What Causes IBS? Identifying the Root Cause of Your Digestive Symptoms
Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that affects millions of women worldwide, significantly impacting their daily lives and overall quality of life. During IBS Awareness Month, it’s crucial to shed light on this condition, exploring not just the symptoms and immediate management strategies, but also the deeper, underlying causes. In this blog post, I will take a comprehensive look at IBS through a functional medicine lens, which seeks to identify and address the root causes of conditions rather than just managing the symptoms.
What is Irritable Bowel Syndrome (IBS)?
IBS is a disorder of the gut-brain axis, which refers to the biochemical signalling that takes place between the gastrointestinal tract and the brain, characterised by a combination of symptoms that can include abdominal pain, bloating, abdominal distention and changes in bowel habits such as constipation, diarrhoea, or alternating between the two.
What causes Irritable Bowel Syndrome (IBS)?
The exact cause of IBS is not well understood, but it is believed to result from a combination of factors including:
Altered gastrointestinal motility
Infections such as gastroenteritis
Hypersensitivity to pain from within the bowel
Psychosocial factors like stress
Genetic predisposition
The Functional Medicine Perspective on Underlying Factors of IBS
Functional medicine is a systems biology-based approach that focuses on identifying and addressing the root cause of disease. Unlike conventional medicine, which often emphasises treating symptoms, functional medicine seeks to understand the origins, prevention, and treatment of complex, chronic disease. This methodology is particularly effective for managing chronic conditions like IBS, where multiple causative factors such as lifestyle, diet, and genetic predispositions play a critical role.
1. Poor Digestive Output
Digestive output refers to the body's ability to break down food using stomach acid and digestive enzymes. When these are insufficient, food isn't properly digested, leading to symptoms like gas and bloating. Enhancing digestive output through dietary and lifestyle changes, in addition to the use of supplements, can help alleviate these symptoms.
2. Gut Dysbiosis
Gut dysbiosis means there is an imbalance in the gut microbiome (the trillions of microorganisms that reside inside our gut - bacteria, yeast, fungi) where there is too little of the good guys and too much of the not so good ones. This imbalance can lead to gastrointestinal symptoms like excessive wind, bloating, cramps, loose stools, diarrhoea, and constipation.
3. Small Intestinal Bacterial Overgrowth (SIBO)
SIBO occurs when bacteria that normally reside in the large intestine starts to overgrow the small intestine. This leads to symptoms of bloating, gas, constipation, diarrhoea, nutrient deficiencies and eczema to name a few. Studies suggest SIBO has been shown to exist in up to 80% of IBS cases.
4. Low Thyroid Function
The thyroid gland is a small butterfly shaped gland situated in the front of our neck, responsible for regulating many body functions by releasing a steady amount of thyroid hormones into the bloodstream. When it becomes under-active, it decreases gastrointestinal motility and slows down transit time resulting in constipation. In addition, decreased GI motility can also result in SIBO and studies have found that over 50% of individuals with hypothyroidism actually test positive for SIBO.
5. Chronic Stress
Chronic stress affects the body in numerous ways, including altering the gut-brain axis. It can change gastrointestinal motility (the movements of the digestive system) and increase sensitivity in the gut, exacerbating IBS symptoms.
6. Food Poisoning
Post-Infectious IBS is a form of IBS that is caused by gastroenteritis, aka stomach bug. One in every nine people who experience gastroenteritis happen to develop post-infectious IBS up to six months after the initial bacterial infection. A bacterial infection can disrupt the gut microbiome and promote visceral hypersensitivity, a hallmark symptom of IBS.
Managing IBS: Strategies and Solutions
Managing Irritable Bowel Syndrome (IBS) effectively requires a personalised, multifactorial approach, as there isn't a one-size-fits-all solution. The complexity of IBS, influenced by factors such as diet, stress, and underlying health conditions, demands a comprehensive strategy tailored to each individual's unique needs. Here, I explore several key components of managing IBS, emphasising the importance of working with a gut health expert to address underlying causes and develop an effective roadmap.
Personalised Dietary Changes
Diet plays a crucial role in managing IBS symptoms, but the right diet can vary significantly from person to person. Common strategies include:
Low FODMAP Diet: Up to 75% of individuals find relief by following a low FODMAP diet, which eliminates foods that cause excessive fermentation in the gut, leading to gas and bloating. Foods high in FODMAPs include onions, garlic, certain fruits, and wheat products. This diet is typically implemented in phases, starting with a strict elimination of high FODMAP foods, followed by a careful reintroduction phase to identify personal triggers.
Fibre Modification: Adjusting fibre intake can also help manage symptoms. Some people benefit from increasing fibre to alleviate constipation, while others might need to reduce fibre to lessen diarrhoea.
Stress Management Techniques
Since stress can significantly impact the severity and frequency of IBS symptoms, effective stress management is a key component of any treatment plan. Techniques may include:
Cognitive Behavioural Therapy (CBT): This therapy helps patients identify and manage stressors that trigger or worsen their symptoms.
Mindfulness and Relaxation Techniques: Practices such as yoga, meditation, and deep breathing exercises can help reduce overall stress levels and improve gut-brain axis communication.
Medications and Supplements
Supplements can play a role in managing IBS, particularly in cases of dysbiosis or poor digestive output:
Antibiotics: These can help eliminate bacterial overgrowth in the small intestine, reducing symptoms of bloating and diarrhoea.
Probiotics: These can help rebalance intestinal flora, reducing symptoms of bloating and irregular bowel movements.
Digestive Enzymes: These may aid in the breakdown and absorption of nutrients, especially in individuals with enzyme insufficiencies.
Fibre Supplements: These can help regulate bowel movements, though they should be used cautiously depending on whether the individual suffers more from constipation or diarrhoea.
Peppermint Oil: Peppermint has natural properties that help relax the smooth muscles of the gut.
Conclusion
Effectively managing IBS requires a thoughtful, personalised approach that addresses both the symptoms and the underlying causes of the disorder. By combining dietary management, stress reduction techniques, appropriate use of medications, and possibly supplements, individuals with IBS can achieve significant improvements in their quality of life. Working with a gut health and IBS expert is crucial to developing a comprehensive management plan that is both effective and sustainable.
Written by Marilia Chamon
Registered Nutritional Therapist, Gut Health, IBS & SIBO Expert
Founder of Gutfulness Nutrition
Instagram @gutfulnessnutrition