What's Underlying Your IBS Diagnosis?

Irritable bowel syndrome (IBS) is a term that gets thrown around a lot in the gut health world. Although, there is considerable debate among natural health practitioners about whether IBS is a real diagnosis or not, and what might actually be underlying your IBS diagnosis.

While many health experts believe that it is a legitimate condition that can be treated with natural remedies, others suggest that IBS is a diagnosis of exclusion - meaning that people are labeled as having IBS if they can’t figure out what's actually wrong.

LIMITATIONS OF AN IBS DIAGNOSIS

The conventional medical community considers IBS to be a functional disorder, meaning that it is not caused by any physical abnormalities in the digestive tract. Instead, IBS is believed to be caused by problems with the way the muscles in the intestines contract and relax, which can lead to the symptoms such as abdominal pain, cramping, bloating, constipation, and diarrhoea. This explanation, however, does not take into account the fact that many people with IBS also have underlying health issues, such as gut dysbiosis, leaky gut syndrome, and food sensitivities, that can contribute to the development of said ‘Irritable Bowel’.

HOW DO DOCTORS DIAGNOSE IBS?

The latest rome IV criteria defines IBS as recurrent abdominal pain, on average at least 1 day per week in the last 3 months, associated with two of more of the following:

• Related to defecation

• Associated with a change in the frequency of stools

• Associated with a change in the form or appearance of stools

Additionally, Rome IV states that a person should fulfill these criteria for the last 3 months with symptom onset at least 6 months before diagnosis.

There is further classification of subtypes:

• IBS-C = constipation dominant

• IBS-D = diarrhoea dominant

• IBS-M = mixed, both constipation & diarrhoea

• IBS-U = undefined

The problem with the above criteria, is that so many people with a variety of digestive issues would be categorised into subtypes of IBS, when in fact they may have an entirely different underlying condition! This results in IBS often being misdiagnosed and misunderstood. Instead, we know that IBS is a multifactorial condition that can have a variety of underlying causes, and that a personalised approach to treatment is necessary for successful management.

COMMON DIGESTIVE CONDITIONS TO CONSIDER

Any number of the following conditions could be the underlying driver of someone's gut condition, rather than it just being 'IBS' - and this is not an exhaustive list:

• Deficiency dysbiosis

• Overgrowth dysbiosis (including parasites, fungi & opportunistic bacteria)

• SIBO (of which there are many different subtypes!)

• Increased intestinal permeability (aka leaky gut)

• Fructose malabsorption

• Lactose intolerance

• Bile acid diarrhoea

• Non-coeliac gluten sensitivity

• Other food sensitivities (which general result from having leaky gut)

• Slowed motility 

DYSBIOSIS

A common underlying cause of IBS is gut dysbiosis, which is an imbalance of the bacteria in the gut. The gut microbiome plays a critical role in digestion, and imbalances in the microbiome can lead to a range of digestive issues. To resolve dysbiosis, we need to change bacteria balance through dietary changes, prebiotics and probiotics.

INCREASED INTESTINAL PERMEABILITY

Increased intestinal permeability (aka leaky gut) is another underlying cause of gut issues. Increased intestinal permeability occurs when the lining of the gut becomes permeable, allowing undigested food particles and toxins to leak into the bloodstream. This can cause inflammation throughout the body, including in the gut, and contribute to a range of gut symptoms. Healing the gut barrier can be made through dietary changes and supplementation with nutrients such as glutamine, vitamin A and zinc.

FOOD SENSITIVITIES

A flow-on effect of having an overly permeable gut barrier is developing food sensitivities. (I very rarely suggest a food intolerance test, because this is the flow-on effect, not the underlying issue). Food sensitivities can cause inflammation in the gut and a range of uncomfortable symptoms. Common food sensitivities include garlic, onion, raw foods, legumes, gluten, dairy, soy, and egg  but other foods may also be triggers for you. Pay attention to your triggers, and temporarily avoid these foods while you do the underlying work to heal your gut barrier.

SYMPTOMATIC SUPPORT

In addition to addressing your underlying gut conditions, symptomatic support can provide much needed relief. Consider: 

• Herbal remedies such as peppermint, chamomile, and ginger. 

• Dietary changes such as increasing fibre intake and avoiding processed foods. 

• Stress reduction techniques such as yoga, meditation, and deep breathing exercises, as stress can exacerbate the condition.

HOW TO RESOLVE IBS?

It is important to work with a qualified healthcare practitioner to determine the underlying causes of your gut symptoms and to develop an individualised treatment plan. Do not take IBS as an absolute diagnosis. There is more to uncover in your gut health journey.

If you are experiencing gut symptoms and would like individualised support, please get in touch by booking in a Discovery Call HERE.

REFERENCES

https://www.msdmanuals.com/en-au/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs
https://www.ncbi.nlm.nih.gov/books/NBK534810/