Whether you over indulged over Christmas or have a re occurring problem that you cant put your finger on the trigger of, digestive disorders are becoming more frequent. Many people complain about painful bloating, constipation or diarrhea, or food reactions. IBS is often a label given to un-diagnosed problems.
This is a great article by Dr Nirala Jacobi, ND (USA) on the 6 leading causes of IBS.
Yours in good health
We all can relate to the occasional digestive discomfort after a heavy meal, constipation after travelling, or diarrhea after a case of food poisoning. People suffering from IBS however, talk about diarrhea that’s almost incapacitating, severe abdominal cramping, and extreme pain. “I don’t leave the house unless I know there’s a toilet close by to where I’m going” is a common statement. There are different levels of severity of IBS, but here are the common features:
- Bloating and gas
- Diarrhea or constipation, or alternating
- Abdominal cramping and pain
1. The foods you eatFood sensitivities or food allergies can cause symptoms of IBS. Some people are very sensitive to food additives or preservatives, or even natural food irritants like salicylates or high levels of amines. A newer diet called FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharaides, and polyols) focuses on the removal of fermentable fibres which has shown great benefit for some IBS sufferers. Those that are sensitive to these FODMAPs should consider ruling out small intestine bacterial overgrowth as the reason why they are fermenting food in their small intestine. To see if foods are an issue, naturopaths and other health practitioners may do an elimination diet or order food hypersensitivity testing.
2. Inadequate digestive juicesA lack of hydrochloric acid due to stress, zinc deficiency or a number of other factors can cause the improper breakdown of proteins in your gut, leaving them to be fermented by gut bacteria, causing gas. Lack of pancreatic enzymes, for much of the same reasons can cause similar symptoms—people often complain of undigested foods, and greasy stools with enzyme deficiency. Lack of stomach acid, orhypochlorhydria is far more commonly the culprit than the often over diagnosed reflux and acid indigestion. Unfortunately there isn’t a quick and easy test for this condition and practitioners often rely on seeing improvements with a trial of hydrochloric acid supplements. Pancreatic deficiency can be assessed with a stool test, looking for pancreatic elastase. Low levels of pancreatic elastase indicates low level digestive enzyme output which can be corrected with enzyme supplementation.
3. BacteriaBacteria live in the different places inside of your small and large intestine. Did you know that you have FAR more bacteria in your digestive tract than cells in your body?
Normally these bacteria help to regulate your immune system, keep the integrity of the mucosa intact, and have other important functions. Years or lifetimes of poor diet and medication such as antibiotics severely disrupt the ecology of your gut, leaving a state of “dysbiosis” where pathogens such as yeasts and bad bacteria can flourish. Dysbiosis can cause severe digestive symptoms such as IBS. This condition is easily assessed by a comprehensive stool test and culture, ordered by your practitioner. Another bacterial problem is called SIBO – small intestine bacterial overgrowth. Whereas the large intestine is usually ground zero of the pathological overgrowth, SIBO is as equally common in IBS. Some researchers suggest that most cases of IBS are actually SIBO. The problem with this condition is that bacteria are in the wrong location, severely disrupting the process of digestion. Hydrogen and Methane gas production is damaging to the absorptive surface of the gut, but can also directly cause diarrhea or constipation. SIBO is diagnosed with breath testing. You can check out www.sibotest.com for more information.
4. The integrity of the barrierYour internal skin that keeps you protected from the external environment. This barrier is the mucosa that stretches from mouth to anus. Cells that line the mucosa are tightly woven together to prevent “leakage” or partially digested foods coming into contact with the underlying immune system. Leaky gut is a condition where this barrier has been compromised resulting in food allergies, sensitivities, bloating, and general IBS symptoms. Having excessive reactions on a food sensitivities panel is one clue that the barrier has been breached. Your practitioner can also order a “Lactulose/Mannitol” test to see if you have leaky gut.
5. Immune system of the gutThis system lies beneath this mucosa and makes sure you are appropriately defending yourself from bad bugs and foods that may have breached the barrier. What many people don’t know is that the gut immune system is a huge driver of overall inflammation. It constantly communicates with your brain, nervous system, and other immune cells that are far flung throughout your body. Because we come into contact with such a huge amount of foreign material through our food, 99% of the time it is the immune system’s job to NOT react. Hypersensitivity of the immune system can send the signals to the rest of the system to increase inflammation and therefore pain. One of the soldiers of the mucosal system is an immune molecule called sIgA—it’s like a little samurai released from the mucosa to fight food allergies, yeasts, parasites, and bad bacteria. In IBS, sIgA is often low due to chronic stress or dysfunctional musical status in general. sIgA can be assessed via a stool or saliva test
6. The nervous system of your gutThe gut actually has more nerve endings than your brain! So it is very important in the overall functioning of your digestion. A hallmark symptoms of IBS is the hypersensitivity to pain in the gut— this is caused by an over reactive gut nervous system.
One of the main causes of IBS is stress. You’ve probably heard the saying “fight or flight” and “rest and digest”. During fight or flight blood flow is shunted away from the gut, and towards muscles that can fight the perceived stress. This is why food feels so heavy and undigested, which it is, if we eat on the run or whilst stressed. We literally shut our gut down in order to attend to more urgent matters. Our stress response has not changed in 50,000 years. We were meant to experience stress in short bursts and then go back to more relaxed activities. Many people living the modern lifestyle have FAR too much stress which is unrelenting and constant. Not only will you have chronic poor blood flow to your gut, but also high levels of the stress hormone cortisol as well as stress related neurotransmitters such as adrenalin and glutamate (not be mistaken with the gut healing nutrient L-glutamine) which can cause damage to the mucosal barrier. In studies conducted on animals, stressed animals had ulcerations all throughout their digestive tracts in a short period of time. A patient suffering from stress and IBS will not totally improve until the stress has been addressed.
In summary, there are several factors which contribute to the development of IBS—diet, enzyme/acid deficiency, mucosal barrier and immune dysfunction, SIBO and/or large intestinal dysbiosis, as well as enteric nervous system overdrive due to prolonged stress.
Not all of these factors need to be present to develop IBS—some patients however, have a combination of dysfunctional factors. Naturopathic practitioners are excellent in addressing these areas of dysfunction with herbs, nutrients, stress reduction techniques, dietary recommendations as well as probiotics.
IBS is a treatable condition, so long as the practitioner is diligent in finding the cause to the problem.