Irritable Bowel Syndrome (IBS)
Helping my patients optimize their digestive function is one of my special interests! A major portion of our overall health is rooted in healthy digestion, so it makes sense that we pay attention and address issues as they come up.
A diagnosis that gets tossed around a fair bit these days is that of irritable bowel syndrome (IBS). IBS is a label that can encompass many symptoms such as excessive gas, abdominal bloating, abdominal cramps, loose stool/diarrhea, constipation, or any/all of the above. IBS symptoms can be mild enough that a person can live with the symptoms, but in other cases the symptoms can be debilitating and very disruptive to their daily lives (school, work, socializing, travelling, etc.) The longer digestive issues go on, the more likely related complications and health issues can arise, often related to the malabsorption of nutrients and the effects of leaky gut syndrome (i.e. increased intestinal permeability, often due to chronic intestinal inflammation, and leading to inflammation and other symptoms elsewhere in the body...more on this topic at a later date!) It isn't uncommon to see a person with IBS suffering from fatigue, iron deficiency, vitamin B12 deficiency, and a weakened immune system. Another common issue that is connected with IBS is anxiety and/or depression.
So what are the risk factors for developing IBS?
Mental health issues (such as anxiety, PTSD, depression)
Lifestyle factors: excessive alcohol consumption, smokers
History of oral antibiotic use (especially multiple rounds)
History of gastroenteritis (intestinal infection, for example, traveller's diarrhea or “stomach flu”)
Bowel surgery (e.g. Gallbladder removal, gastric bypass)
Diabetes (type 1 and 2)
Celiac disease or inflammatory bowel disease (Crohn's, ulcerative colitis)
Unfortunately, there isn't much that conventional medicine can offer to a patient diagnosed with IBS. Some medical doctors may or may not recommend a change in diet, or they may prescribe antidepressant or anti-anxiety medications.
The good news is naturopathic medicine has much to offer to patients with IBS...in fact, this is what we heal best!
As with any malady, the first order of business is to investigate the root cause of the symptoms. Here are some investigations that I will often consider for an IBS patient:
History of antibiotic use
History of gastroenteritis
Stress and lifestyle factors
Test for food intolerance (either through elimination & reintroduction, or via food intolerance testing at a local lab such as Dynacare)
Test for stomach acid insufficiency (simple at-home tests to determine whether or not your stomach is producing sufficient hydrochloric acid to digest your food; low stomach acid production is more likely to lead to gas, bloating and constipation)
Review basic blood work (e.g. Iron, B12, etc., which can be run by myself or your medical doctor; IBS will often lead to malabsorption and various nutrient deficiencies)
Stool testing for intestinal bacteria/ parasites/ yeast (I may refer patients back to their doctor for a basic ova & parasite test, or I may use other labs such as Doctor's Data, or Diagnostic Solutions for more comprehensive digestive panels)
SIBO Breath Test (I use SIBO Diagnostics: https://sibodiagnostics.com/)
SIBO is becoming a more commonplace diagnosis and treatment approach for many patients with IBS (SIBO is pronounced “SEE-BOH”, which stands for small intestinal bacterial overgrowth). When the basic interventions for IBS do not improve a patient's symptoms, or when a SIBO breath test is positive, then a SIBO treatment approach can be LIFE-CHANGING! There are some distinctive characteristics of a SIBO patient: poor toleration of probiotic supplements, and IBS symptoms triggered by a wide variety of carbohydrate-rich foods (as in breads, cereals, grains, certain fruits, vegetables, foods containing lactose, and certain alcohol sugars as in sugar-free gum). Oftentimes those with SIBO may see an improvement in their symptoms if they follow a low FODMAP diet (FODMAP stands for fermentable oligo-, di-, mono-saccharides and polyols). See here for more info on a low FODMAP diet: https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/ (you can also download the app!) Foods that are rich in FODMAPs are extremely fermentable by intestinal bacteria, which can lead to bloating, gas and abdominal pain. However, a SIBO breath test is THE definitive test to know if you have an intestinal infection that is causing your IBS.
Once a diagnosis is found the path to wellness has already begun! Basic interventions may include a trial elimination diet, hydrochloric acid support, a trial run of probiotics, and/or various recommendations to address psychological stress. SIBO is best treated using a combination of natural medicines and a unique antibiotic called Rifaximin (which requires a doctor's prescription). A SIBO treatment plan may last anywhere from 6-12 weeks, and is best done alongside a practitioner trained in SIBO treatment.
So if you or someone you know is suffering with digestive issues please be sure to consider consulting with a naturopathic doctor. We can most certainly help!