What is IBS
The NHS website describes IBS as uncurbable, lifelong and with no known cause. Not the best news to hear but you’re not alone. IBS is thought to affect between 10 and 20% of the population affecting women more than men. Failing to cure IBS the NHS leaves people to get on with their lives with uncomfortable, painful and debilitating symptoms that often impact negatively on your quality of life and enjoyment. It doesn’t have to be like this though – new research is showing there are a host of reasons why you may have IBS and the catch all umbrella term is being challenged. There is actually a lot you can do to address IBS.
What are the symptoms of IBS.
Not all of the symptoms are present for everyone but tend to be worse after eating, come and go over time, and can last for days, weeks or months at a time.
- Excessive wind
- Abdominal pain
- Abdominal discomfort
- A change in bowel habits
- Faecal incontinence
- Urgent need to go to the toilet
- Constipation and or straining to pass a stool
- Feeling of incomplete emptying after passing a stool
- Stomach cramps that may or may not be relieved by passing a bowel movement.
- Back ache
- Passing mucus
- Nausea (feeling sick)
- Tiredness and fatigue
- Bladder symptoms – needing to pee or finding it hard to pee.
The Three main types of IBS
- IBS D – IBS with repeated bouts of diarrhoea
- IBS C – IBS with repeated bouts of constipation
- IBS M – IBS with repeated bouts of Diarrhoea and constipation – this is the most common type of IBS.
Your own individual health picture or jigsaw puzzle.
Over the past 10 + years I’ve seen thousands of people with IBS and each person has had their own individual set of symptoms and probable causes. No two people are ever exactly the same. This is one of the reasons the NHS finds it so difficult to deal with IBS. I always talk in terms of a person’s individual health picture which is made up of different sized pieces and although the majority of people with IBS will share quite a few of the same pieces the size of those pieces and therefore the relevance to that individual is always different.
What are the possible contributory factors or causes of IBS
The world of IBS has been picking up speed recently and we know that there can be multiple reasons why an individual may be labelled with the term IBS.
In some cases, just one of the drivers – or causative factors are present and for others there can be multiple drivers or factors that lead someone to be diagnosed with IBS. Everyone that has IBS will have their own unique set of factors, drivers and triggers. Here at IBS and SIBO clinics we work on building a health picture for each individual where we consider all of the possible contributory factors that may have led you to get a diagnosis of IBS. In some cases this is relatively straightforward for us and sometimes it can be a little like restoring a picture in a museum – as we address one imbalance or trigger another one becomes clear and that needs to be worked on as well as it was masked by the other symptoms. It may sound complicated but we are well practised in building your individual health picture and peeling back the layers to address any and all contributory factors.
Below is a list of some of the possible pieces of your health pictures jigsaw puzzle that may need to be investigated and ruled in or out to build your health picture when looking for solutions to IBS.
SIBO (Small intestinal Bacterial Overgrowth)
One study of more than 200 patients with IBS found that 78% tested positive for SIBO. Of those successfully treated for SIBO, 48% no longer met the Rome criteria (one of the ways people can be diagnosed with IBS) for IBS.
SIBO refers to a condition in which abnormally large numbers of bacteria are present in the small intestine. Symptoms of SIBO are bloating that usually occurs higher up quite soon after eating, gas, diarrhoea, constipation, abdominal cramping, burping after food, fatty stools and a lot of noise and gurgling.
More about SIBO
Candida and or other yeasts
An overgrowth of unfriendly yeast – Often Candida or Rhodotorula, Giabrata or Geotrichum can cause many of the symptoms of IBS and greatly exacerbate the condition.
An imbalance between good and bad bacteria, yeast and/or intestinal parasites within the bowel can cause many of the symptoms of IBS and greatly exacerbate the condition. A bowel infection may simply be something you picked up on holiday or a consequence of poor dietary habits and compromised immunity. Either way, the offending invaders can easily be identified by having a stool test.
I have seen a large number of people with IBS in my clinics who have tested positive for parasites – 31%! If you have had a bout of food poisoning or have travelled abroad and experienced an upset stomach whilst away then these may be the cause or a contributory factor for your IBS. If you have symptoms of loose stools, abdominal pain, lack of energy and a lot of gurgling and churning in the gut and especially if these happen on a cyclical basis parasite may well be the problem. I commonly see Blastocystis hominis and Dientamoeba Fragillis along with Giardia and endolaminax nana many others.
In many cases people have had stool tests carried out with the NHS and parasites have not been found but the sophisticated test that I offer can find parasites that the NHS test has missed. I would still recommend a test even if the NHS have ruled parasites out.
If the body is unable to digest food completely this can lead to a range of different digestive symptoms.
If we cannot digest fats correctly then fatty meals can leave us feeling nauseous, bloated with discomfort and can lead to a fast transit time meaning diarrhoea can be a common problem which is often accompanied with light-coloured and smelly stools.
Protein digestion – hypochlorhdria
If proteins aren’t digested properly then upper discomfort is common and people often talk about food feeling like it’s in the stomach the day after a heavy protein meal, such as steak has been eaten.
A problem with digesting carbohydrates can lead to more bloating and discomfort; higher up – just below the stomach or lower down in the belly and is often due to the body not being able to break down the different sugars found in foods but can be due to bacteria in the digestive tract fermenting the carbohydrates and producing a lot of gas.
Sensitivity to foods, additives or medicines
People with IBS may have colons that are more sensitive and reactive to things that might not bother other people, such as certain foods, additives and medications. Some people will react to proteins in foods, others to sugars and some to natural chemicals in foods such as histamine or oxylates whilst for some food additives such as monosodium glutamate.
For those that are sensitive FODMAPs (Certain sugars found in foods) are poorly absorbed in the small intestine and move along into the large intestine without being properly digested, where they react with healthy and unhealthy bacteria to produce unwanted gas. FODMAPs also act like a sponge in the large intestine, where they draw and hold excess fluid which can lead to bloating, wind, loud and volatile digestive noises, loose stool and depending on which kind of gas is produced constipation.
An inability to digest lactose – the natural sugar found in diary produce can lead to urgency and diarrhoea and symptoms that mimic IBS. This can be a genetic issue but also commonly comes on after a course of antibiotics.
This often leads to urgency, smelly wind, diarrhoea and IBS like symptoms. `This can be genetic but it can also be due to other issues. People that swop to a ‘healthy’ diet by increasing fresh fruit and veg and fibre may find this appear – making the apparent healthy changes seem problematic.
Celiac Disease and non celiac gluten sensitivity
Researchers have found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. They cannot eat these foods without becoming ill because their immune system responds to them by damaging the gut. In addition a condition now recognised by the NHS called non celiac gluten sensitivity can also cause digestive issues that can mimic IBS in some people.
Feeling mentally or emotionally tense, troubled, angry, or overwhelmed can stimulate digestive spasms in some people with IBS. The gut has many nerves that connect it to the brain. These nerves control the normal digestive contractions and can cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress.
Imbalanced female hormones
Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms. Consequently, imbalances in female hormones can make IBS symptoms much worse. If your symptoms are worse around menstruation imbalanced hormones may be a contributory factor.
Back Problems and poor posture
The Vegas nerve is responsible for the automatic part of your digestion – the mixing and churning of food, stimulation of the production of digestive juices and the movement of food along the digestive tract. Any upper back or neck problems may impact on this nerve and hinder digestive function.
Chemotherapy not only kills cancer cells it also damages our own body cells particularly those in the gut. This can make it more sensitive and reactive.