Updated: Sep 17
Abdominal pains that kept me awake at night. Bloating to the point I looked pregnant. Stools that looked like pellets (if I was lucky to even pass stools that day). Then there was the fatigue, brain fog, nausea, depression and acne. I suffered for years.
What was the specialist's response? You have irritable bowel syndrome. Eat more fibre, take Metamucil and drink more water. None of those things helped.
You see, irritable bowel syndrome (also known as IBS) is a BS diagnosis. It is a term used for a collection of symptoms (like abdominal pain, diarrhea and gas) with numerous underlying triggers and causes. It is a "waste basket" diagnosis used when the standard medical tests (like a colonoscopy) fail to turn up any of the more obvious causes. Unlike, those with inflammatory bowel disease for example, IBS shows no visible signs of structural damage to the bowel.
How is Irritable Bowel Syndrome defined?
According to the Rome IV criteria the patient must have:
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria: – Related to defecation – Associated with a change in frequency of stool – 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.
There are also subtypes:
IBS-C = IBS with predominant constipation
IBS-D = IBS with predominant diarrhea
IBS-M = IBS with mixed bowel habits
IBS-U = unclassified IBS.
Once more serious conditions such as coeliac disease, colon cancer and inflammatory bowel disease have been ruled out, everyone else with the symptoms above are lumped under one umbrella term, IBS. It is simply a diagnosis of exclusion.
(Note: Coeliac disease is often ruled out far too quickly. Especially when blood tests measuring IgA tissue transglutaminase – IgA TTG levels are solely used for diagnosis).
An estimated 10 – 20% of people throughout the western world are thought to have IBS. IBS is reported to be one of the top ten reasons for visiting a General Practitioner, although it is thought that up to 50% of people with symptoms of IBS do not even consult their General Practitioner.
Why is there no "cure" for IBS and why use the term IBS, at all?
Because there is not just one single cause or treatment, and determining the cause or causes in an individual can be tricky when relying on standard medical testing.
Furthermore, we like our labels. It reduces fear and uncertainty. We'd rather be told we have IBS, than be told "sorry, we don't know what's wrong with you".
Although a label provides comfort in the short term and makes it easier to talk about, it does little to empower an individual to find a long-term solution to their symptoms.
We may leave with a diagnosis, but no effective guidance on the next steps to take, and little desire to search out the root cause of the symptoms. The IBS label implies that you have identified the problem, which is far from the truth.
IBS is not a cause, it is only a description of your symptoms.
So, what are the underlying causes of IBS?
Fortunately over the past decade, there has been an explosion of research on gut health and the identification of specific diseases and disorders that can cause IBS symptoms.
Listed below are some of the common causes: (Click the links for more information).
Bacterial or viral infection e.g Clostridium difficile
Intestinal dysbiosis (i.e. a disrupted gut microbiome)
Increased intestinal barrier permeability (leaky gut)
Food sensitivities and intolerances such as to gluten
Women with endometriosis, can also experience IBS-like symptoms.
Often, more than one condition is involved, interacting in a way to produce a perfect storm of debilitating symptoms.
Why is testing for these conditions rarely done?
Unfortunately only a small percentage of medical training involves exploring how nutrition, gut health, and our microbiome impacts our overall health and well-being. Those interested in a more holistic approach need to undergo post graduate study in these areas, and then find a way to implement these discoveries into their busy practices. Which is why, I believe, it is rare to find a General Practitioner with a great level of knowledge in this area.
Furthermore, it is also only in the past decade that we have gained access to more accurate and reliable testing.
Stool testing can now involve using DNA technology to identify previously undetected harmful bacteria and parasites. The hydrogen and methane breath test used to diagnose a small intestinal bacterial overgrowth (SIBO) is now more fully understood and reliable.
However with more advanced tests, comes a cost. A cost, governments are unwilling to pay at this point in time. It is likely to take many years, if not decades, before these tests will be readily available in GP offices.
Why is identifying the underlying root cause not only critical to eradicating symptoms, but also essential to improving long-term health?
The body's microbial community or collection of germs (that largely resides in our gut) are thought to influence our our mood, our behaviour, our weight, and our ability to fight infection. They may even play a role in dementia, autism, eczema, allergies, autoimmune disorders and so much more. (See "You are 90% bugs, but are you the right kind?)
Accepting IBS as a life-sentence and managing symptoms without addressing the underlying causes, not only can doom you to a lifetime of unnecessary suffering and frustration, but can potentially be dangerous. 70-80% of your immune system is thought to reside in your gut. If you want to address or prevent any chronic disease, you must first look to the gut.
So did I discover the root cause of my IBS-C?
Thankfully I did. I was riddled with parasites and an overgrowth of the yeast candida albicans. Plus, I was highly sensitive to gluten. What were the likely triggers? A drug called Roacutane, oral contraceptives, antibiotics, a low nutrient diet high in sugar and alcohol, a zinc and B vitamin deficiency and stress.
How did I address all of this? With the help of a holistic, functional health practitioner I went on a gut healing journey, changed my diet and cleansed my gut with natural herbal remedies. Constipation and brain fog are no longer an issue, I have more energy, and my mood has improved dramatically.
Now I may experience the odd period of abdominal discomfort, but if so, I know it's because I've consumed gluten, drunk too much alcohol, overloaded on sugar or I'm way too stressed. Stress impacts greatly on gut motility and "leakiness"; enzyme, bile and stomach acid secretions; and the diversity of the microbiome. But it's only one cause of gut issues, usually an individual has multiple.
Please don't ever settle for an IBS diagnosis. You too can discover and address the underlying cause of your IBS, reducing your risk of further disease and improving not just IBS symptoms but your overall health and well-being.
B.Sc, B. Chiro, CFMP, MNZCA
Certified Functional Medicine Practitioner & Chiropractor
Interested in learning more about IBS, gut health & gut healing? Join me in The IBS & Gut Healing Facebook Support Group here.