Functional Approaches to Irritable Bowel Syndrome (IBS)

Get control of your inflammation and muscle spasm symptoms to feel your best.

Irritable Bowel Syndrome (IBS) is frustrating to millions of Americans with the fear of missing out on everyday activities including road trips, beach runs, eating out, vacations, and work.

If you have IBS, you are not alone. According to an international survey of patients with IBS:

  • 79.5% of individuals felt pain
  • 74.4% had bowel difficulties
  • 69.4% experienced bloating
  • 69.2% put limits on what they ate
  • 61.5% limited social interaction
  • 53% cannot leave home (even to work!)

…and the list goes on and on. Turns out that IBS mostly affects women who would give up 25% of their remaining life (about 15 years) to receive treatments to make them symptom free!

“14% of people surveyed say they would risk 1/1000 chance of death to get symptom free.”

It is sad to report that people the people of this survey were so desperate that they take antidepressants (30.8%) and narcotics. It dumbfounds us that these highly addictive drugs, proven to stress the digestive system are being prescribed.

Even though Irritable bowel syndrome effects more than 7% to 16% of the American population, complementary and alternative treatments were only used by 37% of the time.

Does Conventional Healthcare Even Know What They Are Doing?

If you are a person who feels that you have been through the ringer, then the answer is probably a resounding, “no”. Unless your practitioner specializes in Integrative and/or Functional Medicine work, then the well-researched and highly studied tools like enzymes, herbs, and whole food nutrients are pretty foreign concepts. You may have even heard from your doctor, “There are no studies to show that alternative therapies work at all.”

79% of polled individuals feel that they do not have a grasp on their symptoms that included moderate to severe:

  • abdominal pain
  • bloating
  • constipation
  • diarrhea
  • urgency
  • straining
  • recurrent inclination to have a bowel movement

How is IBS Diagnosed with Symptoms?

IBS is typically diagnosed by symptoms with The Bristol Stool Chart, and/or with a colonoscopy (61% of participants). According to ROME IV Diagnostic Criteria, IBS is diagnosed when you have abdominal pain every week for at least 6 months

OR

if you experience pain 30% of time for two of the following: 1) with bowel movements, 2) with a change in frequency, and/or 3) with a change in appearance of stool.

What are the Different Types of IBS?

Using the Bristol Stool Chart as a guide, IBS is given a sub category of:

  • IBS-C for constipation (types 1 & 2)
  • IBS-D for diarrhea (types 6 & 7)
  • IBS-M for mixed (with at least ¼ constipation AND at least ¼ diarrhea)
  • IBS-U if the individual never or rarely has abnormal stools

How is IBS Conventionally Treated?

It is conventionally treated with anti-inflammatory drugs, antibiotics, antidepressants, and antacids… a very surface strategy targeting the symptoms instead of the root cause. What the author of this article does not understand, is why the first line therapy is not enzymes, bitters, whole food nutrients, and herbs. Plus these drugs are expensive in comparison to specialized herbal and nutrient blends… Let’s take a look at Rifaximin used to treat bacterial overgrowth in the small intestine:

According to Goodrx, “There are currently no generic alternatives to Xifaxan (Rifaximin). It is not covered by most Medicare and insurance plans, but some manufacturer and pharmacy coupons can help offset the cost. The lowest GoodRx price for the most common version of Xifaxan is around $1,482.75, 11% off the average retail price of $1,682.28.”

How is IBS Treated Using Functional Approaches?

There is a light at the end of the tunnel. Published, peer-reviewed, well-researched studies on herbal and nutrient protocols for SIBO and Leaky Gut are seeing the light of day in PubMed.

Functional (also known as Integrative) Approaches are popular right now for good reason… The old conventional approaches of Proton Pump Inhibitors (PPIs), OTC Antacids, and Antibiotics are not optimal for supporting conditions such as Low Stomach Acid, Small Intestine Bacterial Overgrowth (SIBO) and Intestinal Permeability (Leaky Gut).

This is where a functional approach using specialized testing, herbs, and whole food nutrients can be very helpful.

What Causes Intestinal Inflammation?

Both Conventional and Integrative Practitioners agree that inflammation is at the heart of many of the symptom patterns they are seeing. What is not in agreement is how or even why to treat the underlying causes.

  • Undigested Food (rotting, fermenting, or oxidizing in the intestines)
  • Poor Mucous Formation (in instances of Leaky Gut)
  • Imbalanced Gut Bacteria (such as SIBO)
  • Proton pump inhibitors
  • Anti-motility aids
  • Fiber Imbalances
  • Antibiotics, opiates, and other prescription drugs
  • Excessive alcohol
  • Toxins
  • Infection
  • Hormonal Imbalances

Intestinal inflammation typically gets worse over time because the problems compound.

For example, to deal with the symptoms like heartburn, individuals take OTC or prescription acid blocking medications (like PPIs) stop proteins from digesting (lowering pH and deactivating protein-digesting enzymes). Undigested proteins then putrefy causing well-documented inflammation.

“The problem with diagnosing IBS is it typically leads to a single treatment option (of giving anti-inflammatory drugs) without looking at what is causing the inflammation.”

We feel that most digestive problems begin with stressed organ systems that are tired from years of poor lifestyle and dietary habits. Nutritional deficiencies from these poor diets and stressful events keep the individual from creating enough acids and enzymes. Food then rots, ferments, and oxidizes causing excessive gas, bloating and inflammation.

What Causes Poor Sphincter Tone?

  • Low or High Stomach Acid
  • Low Dietary Bitters
  • B Vitamin Deficiencies
  • Mineral Imbalances (Calcium, Magnesium, Phosphorous)
  • Bacterial or Yeast Infection

Most integrative conferences only talk about muscle and sphincter syncing when bitter herbs are brought up. But, it so happens they are very important. They regulate the filling and emptying of the different compartments of digestion. Each compartment of your digestion has its own biome (bacterial environment) and pH. If the muscle bands of your stomach, muscle bands of the intestine, and sphincters are not moving and grooving correctly, then symptoms such as reflux, constipation, diarrhea, pain, and bacterial overgrowth can occur.

What Can I Eat?

When eating anything makes you anxious, upset, worried, and down-right frustrated, then it is time to reset your mind and look into some tried and true options. It is important to fit the diet into what you can actually do. Instead of focusing on what you shouldn’t eat, let’s focus on what you should be doing.

Where to Start:

  1. Make Bone Broth Soups – The bone meal and cartilage will help soothe and heal. Grab a rotisserie chicken and boil those bones with healthy veggies to make a broth. Add some of the chicken back in. You can also grab bovine bones and slow cook them in the crock pot.
  2. Eat Cooked, Steamed, and Blended Vegetables – Pre-cook your vegetables to make them easier to digest. Add back in raw vegetables as you become healthier.
  3. Stay away from FODmaps – These sugars are found in high quantities in many common fruits and vegetables. It you do not have enough enzymes, then bacteria will digest your food for you, leading to a bad bacterial overgrowth. IBS is one of the many different disease states that are seen. FODmaps stand for:
    • Fermentable– meaning they are digested by bacteria (fermented)
    • Oligosaccharides– “oligo” means “few” and “saccharide” means sugar. These individual sugars are made into a chain, bacteria and yeast love them.
    • Disaccharides– “di” means two. This is a double sugar molecule that bacteria and yeast also love to eat.
    • Monosaccharides– “mono” means single. This is a single sugar molecule, the easiest for bacteria and yeast to consume.
    • And Polyols– these are sugar alcohols.
  1. Eat Nutrient-Dense Smoothies – When you blend specific fruit and vegetables prized for their enzymes and phytochemicals, you are actually predigesting them. We have 6 different recipes to get you started. Check out the smoothie recipes here.

Elimination diets can be extremely helpful to figure out what foods are triggering any Leaky Gut or SIBO symptoms. We also recommend using a food diary every day and our Progress Survey every two weeks during your elimination diet to track the foods, how you are feeling, the supplements, and symptoms.

Feeling Overwhelmed? Get a Functional Digestion Practitioner to Help!

When looking for a practitioner who can help you, here are some helpful questions to get the ball rolling.

  1. What does our first appointment look like?
  2. What is expected from me?
  3. Do you offer protocols for Leaky Gut and SIBO?
  4. Do you offer dietary counseling?
  5. Do you offer follow-up testing and assessment?
  6. How do we start?

Finding the right practitioner that attends ongoing seminars and conferences, does their own research, follows up with their patients, and keeps data on how their protocols work is very important. If you need help finding a practitioner to work with, fill out our form and we will help you find a practitioner that can help when others have failed.

Conclusions

Keep in mind that IBS is merely a diagnostic code for insurance purposes, a collection of symptoms. IBS is not the cause of your symptoms. To find the cause, you should do a little research to understand which macronutrients are not being digested by your enzymes, rather they are digested by bacteria, yeasts, fungi, bugs, and biological processes that can alter your intestinal flora, degrade your mucus membrane, and cause chronic inflammation of your gastrointestinal system.

Start your journey by getting a free digestive assessment and finding a practitioner that can ask the right questions and put you on the right diet and supplement protocol.

Resouces

1) Diagnosis and management of small intestinal bacterial overgrowth. Bohm M, Siwiec RM, Wo JMNutr Clin Pract. 2013 Jun; 28(3):289-99

2) Drossman, Douglas A. et al. “INTERNATIONAL SURVEY OF PATIENTS WITH IBS: SYMPTOM FEATURES AND THEIR SEVERITY, HEALTH STATUS, TREATMENTS, AND RISK TAKING TO ACHIEVE CLINICAL BENEFIT.” Journal of clinical gastroenterology 43.6 (2009): 541–550. PMC. Web. 2 July 2018.

3) Stephan C Bischoff, corresponding author Giovanni Barbara, Wim Buurman, Theo Ockhuizen, Jörg-Dieter Schulzke, Matteo Serino, Herbert Tilg, Alastair Watson, and Jerry M Wells. “Intestinal permeability – a new target for disease prevention and therapy.” BMC Gastroenterol. 2014; 14: 189. Published online 2014 Nov 18. doi: 10.1186/s12876-014-0189-7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/table/Tab6/

4) Dulantha Ulluwishewa, Rachel C. Anderson, Warren C. McNabb, Paul J. Moughan, Jerry M. Wells, and Nicole C. Roy. “Regulation of Tight Junction Permeability by Intestinal Bacteria and Dietary Components.” 2011. American Society for Nutrition. http://jn.nutrition.org/content/141/5/769.full

6) Grace E. Shaw C, Whelan K, Andreyev HJ. Review article: small intestinal bacterial overgrowth–prevalence, clinical features, current and developing diagnostic tests, and treatment. Aliment Pharmacol Ther. 2013 Oct;38(7):674-88.

7) Diagnosis and management of small intestinal bacterial overgrowth. Bohm M, Siwiec RM, Wo JMNutr Clin Pract. 2013 Jun; 28(3):289-99.

8) Microbial biofilm communities in the gastrointestinal tract. Macfarlane S
J Clin Gastroenterol. 2008 Sep; 42 Suppl 3 Pt 1():S142-3.

9) Lembo A, Pimentel M, Rao SS, Schoenfeld P, Cash B, Weinstock LB, Paterson C, Bortey E, Forbes WP. Repeat Treatment With Rifaximin Is Safe and Effective in Patients With Diarrhea-Predominant Irritable Bowel Syndrome. Gastroenterology. 2016 Dec;151(6):1113-1121.

10) Low K, Hwang L, Hua J, Zhu A, Morales W, Pimentel M. A combination of rifaximin and neomycin is most effective in treating irritable bowel syndrome patients with methane on lactulose breath test. J Clin Gastroenterol. 2010 Sep;44(8):547-50.

11) Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014 Jan;146(1):67-75.e5.

12) Barrett JS. Extencarbohydrates for managing gastrointestinal symptoms. Nutr Clin Pract. 2013 June;28(3):300-306. Published online 7 May 2013 at http://ncp.sagepub.com/content/28/3/300.

13) Lacy BE, Chey WD, Lembo AJ. New and emerging treatment options for irritable bowel syndrome. Gastroenterol Hepatol (N Y). 2015 Apr;11(4 Suppl 2):1-19.

14) Yao CK, Tan HL, van Langenberg DR, Barrett JS, Rose R, Liels K, Gibson PR, Muir JG. Dietary sorbitol and mannitol: food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome. J Hum Nutr Diet. 2014 Apr; 27 Suppl 2:263-75.

Get Your Functional Digestive Assessment

Our 5-minute ‘yes’ or ‘no’ questionnaire will give you a 6-page educational report. Start your journey to feeling great, looking better, and living longer by addressing your digestive health.

Get Your Functional Digestive Assessment

Our 5-minute ‘yes’ or ‘no’ questionnaire will give you a 6-page educational report. Start your journey to feeling great, looking better, and living longer by addressing your digestive health.

2018-07-05T15:33:57+00:00