IBS is a BS diagnosis. I don’t want to discredit the symptoms associated with IBS because they are absolutely real…the abdominal pain, bloating, gas, constipation, and/or diarrhea can be debilitating. I know all too well the significance of these symptoms because I myself have suffered, and I have helped thousands of patients with these symptoms. But let’s remember that the diagnosis of IBS is a label that provides no effective guidance or next steps. It can be disempowering as it does little to empower you to find a long-term solution to your symptoms.

The endless number of tests can be frustrating and exhausting, leaving you with no real answers. In many cases, it is absolutely important to rule out the more serious conditions, such as colon cancer and inflammatory bowel disease. And conventional medicine does this well with state-of-the-art diagnostic techniques, such as colonoscopies. Once these tests come back negative, however, the investigation often stops and you are labeled with IBS. Here is the diagnostic Rome IV criteria for IBS⁽¹⁾:

• Recurrent abdominal pain present at least 1 day per week during the previous 3 months and be:
  • Related to defecation and/or
  • Associated with a change in frequency of stool and/or
  • Associated with a change in form (appearance) of stool
• Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.

This criteria lists a set of symptoms, but it fails to offer any explanation as to WHY these symptoms occur. We know that your gut is irritable, but the real question for ultimate healing is WHY.

Medications such as antacids, laxatives, anti-diarrheal medications, and antispasmodics may be prescribed to alleviate symptoms. And while there is often a place for temporary symptom relief, these are band-aid approaches, failing to address the root cause.

Symptoms are our bodies way of communicating with us that something is out of balance. There are always reasons for symptoms. There are actual root causes of IBS that the conventional medical community are less likely to acknowledge and test for. Fortunately, there has been whole host of research on gut health and the microbiome in the last decade and the identification of specific diseases and disorders. Here are the most common underlying causes of IBS that we test for and address as naturopathic and functional medicine practitioners:

• Small Intestinal Bacterial Overgrowth (SIBO)⁽²⁾ More than 1/3 of individuals with IBS have SIBO.⁽³⁾
• Fungal or yeast overgrowth
• Parasitic infection⁽⁴⁾. Some studies have shown that up to 30% of people labeled with active IBS have a parasire. In one study, 30 out of 100 people with IBS were infected with at least one gut parasite (ie. Giardia, Blastocystis hominis).
• Food sensitivities and intolerances
• Pancreatic insufficiency
• Histamine intolerance. Histamine, which we typically think of for allergic reaction is also produced in the gut and is thought to contribute to the “visceral hypersensitivity” of IBS patients.⁽⁴⁾
• Dysbiosis
• Stress and gut-brain axis dysfunction

Fortunately, there are now a multitude of reliable diagnostic tests for the above conditions. I encourage you to continue to seek answers. Don’t settle with a diagnosis of IBS. You bring self-knowledge and we bring scientific knowledge of the human body and together, we devise an individualized wellness plan that gets to the underlying cause of your IBS, allowing you to feel well and able to do what you love to do.

References:

1. Mearin, F., et al. (2016). Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult. Rev Esp Enferm Dig, 108(6), 332-63
2. Takakura ,W, et al. (2020). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update. Front Psychiatry, 2020 Jul 10;11:664.
3. Chen, B, et al. (2018). Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J. Gastroenterol, 2018 Jul;53(7):807-818.
4. Shafiei, Z, et al (2020). Parasitic infections in irritable bowel syndrome patients: evidence to propose a possible link, based on a case–control study in the south of Iran, 2020 BMC Res Notes 2020; 13: 264.
5. Wouters, M, et al. (2016). Histamine Receptor H1-Mediated Sensitization of TRPV1 Mediates Visceral Hypersensitivity and Symptoms in Patients With Irritable Bowel Syndrome. Gastroenterology, 2016 Apr;150(4):875-87.e9.

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.