Irritable bowel syndrome has been around for a long time and if your symptoms did not match a disease you where diagnosed with it. A diagnosis of exclusion as they say, however if you ask me it’s a lazy and unspecific diagnosis. This is a common condition affecting 1 in 5 Australians1 it affects the gut but also causes fatigue and considerably lowers a person’s quality of life.
The story usually starts like this, you notice bloating after meals or at the end of the day the clothes are a little tighter. The stomach is uncomfortable, there could be some gurgling or it can even be painful, like cramping. There is excessive gas that passes or it does not pass making the discomfort worse. Then along come the bowel habits of random diarrhoea or loose stools then nothing! Then random diarrhoea again or you could be the unlucky few that gets no relief from the discomfort and constipation prevails.
Now that the symptoms have set in the investigations start, could it be this food or that, could it be I worry too much or I must have a parasite. Then comes the appointment with your health care practitioner, you go through your symptoms and either a swift diagnosis of IBS gets handed to you “relax, take a holiday and eat more fibre” or you get referred to a gastroenterologist. The gastroenterologist then performs a series of tests to rule out any serious diseases (an important step I might add) to come to the conclusion you have IBS and the only solution is to follow a restrictive diet.
You are left leaving dismayed by the experience, with little hope to reduce your symptoms let alone treat them. “There must be more out there to explain my symptoms” is the burning statement left in your mind.
If we look into the proper classification of this syndrome there is more to it and what you will notice is there are many types and this is the key to finding the root cause.
Lets break things down into the two major categories:
GAS; WHAT TYPE, WHO PRODUCED IT AND WHERE?
Bloating and distension (almost like being pregnant in some cases) is caused by gas production in the small or large intestine. Gas does not get formed from nothing it needs to be created via fermentation. Fermentation is the process of turning one substance in this case a food into a gas (can also form alcohol and acids). So in a case of IBS the person is eating food fermenting it, forming gas and now we have bloating. What we need to understand is that the type of gas and what formed it and where, is very important, as that will dictate how we treat your IBS.
An example case of mine was a woman in her early 40s with classic IBS symptoms bloating, distension, diarrhoea and fatigue. Through investigations via detailed case history and breath testing I found that she did not absorb fructose (a sugar in fruit) very well and it caused bacterial overgrowths that produced much hydrogen gas in her small intestine. Fructose intolerance is a major underlying cause of IBS, upwards of 60% in some populations2. Coupled with hydrogen gas formed in her gut, it is linked to a faster transit of waste through the bowel aka diarrhoea4.
This can be in stark contrast to others as the gas called methane can be overproduced in any part of both of the intestines and cause an increase in transit time of waste aka constipation4.
So in these cases of IBS you remove the microbial fermentation, the reason the microbes are there in high amounts and you can remove the IBS. To use my example case I removed excess fruit, removed the overgrowth of bacteria, healed the gut lining to restore digestive processes and IBS is now controlled.
SENSITIVITY – WHAT TRIGGERED IT AND WHAT SUPPORTS IT NOW?
The lining of the intestine can become irritated causing pain/discomfort also known as visceral hypersensitivity5. This does not occur in every IBS sufferer but accounts for the subset of people that experience pain. There seems to be a threshold of tolerance to insult, as I like to call it in the gut. An example is if I add a food that my gut is irritated by, plus stress, plus an infection a persons gut can develop bloating, pain and urgency to pass stool. This can then persist if a person is susceptible (for example genetically) to visceral hypersensitivity.
One of my clients a mid 30s mother of two had pain soon after eating with urgency to pass stool and moderate bloating. Water would even give this person pain and bloating on some occasions. In this persons case it all started since the birth of the second child, antibiotics where needed soon after birth and the stress of two children was overwhelming her to start with. Post infection IBS is common for example approximately 20-25% of salmonella infections produce IBS symptoms long after the infection had ceased5. Stress hormones are also linked to increasing pain sensitivity in the gut, alterations in gut microbial patterns and intestinal function3.
Pain can be debilitating and lessen quality of life considerably. A person with pain occurring in IBS needs to have a proper analysis of the insults that there body is not coping with. As once they are controlled for or removed, the gut environment and the connection with the mind are improved, symptoms can be lessened considerably. In the case above correcting the balance of microbes and stress hormones with dietary changes, specific probiotics therapies and stress management, resulted in the client regaining pain free digestion.
So IBS can be treated effectively if you know what variation of the disorder that you have and what is triggering it. In light of this if you have IBS you need to get it tested correctly. Go out and find a practitioner that has experience in treating all of IBS’s variations and is familiar with the testing involved.
- Lactulose Breath Testing
- Fructose Breath Testing
- Sorbitol Breath Testing
- IgG Food Allergy Testing
- IgE Food Allergy Testing
- Comprehensive Digestive Stool Analysis (CDSA)
- Parasite Stool Analysis (Faecal PCR and Faecal MCS)
If you know now is your time to finally take control of your IBS once and for all so you don’t have it hanging over your head anymore and you know that you need support through the process then take our team up on their free initial consultation where they can show you what will be the best process for you to get the lasting change your looking for.
Adrian Adams is Victoria O’Sullivan and Associates resident nutritionist/naturopath specialising in functional digestive disorders, metabolic disorders and sports performance goals.
- ACT Government Health, Irritable Bowel Syndrome, <https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/irritable-bowel-syndrome-ibs>, 2015 (accessed October 2017)
- 2. C. H. Wilder Smith et al, Fructose and Lactose Intolerance, 2013, 37 (11) 1074-1083
- HY. Qin et al, Psychological Stress on Irritable Bowel Syndrome, 2014, 20 (39) 14126-14131
- J. Jahng et al, Effects of Methane and Hydrogen Gases, 2011, 24 (2) 185-190
- Q. Zhou & G. N. Verne, New Insights to Visceral Hypersensitivity, 2011, 8 (6) 349-355