If you’ve just been diagnosed with Irritable Bowel Syndrome, the good news is that it doesn’t have to be a lifelong sentence! There’s a lot that can be done with nutrition and lifestyle to help support you because they are tailored to your individual needs, depending on the underlying causes of your IBS. Each person will have different root causes, unique triggers and struggle with different symptoms so an individualised, holistic approach is especially helpful.
IBS symptoms can include bloating and gas, cramping and abdominal pain, diarrhoea and/or constipation, and changes in poop colour and appearance.
Causes of IBS Symptoms
- Imbalances in the composition of the gut bacteria in the colon (large intestine). Specifically, those with IBS tend to have decreased levels of “good” bacteria, such as Lactobacilli and Bifidobacteria, and increased levels of harmful strains such as E. coli and Clostridia.
- Small intestinal bacterial overgrowth (SIBO) -a kind of bacterial imbalance where the small intestines harbour an abnormal number of bacteria. Compared to the colon, the small intestine should have a bacterial concentration that is considerably lower.
- Increased Gut Permeability (or ‘Leaky Gut’)– the gastrointestinal tract is lined with a single layer of tightly packed cells designed to keep unwelcome visitors and large undigested food molecules out of the bloodstream. If the barriers between cells become permeable or ‘leaky’ undigested protein molecules and bacterial toxins can pass through and trigger immune reactions and inflammation
- Gut infections– many studies have confirmed a link between bacterial gastroenteritis and future development of IBS.
- Food Intolerances– are extremely common in IBS patients and include gluten dairy, seafood, and soy. But bear in mind that food intolerances themselves are often symptoms of deeper causes like SIBO, gut infections, and/or gut permeability.
- Gut-brain Connection– The digestive tract is sensitive to emotion. Anger, anxiety, sadness, elation—all these feelings can trigger symptoms in the gut. That’s because the brain and the digestive system are intimately linked through a two-way communication channel. It makes total sense. When we’re nervous we feel “butterflies” in our stomach. When we’re full, the stomach sends a message to the brain to stop eating.
What You Can Do About It
Here are some of the approaches that have helped my clients who have suffered from IBS symptoms.
Testing for Root Causes
Testing is extremely useful as it helps identify root causes of IBS, and saves a lot of time.
Stool testing can be very helpful in determining how well you’re digesting your food, whether you have a bacterial imbalance or unwelcome visitors such as parasites or yeast overgrowth contributing to your symptoms.
A SIBO breath test can be done to determine whether there is an overgrowth of bacteria in the small intestine.
A simple elimination diet or food intolerance test can be used to help identify potential offending food.
Once testing identifies imbalances, nutritional approaches can be used to help rebalance gut bacteria and support healing of the digestive tract. Below are some of the tools I commonly use in my clinic.
Digestive enzymes and stomach acid– can be used to help support optimal digestion, which in turn helps reduce IBS symptoms. Stomach acid is vital for protecting against infectious agents and digesting food but also for preventing bacterial overgrowth in the small intestine, especially important when addressing SIBO-related IBS.
Probiotics– can help boost levels of friendly bacteria and thereby help support optimal intestinal motility (to reduce diarrhoea and constipation), reduce gut permeability and intestinal inflammation. The most appropriate probiotic will depend on your specific issues- in SIBO for example, certain strains are better tolerated than others.
Low-FODMAP Diet– clinical trials have consistently shown that adopting a diet low in FODMAPs can significantly reduce the severity of IBS symptoms. FODMAP stands for fermentable oligo-, di-, mono-saccharides, and polyols and is a kind of short-chain carbohydrates that are poorly absorbed by humans. These unabsorbed FODMAPs are fermented by intestinal bacteria, resulting in gas, bloating, and abdominal distention. FODMAPs also draw liquid into your intestines, which can contribute to abdominal discomfort and diarrhoea. However, it’s important to realize that a strict low-FODMAP diet is not for everyone, and it is primarily a way to manage symptoms in the short term. Maintained long term, it can lead to reduced bacterial diversity in the gut, which can actually contribute to IBS.
As I mentioned above, the digestive system is connected to the brain. Stress signals along the gut-brain communication pathways can actually affect stool transit, increase sensitivity to abdominal pain and discomfort, increase intestinal permeability, and disrupt the delicate balance of intestinal bacteria. Having effective ways of managing mental stress is not only important in itself but also helps other approaches to be more effective- this could be walking in nature, meditation or yoga for example.