria. When there is a bacterial overload in the small intestine, it interferes with digestion and nutrient absorption causing symptoms similar to IBS.
Studies have shown a link between IBS and leaky gut. A leaky gut occurs when there is consistent damage to the GI tract over time and it becomes permeable. This can happen as a result of yeast overgrowth or Candida, poor diet high in sugar, overuse of antibiotics, chronic stress and more. Symptoms commonly attributed to IBS, including bloating, gas, constipation and diarrhoea can also be attributed to yeast overgrowth and leaky gut.
Many people with IBS also have food intolerances such as gluten or dairy sensitivity or intolerance to eggs, peanuts or almonds, seafood, yeast and soy. Food sensitivities will likely indicate an underlying leaky gut or SIBO.
Studies have shown a link between higher stress levels and increased rates of IBS. It is suspected that this is because of the connection between the gut and the brain via the Vagus nerve. The brain sends signals to the gut in response to stress. Conversely, the gut produces key neurotransmitters including serotonin which regulate mood and sleep. Gut issues therefore affect serotonin production, which can cause increased stress, which in turn can affect the gut.
This is the exciting part. IBS was considered to be a long-term condition with no cure other than symptom suppression and management. New research demonstrates that there are other options available to us that could uncover the cause of IBS and as a result reduce the need for lifelong medication.
Depending on the type of IBS that you have, suggested treatments include:
Pre and probiotics
Testing for food intolerances
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