Understanding the Root Cause of Your IBS
by Dr. Megan Taylor
Irritable Bowel Syndrome (IBS) is an incredibly common, but not often talked about, medical condition that affects 1 in 10 Americans. Specific populations at greatest risk for this condition include, individuals who’ve:
had gut infections, including travelers diarrhea, food poisoning, or stomach flu, even in the distant past
traveled internationally
taken antibiotics (especially multiple courses)
had abdominal or pelvic surgeries, endometriosis, or appendicitis
experienced adverse childhood events
experience anxiety or depression, chronic fatigue, fibromyalgia, and other similar conditions
IBS is characterized by intestinal or abdominal pain that occurs regularly and is accompanied by some change in bowel habits. Those with IBS-D (IBS with Diarrhea) have abdominal pain and a tendency toward looser stools or diarrhea, while those with IBS-C (IBS with Constipation) have a tendency towards constipation (ie, hard stools, infrequent stools, and/or stools that are difficult to pass). There is also a category, called IBS-M (or Mixed-type IBS) that can experience both diarrhea AND constipation that will often alternate or occur in cycles. While someone needs only experience abdominal pain and stool changes for the diagnosis of IBS, many IBS sufferers also experience abdominal bloating, distention, flatulence, belching, a feeling of fullness especially after meals, a sensation that bowel movements are incomplete, and other symptoms.
Historically, patients diagnosed with IBS were often told that there symptoms were simply due to stress, that they had a “nervous stomach”, and were told to focus on strategies to decrease their anxiety. Additionally, they were often prescribed antidepressants, which lead patient’s to feel dismissed and that physicians were telling them their, often debilitating condition, was “all in their head”. While stress can certainly worsen symptoms of IBS, this condition is NOT due solely to unaddressed feelings of anxiety.
Thankfully, diagnostic strategies have advanced greatly in the intervening decades and we now know that symptoms of IBS are often due to any number of factors including:
changes in intestinal motility
increases in mast cell (the cell type that releases histamine) density in the gut lining
changes in the microbiome both in the small and large intestine
imbalances in the “gut-brain axis” that lead to an increase sensation of pain in the intestine
among others!
It is often a combination of these changes that can result in the symptoms of IBS, and therefore multiple strategies are needed to identify the root causes of someone’s IBS.
At Neighborhood Naturopathic, we utilize a number diagnostic strategies to explore what might be causing someones symptoms of IBS, including:
Blood testing to screen for inflammation, Celiac Disease, and food sensitivities
Stool testing to look for gut pathogens, inflammatory markers, and enzyme production
Microbiome analysis to evaluate the balance of “beneficial” gut bacteria, and whether yeast (Candida) maybe be overgrown
Breath testing to assess for carbohydrate malabsorption due to Small Intestinal Bacterial Overgrowth (SIBO)
Detailed questionnaires to explore underlying risk factors
Diagnostic imaging to identify any changes in the gallbladder, pancreas, stomach, or intestines that could mimic or contribute to symptoms of IBS
And last, but not least, referrals to Gastroenterologists when patients have more concerning symptoms, such as blood in their stool, weight loss, or severe symptoms that need to be worked up via colonoscopy or other methods
In future posts, I’ll explore various specific treatments, both naturopathic and more conventional, that have been show to be helpful for the symptoms of IBS. But in the meantime, if you are curious to learn more about how naturopathic medicine can help folks with IBS, check out this article I wrote a few years back. Or schedule a visit with one of our GI-focused providers to get the up-to-date support you deserve for this very treatable condition!
warmly,
Dr. Taylor