IBS — What is it?
Irritable Bowel Syndrome, commonly known as IBS, is an umbrella term that regroups many conditions, very often debilitating, that are diagnosed according to symptoms reported by patients.
Commonly affecting the large intestine, signs and symptoms include abdominal cramps, intestinal distention and tummy pain, bloating, gas, irregular bowel movement (loose and more frequent stools), diarrhoea or constipation (or both), mucous in the stools, and the feeling of fulness straight after eating (even after eating small portions).
Different diagnosis:
IBD (irritable Bowel Disease), which includes ulcerative colitis and Crohn's disease, long-term conditions that involve inflammation of the gut. Symptoms include: pain, cramps or swelling in the tummy, recurring or bloody diarrhoea, weight loss, extreme tiredness.
Also, SIBO (small intestine bacterial overgrowth) and SIFO (small intestine fungal overgrowth) have many common traits with IBS and all of these conditions are more often than not misdiagnosed.
Why are SIBO and SIFO a problem?
Both fungal and bacterial micro-organisms are part of the normal intestinal ecosystem; these are normally regulated and kept in balance by the body’s immune system and through mechanisms such as gastrointestinal peristalsis (the unidirectional movement of food in the GI tract). Optimal peristalsis is critical as it ensures microbes cannot migrate back into the small intestine from the large intestine.
Normally the small intestine contains relatively low amounts of bacteria and fungi/yeasts. It is only when the protective immune and/or GI mechanisms fail that SIBO/SIFO can occur. This overgrowth of micro-organisms in the small intestine causes production of large amounts of gases, such as hydrogen and methane, when partially digested food matter is fermented.
The small intestine is not designed to handle large populations of microbes or gases produced from the premature fermentation of carbohydrates or putrefying proteins due to low stomach acid levels (and/or not chewing food for long enough, eating too fast and drinking too much while eating). This, therefore, causes damage to the gut wall, impairs the absorption of nutrients and generates a myriad of symptoms.
Also, accumulation of gases in the bowel can push the 'gate' opened, known as the ileocecal valve (a sphincter muscle situated at the junction of the ileum — the last portion of your small intestine -- and the colon (its function is to allow digested food materials to pass from the small intestine into your large intestine).(Miller, LS. et al. 2012)
How can we differentiate from SIBO, SIFO or IBS?
According to microbiologist Kiran Krishnan, "Many diseases have a unique ‘microbial signature’ or enterotype, which means that specific bacterial patterns can be consistently linked to a particular disease."
This is particularly important because research and our understanding of the gut microbiome is exploding, and discoveries are made almost weekly. There are thousands of studies published in peer-reviewed literature that have solely been dedicated to the gut microbiome and its involvement in almost all systems in the body.
It also means that by booking a consultation and getting a comprehensive stool analysis or GI mapping, you already know where you stand and adapted protocols can help you target specific overgrowth and/or promote the growth of essential bacteria too low in number.
For example, methanogens (methane-producing micro-organisms (archaea) that produce methane by fermenting hydrogen), which normally reside in the intestinal tract. They're an essential component of the luminal intestinal ecosystem and are present in regulated numbers in healthy people. In a dysbiotic gut, methanogens can multiply and cause the severe depletion of short chain fatty acids (SCFAs). SCFAs (especially butyrate) stimulate motility and most importantly support intestinal cell energy production and repair.
Overgrowth of methanogens is a key feature of constipation-type SIBO (SIBO-C) and may also occur in the bowel. Symptoms include constipation, bloating, nausea and belching. In addition, strong evidence links intestinal methanogen overgrowth (IMO) with wide-ranging digestive and systemic conditions IBS.
A growing body of evidence suggests specific probiotic strains such as L. reuteri DSM 17938, significantly benefit cases of IMO. Herbs with antimicrobial medicines can be utilised clinically to reduce IMO, including:
Garlic (Allium sativum)
Oregano (Origanum vulgare)
Pomegranate (Punica granatum) peel
Black Cumin. also known as Nigella seeds (Nigella sativa)
and berberine-containing herbs such as Phellodendron (Phellodendron amurense), which are key to restore motility
Digestive enzymes can also play a key role in helping digesting the food you eat. We already know that poorly digested foods can cause problems in the gut and increase the production of gas, generating discomfort and very often pain.
Since the vast majority of people do not manage to eat their 5-a-day, it is easy to understand why the body struggles with over-producing digestive enzymes to catch up. Raw plant foods are packed with enzymes (e.g. papaya contains papain, pineapple contains bromelain, mango contains amylase, which is also found in bananas, together with glucosidases, which are essential to digest complex carbs, avocados contain lipase (helps break down fat molecules), kiwi contain a a protease called actinidain, and ginger, a protease called zingibain, which help breaking down long chains of amino acids - proteins). Enzymes can truly increase nutrient absorption and indirectly increase the variety of foods in your diet. You may have to supplement if your digestive system is struggling.
These are some of the main reasons for inadequate digestive enzymes:
Stress
Genetic predisposition (common with lactose intolerance)
Crohn’s disease
Leaky gut
And SIBO/SIFO/IBS.
How to treat IBS?
First, you must identify causes and drivers.
Dietary and lifestyle changes are unavoidable. You cannot be healthier if you do not change the terrain and help your gut heal. Lifestyle changes are also key to recovery.
Be careful with prebiotic fibre concoctions and probiotic supplements, which may make your condition much worse and create more problems than they were supposed to solve.
It is important that you consult a specialised health practitioner if your current doctor is not current in the condition or too busy looking at the clock to care, and that you make the proper test to lay the foundation for your recovery.
It is also very important to consider that many of the symptoms may have taken decades to manifest and it may take time for your gut to heal and be "symptom-free".
On average, patients start to notice improvements straight away but symptoms may persist for up to 18 months (depending on the severity of the initial damage inside the gut, food choices and, most importantly, compliance).
At Nutrunity UK, our commitment is your health. Contact us today for a free consultation and benefit from our expertise, setting you on a new path to health.
References and Sources:
Miller, LS. et al. (2012). Ileocecal valve dysfunction in small intestinal bacterial overgrowth: A pilot study. World journal of gastroenterology. 18(46), pp. 6801–6808. doi:10.3748/wjg.v18.i46.6801
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