Irritable Bowel Syndrome
Irritable Bowel Syndrome
Irritable Bowel Syndrome

Functional Medicine Treatment of
Irritable Bowel Syndrome (IBS)

What is important to patients when trying to find a treatment for
IBS that works?

Irritable Bowel Syndrome (IBS) is a collection of symptoms which may have different causes and contributing factors. Doctors diagnose IBS through a process of exclusion. Other conditions, for example Inflamatory Bowel Disease (IBD) such as Crohn's disease and Ulcerative Colitis, or even bowel cancer need to be excluded, before we can diagnose IBS. Most tests including blood tests and even camera tests which allow us to look inside the bowel remain normal.

IBS is a widespread problem and causes a lot of misery and suffering. For the treatment of IBS and other bowel problems it is important to follow a holistic treatment approach which looks at the whole person, the entire gastrointestinal tract, all aspects of gut function, the gut flora, food allergies, the diet and other factors which are related to healthy digestion.

In IBS a number of functional disturbances of the gastrointestinal tract (GI tract) exist, which can be grouped into different categories:

In most cases patients suffer from food intolerances. They develop symptoms immediately or some time after consuming certain foods, which can range from fatigue, to muscle and joint pains, head aches, depression and more.

Along side these food intolerances there is often a disturbed bacterial gut flora (dysbiosis) which means that the combination and number of gut bacteria that we carry within the GI tract, which normally help us break down food and fulfill a number of other vital functions in the gut, is out of balance. There are too many pathogenic bacteria and less of the types which are desirable for optimal gut function. This happens for numerous reasons including Western diet and lifestyle, frequent use of antibiotics, the contraceptive pill, amalgam fillings and toxic mercury exposure, environmental toxins, chemicals and much more. In many patients we find an overgrowth of yeasts (e.g. candida albicans) called fungal type dysbiosis caused amongst other things by high sugar and carbohydrate consumption.

A third common problem is so-called leaky gut syndrome. Healthy gut bacteria are vital for the function and integrity of the gut lining, made up of enterocytes. Gut bacteria help us to break down the food and make the nutrients available to the enterocytes, to nourish the body but also to feed the enterocytes. Enterocytes rely on healthy gut bacteria for their own nourishment. In dysbiosis, where the balance of healthy gut bacteria is disturbed the gut cells are not supported and cannot function properly. The result is leaky gut syndrome. The barrier function of the gut lining is undermined and incompletely digested proteins and peptides get into the blood stream, leading to reactions of the immune system and food allergies. Nutrients are not absorbed leading to nutrient deficiencies.

What can I expect from a functional medicine treatment of IBS?
When I see patients with Irritable Bowel Syndrome and related disorders, I take a full history and try to discover all the factors which have undermined healthy gut function. Often I find a history, going back to childhood or teenage years when the first symptoms appeared and gradually got worse. I try to establish which parts of the GI tract are involved and whether there are symptoms of food intolerances or dysbiosis which often causes bloating and wind.

When I see signs of food intolerances I recommend a diet which excludes the most common foods that cause allergies such as grains, wheat and diary products. I also try to reinstate and support a healthy gut bacterial flora by using probiotic supplements and fermented foods (e.g. yoghurt, kefir, sauerkraut, beet kvas) alongside additional supplements to treat nutrient deficiencies and some herbal remedies to support digestive functions.

Some-times when simple dietary changes don't have the desired effects we decide to use specialised tests to gain a better understanding of the underlying problems such as the "Comprehensive Digestive Stool Analysis" or the "Gut Fermentation Test".

I frequently recommend "Gut and Psychology Syndrome" a book written by Dr. Natasha Campbell-McBride. This book is brilliant at explaining the connection between the gut and the physiology of the whole body, including the brain and the persons psychology. Furthermore "Gut and Psychology Syndrome" offers a practical step-by-step program (the GAPS Diet) (LINK TO GAPS ARTICLE) designed to heal the gut and reestablish healthy gut flora.

Why is there such a high prevalence of IBS nowadays?
The Western lifestyle and diet, which is full of highly processed foods, sugar, additives, hormones and other chemicals and deficient in vitamins and minerals is mainly responsible for the sharp increase of IBS. In addition we are exposed to environmental toxins and the stresses of a modern life which overwhelm our ability to cope. Children often inherit an unhealthy gut flora from their mothers and a weak constitution which sets them up for health problems later on in life.

How long will it take to see an improvement in my IBS?
This depends on the severity of your problem and how long you have been unwell. Often you can achieve a fairly rapid improvement when you remove the foods which your body reacts to. However, it usually takes longer to address and correct the other underlying problems such as leaky gut, dysbiosis and weak digestive functions.

In IBS there are several functional abnormalities in the digestive system. When patients don't improve this is usually because one or several of these problems have not been addressed. A simplistic magic bullet approach does not work in my opinion.

Further more, IBS is often associated with other health problems (chronic fatigue, heavy metal and chemical toxicity, low immunity, etc). The body's physiology functions as an interconnected web and each system impacts on the other. None of the organs in the body work in isolation. The gut is connected to the liver (metabolism and detoxification), the endocrine glands (hormone production), the immune and nervous system (the gut contains 2/3 of the body's immune tissue and produces 3/4 of neurotransmitters, like serotonin). In chronic conditions all the other parts of the physiology suffer as well.

If somebody does not improve we need to look further a field and investigate the other parts of the web in order to improve function and remove obstacles for recovery.

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