Understanding gut health and how to treat IBS (irritable bowel syndrome)
Understanding gut health and how to treat IBS (irritable bowel syndrome)
Learn about your Gut Health and how to treat IBS. Recent research in Gut Health demonstrates a strong and important relationship between the health of our gut and our overall health. The evidence that continues to mount signifies that a happy gut means a healthy person.
Having the right balance of bacteria in your gut is critical to ensuring we avoid bloating, Gerd or acid reflux, constipation and heartburn.
Imbalances in the gut microbiome can also lead to irritable bowel syndrome (IBS), one of the most common digestive disorders in western countries.
So, how do we manage this relationship between our gut health and our overall health?
And, how do we ensure that we are doing the right things to keep our gut healthy?
What sort of symptoms should we be looking for?
What is irritable bowel syndrome and how can we avoid it?
Let’s answer some of these questions and make sure your gut is as healthy as it can be.
Why is gut health so important?
Your stomach and intestines absorb energy and nutrients that keep your whole body functioning properly. They are connected to your brain, heart, hormones and immune system and most recently, researchers are finding evidence that links our digestive system to the health of our eyes, kidneys and other organs.
As the effects of poor gut health are so wide-reaching, it can present in many ways, including:
- A general feeling of being unwell
- Anxiety, depression and other mood disorders
- Fatigue, thyroid issues and a heightened stress response
- More common colds and flus than you would usually expect
- Heart disease, blood pressure issues and atherosclerosis
What can cause poor gut health?
The microorganisms living in your intestines is known as the gut microbiome. With between 300 to 500 different species of bacteria living in our digestive system, ensuring we have the right balance of these bacteria is complex and dependent on many factors. Some bacteria are ‘good’, and some are harmful.
A compromised gut microbiome can be caused by:
- Bacterial infections such as klebsiella, citrobacter and pseudomonas
- Fungal infections such as candida and geotrichum species
- Parasitic infections such as blastocystis hominis and dientameba fragilis
- Poor digestive function
- Poor absorption of nutrients and intestinal permeability
- Low levels of good bacteria such as lactobacillus and bifidobacterium
How do I know if my gut health is poor?
If you experience any of the following, your gut health may not be optimal:
- Stomach pains
- Brain fog
- Food intolerances
- Exacerbated mental health issues such as anxiety and depression
- Skin rashes and disorders such as acne, eczema and dermatitis
- Hormonal imbalances
- Compromised immune system
- Weight gain and obesity
- Diarrhea and/or constipation (irritable bowel syndrome issues)
What is irritable bowel syndrome (IBS)?
Irritable bowel syndrome (IBS) is believed to be the most common digestive disorder in western counties, with an estimated international incidence of 11%. (1. Canavan C., West J., Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71.) It is most commonly seen in women between the ages of 20 and 40.
Symptoms of IBS can present as abdominal pain, bloating, distension and altered bowel habits such as constipation, diarrhoea and excessive flatulence. The normally rhythmic muscular contractions of the bowel become irregular and uncoordinated leading to interference with normal movement of food and wastes, causing an accumulation of mucus, toxins, and digestive symptoms.
The following symptoms may vary in intensity and be exacerbated by stress or prior to menstruation:
- Abnormal stool frequency. More than three bowel movements per day or less than three bowel movements per week. Diarrhea and constipation can often alternate
- Abnormal stool form. Lumpy or hard stools, loose or watery stools or ribbon-like stools.
- Straining at defecation, fecal urgency, feelings of incomplete emptying, or explosive diarrhea
- Abdominal cramping, relieved by flatulence and defecation
- Diarrhea often worse in the morning and can be urgent and explosive
- Possibly mucus in stool
- Associated symptoms may include weakness, lethargy, fatigue, bloating, reflux, nausea, and fibromyalgia
What causes IBS?
To date, there is no known cause of IBS although it can often be attributed to food intolerances, intestinal permeability and the presence of pathogens, virus or bacteria in the gastrointestinal tract.
There are factors that may make you more susceptible to IBS, including:
This is also known as visceral hypersensitivity in which people have increased gut sensation.
Although you may not show identifiable inflammation in routine colonoscopies, you may show increased inflammatory markers suggesting low-grade inflammation. These markers can be ascertained through specific testing.
Altered GI motility
This applies to abnormal intestinal contractions, such as spasms and intestinal paralysis. The gut has lost its ability to coordinate muscular activity and may be decreased or increased depending on the predominant type of IBS.
Altered gut microflora
IBS patients have been found to have altered gut microflora (specifically lower lactobaccili and bifidobacteria, and higher enterobacteria), and to have altered short-chain fatty acid profiles.
You may be more likely to develop IBS if one or more of the following apply to you:
- A genetic predisposition
- An acute gastrointestinal infection (viral, protozoal or bacterial)
- Experienced a stressful or traumatic event
- Are using antibiotics
- Experiencing stress, anxiety, depression
- Have a poor diet
- Have a food allergy or intolerance – gluten and dairy are common contributors
- Bowel dysbiosis or SIBO (small intestinal bacterial overgrowth)
To determine if you have IBS, a functional medicine practitioner may conduct a number of tests, these could include an advanced stool analysis, a SIBO breath test, a test to ascertain your intestinal permeability, celiac screening and a test for food intolerances.
After being tested and you have been diagnosed with IBS or a related condition, a treatment strategy will be put into place to get you back on the path to good gut health.
Gut Health and how to treat IBS
What is the functional medicine approach to treating IBS?
Our aims are to help you make a full recovery by restoring optimal gut health through holistic treatment by:
- Identifying and addressing the underlying causes of your IBS. As an example, we will investigate if you have a food allergy or intolerance, gut dysbiosis, a bowel infection or a low fibre diet.
- Eradicating the harmful bacteria and replenishing the healthy bacteria in your gut. With specific antimicrobial treatment plans, we can restore your good gut microflora and remove parasites.
- Repairing the intestinal mucosa barrier
- Supporting your nervous system
- Promoting normal bowel patterns
- Reducing your inflammatory response
- Reducing bowel spasms
- Supporting your liver function
Gut health diet
After having ascertained your complete dietary history, we will be able to understand what diet will work best as a treatment for IBS.
We often ask our patients to adhere to a food elimination diet or Paleo reset diet protocol. The purpose of a Paleo reset diet is to remove inflammatory foods, which means you need to avoid processed foods, all grains, vegetable and seed oils, soy, legumes, added sugars, dairy and alcohol. These items can be reintroduced one by one, to identify which items are causing you issues.
Usually, a general Paleo reset protocol is enough to return a person’s digestion to normal, but in severe cases, we need to restrict a patient’s diet to a low FODMAP diet. FODMAP is an acronym, derived from Fermentable Oligo-, Di-, Mono-saccharides And Polyols. They are short-chain carbohydrates that are poorly absorbed in the small intestine and can lead to fermentation in the bowel and can cause symptoms of IBS.
Foods to restrict on a low FODMAP diet include:
- Lactose foods: milk and dairy products
- Oligosaccharide foods: legumes such as chickpeas and lentils
- High fructose foods: fruit and honey
- High fructan foods: wheat, onions
- Polyol foods: certain fruits and confectionery
- Avoid foods that stimulate GI motility e.g. caffeine and alcohol
On a low FODMAP diet, your diet will be rich in fibre, low in fat, and includes lots of fruits and vegetables, whole grains, legumes, nuts and seeds and oily fish. You can drink herbal teas such as chamomile, peppermint, ginger and fennel seed to aid digestion and reduce gas.
FODMAP is useful while restoring the gut function and gut flora and should only be followed while initial healing of the gastrointestinal system is taking place.
Supplements used to treat Gut Health & IBS
A functional medicine approach will often provide specific supplements used to help treat a range of gut disorders. To treat IBS specifically, we commonly use the below supplements along wioth other targeted therapy as required:
- Broad-spectrum or target anti-microbial therapy to remove parasites or dysbiotic flora, investigative testing required prior to commencement
- Digestive enzymes which aid digestion and normalise bowel function
- Probiotics – strains that have shown efficacy in the treatment of IBS include Lactobacillus plantarum 299v, Bifidobacterium animalis DN-173 010, Bifidobacteria lactis HN019, Bifidobacterium infantis 35624, Lactobacillus fermentum PCC, and Bifidobacteria longum W11. Other lactobacilli and bifidobacter species may also be effective in the treatment of IBS along with spore forming strains. Broad spectrum probiotics can exacerbate symptoms in cases of bacterial overgrowth. Soil and bacillus-based strains are also beneficial in the treatment of IBS.
- Magnesium to support your nervous system and reduce intestinal spasms
Herbal medicine to treat Gut Health & IBS
- Antispasmodics such as peppermint (enteric-coated peppermint oil capsules), chamomile, wild yam, cramp bark, valerian, lemon balm and ginger
- Carminatives such as peppermint, chamomile, fennel and ginger
- Digestive stimulants such as ginger, gentian, dandelion and bupleurum
- Antimicrobials such as pau d’arco, chamomile, barberry, wormwood, black walnut and oregano etc
- Anti-inflammatory agents such as turmeric, licorice and chamomile
What are my next steps to good gut health?
At Advanced Functional Medicine Perth, we have been specialising in the treatment of IBS and returning patients’ gut microbiome to optimal functionality for over 10 years.