If you’re often scrambling to find a bathroom or worry about traveling because your diarrhea might act up, you’re not alone. Irritable Bowel Syndrome (IBS) is the most common functional gastrointestinal (GI) disorder. In fact, studies estimate that 38-96 million Americans suffer from IBS, although only 5 to 7% have been diagnosed. Symptoms of IBS include frequent diarrhea, constipation (or both), gas, bloating, and abdominal pain.
Doctors call IBS a “functional gastrointestinal disorder.” This means that the GI tract doesn’t function properly, but all tests come back normal and conventional doctors just focus on managing the symptoms of the disease with potent immunosuppressive medications and invasive surgeries.
In Functional Medicine however, we know that IBS isn’t just uncomfortable and potentially embarrassing, it is a sign that something is awry in your gut. We also know that treating the symptoms while leaving the underlying cause untreated can lead to even more serious problems, including an autoimmune disease.
What Causes IBS?
Because IBS is not a single disease with a single cause, but rather, a complex collection of symptoms, it has several possible causes. That being said, the latest research, as well as my own clinical experience, suggests that in most cases, there are six main underlying causes of IBS. A functional medicine doctor can help you identify the specific cause (or causes) of your individual IBS symptoms.
1. Leaky Gut
When the cells lining the intestinal wall become damaged, they break apart, allowing undigested food particles, microbes, toxins and other substances to “leak” into the body, where they are treated as “foreign invaders” by the immune system. The immune system launches an attack to rid the body of these invaders, and inflammation can result. Studies have shown a link between IBS and leaky gut.
2. Small Intestinal Bacterial Overgrowth (SIBO)
SIBO occurs when the bacteria in our gut get out of balance and overgrow, causing similar symptoms of IBS, like gas, bloating and diarrhea. In one study, nearly 80% of people with IBS were found to have SIBO. When the SIBO was treated, nearly half of the patients experienced improvement in their IBS. If you suspect that SIBO may be the underlying cause of your IBS, you can ask your doctor to order a SIBO breath test.
3. Yeast Overgrowth
Yeast overgrowth, commonly referred to as Candida, produces symptoms frequently attributed to IBS, including bloating, gas, constipation, and diarrhea. Like SIBO, yeast overgrowth occurs when the natural balance of your gut flora is disrupted, but instead of bacteria, it’s yeast or fungi that multiplies unchecked. There are a variety of tests you can use to determine if you have Candida overgrowth, and you can learn more about them in this article.
Intestinal parasites including Giardia lamblia, Blastocystis hominis, Dientamoeba fragilis, may be a common cause of IBS, and they often are undiagnosed. While parasites can be the cause of IBS and ulcerative colitis, in Crohn’s disease, certain types of parasites can actually be helpful. If a parasite is contributing to your IBS, there are prescription medications specific to certain species of parasites that can be used.
5. Food allergens or sensitivities
Food allergies or food sensitivities typically present with symptoms including gas, bloating, abdominal pain, and changes in stool frequency and consistency, much like those of IBS. In addition to the most common food allergies, such as peanuts, I find tthat gluten, dairy, corn, soy, and eggs are common food sensitivities that irritate the bowel and digestive system, leading to IBS-like symptoms. Removing all common inflammatory foods from your diet and then reintroducing them one at a time will determine any food sensitivities.
Studies have shown a link between higher stress levels and increased rates of IBS. When you are stressed, your body’s stress response can cause your colon to contract too much or too little (causing constipation or diarrhea). Interestingly, the connection shared between your gut and your brain is actually a two-way connection. Your brain sends signals to your gut, but your gut produces key neurotransmitters that your brain uses to regulate mood. This means that gut issues can impact your serotonin levels, causing you to actually experience more stress, which can in turn affect your IBS. To learn more about the gut-brain connection and how to manage your stress, you can read this article.
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Note: PLEASE consult with your doctor before making any changes to your diet or medications. The material on this site is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.