Updated: Mar 25
Irritable bowel syndrome presents as a variety of lower abdominal symptoms including altered bowel habits and abdominal pain. Many patients experience relief symptoms and quick recovery after undertaking our IBS treatment.
IBS affects around 11% of the population globally. Around 30% of people who experience the symptoms of IBS will consult a doctor for their IBS symptoms.
In the UK, it is estimated that almost 1 in 3 people in the UK say they suffer from IBS
The most common age is between 20 – 30. Although, IBS affects people of all ages, even children
IBS is twice as common in women as in men with symptoms increasing during menstrual periods.
What we see in patients with IBS is that the normally rhythmic muscular contractions of the bowel become irregular which leads to the dysregulation of normal movement of foods and wastes, causing a myriad of symptoms, an accumulation of mucous and toxins.
Categorization of IBS
IBS can be classified into different sub-types depending on stool pattern. However, patients can transition between these sub-types:
1) IBS with constipation (IBS-C);
(2) IBS with diarrhea (IBS-D)
3) mixed IBS (IBS-M) or IBS – A (alternating)
Causes of Irritable Bowel Syndrome (IBS)
The underlying causes of IBS remain to be adequately identified, especially if you are visiting your GP, there is very little they can do and often patients are sent away with antispasmodics or anti diarrhea prescriptions and some fiber supplements. At the Integrative nutrition clinic, our practitioners can look at various potential pathways that could be causing the IBS symptoms through bespoke functional lab testing not available with your GP. Nearly all cases can be attributed to food sensitives/allergies (both different to each other), intestinal permeability (leaky gut) and the presence of different type of pathogens, including parasites, yeast overgrowth (Candida), viruses and pathogenic bacteria. There will nearly always be a phycological component, as well, as stress plays such a fundamental part in our “always on” lives.
Possible other factors include.
Gut hypersensitivity: patients with IBS have been found to have increased gut sensation which can cause abdominal pain.
Dysregulated microbiome: IBS patients have been found to have a unbalanced microbiome (specifically lower Lactobaccili and Bifidobacteria, and to have altered short chain fatty acid (SCFA) profiles.
Low-grade inflammation: while IBS patients show no identifiable inflammation in routine colonoscopies, many show increased inflammatory markers which is suggestive of low-grade inflammation within the gut.
Altered motility: may be decreased or increased depending on the predominant type of IBS being experienced.
Serotonin dysregulation - Serotonin, our happy neurotransmitter, which is predominantly found in the gut plays a significant role in the control of gastrointestinal motility, sensation, and secretion. When our serotonin levels have been altered, this can affect our ability to move food through the GI tract. IBS patients have been shown to have dysregulated serotonin levels, with low and high levels corresponding to IBS –C and IBS – D.
Risk factors of IBS
Acute gastrointestinal infection can proceed in the onset of IBS patients, especially a bout of food poisoning.
Stressful and traumatic life events can trigger IBS episodes.
Food allergy / intolerance – Dairy and gluten being the main contributors.
SIBO (small intestinal bacterial overgrowth) has been shown to be prevalent in 50% to 60% of IBS patients.
Anxiety, depression or other mental health illnesses
Female – About twice as many women have it then men
Symptoms: IBS symptoms can present in a myriad of ways and in varying degress of intensity.
Abdominal cramping, relieved by defecation
Abnormal stool frequency: less than 3 bowel movements per week or more than 3 bowel movements per day of Diarrhea and constipation which can alternate.
Abnormal stool form: varying from hard/lumpy to liquid.
Straining at defecation: feelings of incomplete emptying, or explosive diarrhea or urgency to defecate.
Mucous in stool
Associated symptoms may include weakness, lethargy, fatigue, bloating, reflux and nausea.
Investigations into IBS at the Integrative Nutrition Clinic
SIBO breathe test.
Advanced stool analysis (Parasites, Yeast, H Pylori, Candida
Organic Acids Testing (Urine Test)
TREATMENT STRATEGY FOR IBS TREATMENT
Identify and address route causes (e.g. gut dysbiosis, bowel infection, low fiber diet, food sensitives, etc).
Repair intestinal mucosa barrier.
Restore gut microflora.
Repair intestinal mucosa.
Promote normalization of bowel patterns.
Reduce bowel spasm.
Support liver and gallbladder function
Support nervous system.
Diet plan guidelines for IBS
A complete dietary history is important to assess dietary factors (e.g. fibre intake, reactive foods etc)
A food elimination diet or Paleo reset diet protocol would be beneficial
Wheat and dairy are the most common triggers
A low FODMAP diet may be effective in reducing symptoms of IBS. Most times a general Palo reset protocol is enough, in more severe cases it is sometimes required to restrict further to a low FODMAP diet.
FODMAPS are poorly absorbed in the small intestine and can lead to fermentation in the bowel, causing symptoms of IBS. May be useful initially while restoring gut function and gut flora. This diet should not be followed long term and only while initial healing is of the gastrointestinal system is taking place.
Foods to restrict on a low FODMAPS diet include:
Gluten (Wheat, rye, barley, spelt)
High lactose foods: milk and dairy products
High fructan foods: wheat, onions
High polyol foods: certain fruits and confectionary
High oligosaccharide foods:as chickpeas and lentils
High fructose foods: fruit and honey
Avoid foods that stimulate GI motility e.g. caffeine, alcohol
Sugar in all its forms
Supplements that assist IBS
Probiotics: strains that have shown efficacy in the treatment of IBS include specific strains of lactobicullus and bifido bacteria
Magnesium: to support nervous system and reduce intestinal spasm
Broad spectrum or target anti-microbial therapy to remove yeast overgrowth, bad bacteria, parasites, worms ( investigative testing required)
Digestive enzymes: aid digestion and normalise bowel function
Supplemens to stimulate gut motilty: 5 HTP
Herbal medicine treatment for IBS
Antispasmodics: peppermint (enteric-coated peppermint oil capsules), chamomile, wild yam, cramp bark, valerian, lemon balm, ginger
Digestive stimulants: ginger, gentian, dandelion, Swedish Bitters, lemon juice, Apple Cider vinegar (unpasteurised with the Mother)
Herbal teas: fennel, ginger, peppermint, chamomile,
Digestive stimulants: ginger, gentian, dandelion, bupleurum
Antimicrobials: barberry, wormwood, black walnut, garlic, fatty acids (lauric and caprylic), pau d’arco, oregano oil, etc.
Anti-inflammatory: turmeric, licorice, slippery elm, glutamine
FUNCTIONAL MEDICINE TREATMENT OF IRRITIBLE BOWEL SYNDROME (IBS) –
IBS is a multifactorial condition that is extremely common with the modern western diet and lifestyle. A compromised gut with bacterial overgrowth is a presentation we see mostly in clinic with symptoms triggered by multiple food sensitivities.
We tailor specific antimicrobial treatment plans to eradicate the dysbiotic bacteria and replenish the healthy bacteria. Restoration of the mucosal lining and re-establishing the gut-brain axis is key in ensuring complete recovery from the condition.
At the Integrative Nutrition clinic, we specialise in the treatment of IBS and other digestive disorders which can cause a lot of distress for sufferers.
If you or a family member are suffering from IBS or another digestive disorder schedule a free consultation call and we will look to answer any questons you have over treatments plans that we can offer.