Causes Of Ibs

IBS (Irritable Bowel Syndrome) is not an end diagnosis, rather it is a combination of symptoms that require further testing and assessment to understand the root cause and then enable effective, lasting treatment.

It’s common to be told you “just have IBS” after more serious bowel conditions are ruled out. While ruling out these more serious conditions such as inflammatory bowel disease (IBD), coeliac disease or severe constipation is important, we shouldn’t stop there. Your doctor may not have considered or tested for the root cause.

Don’t believe IBS is “all in your head”. With a guided approach to assessment and testing you can live a life free from IBS symptoms of bloating, constipation, diarrhoea and abdominal discomfort.

I see a variety of causes of IBS in my patients and often a combination of more than one cause - these are my top 5 causes to consider and investigate.

# 1 SIBO (Small Intestinal Bacterial Overgrowth)

  • Studies suggest up to 80% of IBS may be caused by SIBO.
  • Overgrowth of bacteria in the small bowel cause fermentation of carbohydrates.
  • Hydrogen or methane forming bacteria can cause either diarrhoea or constipation or a combination.
  • Bloating, burping, reflux or heartburn, gas, gurgling stomach and discomfort, distension and cramping pain are all common symptoms.
  • Tested by SIBO breath testing.

# 2 Food Intolerance and Malabsorption

  • Food Sensitivity or Intolerance (IgG mediated immune responses) differ from ‘true’ allergy (IgE mediated immune responses) and are generally harder to detect as they don’t occur immediately after eating, but can occur hours or even days later.
  • Symptoms commonly include those of IBS – bloating, constipation, diarrhoea, abdominal pain, gas. Inflammation, fatigue after eating, headache and skin conditions can also be present.
  • Foods can be avoided short term, however they may be able to be re-introduced once bowel health is improved.
  • Malabsorption such as with Fructose and Lactose can also be an issue if digestive enzyme function is deficient. Hydrochloric acid (HCl) and pancreatic enzymes can also be lacking.
  • Tested by IgG Food Intolerance Testing, Lactose Breath Test or Fructose Breath Test

# 3 Dysbiosis (disrupted microbiome) and Gut Infection

  • A lack of number or diversity (different strains present) of bacteria in the gut is known as dysbiosis. It can occur for example after a course of antibiotics, or more gradually from drinking chlorinated, unfiltered water or after certain medications. Modern testing methods now identifies this microbiome diversity and counts.
  • With a decline in these beneficial bacteria, which a recent explosion in research has discovered normally support a myriad of healthy bodily functions, IBS symptoms are only part of a possible complex symptom picture.
  • Pathogenic or harmful microbes are also something I commonly see in practice. Some that are often missed as they can present more insidiously or be difficult to detect with standard testing are;
    • Parasites: Blastocystis hominis, Dientamoeba fragilis, Giardia lamblia
    • Bacteria: Helicobacter, Klebsiella, Steptoccocus, Clostridium
    • Yeast / Fungi: Candida species
  • Tested by PCR Stool Parasite testing, CDSA (Comprehensive Digestive Stool Analysis), Microbiome Testing

# 4 Altered Motility

  • Motility refers to the wave or downward movement of the small bowel. The large bowel has it’s own peristaltic mechanism to propel matter downward ready for elimination. In both the small and large bowel this movement can be impaired or effected by toxins.
  • Motility refers to the wave or downward movement of the small bowel. The large bowel has it’s own peristaltic mechanism to propel matter downward ready for elimination. In both the small and large bowel this movement can be impaired or effected by toxins.
  • The nervous system innervation to these areas and the whole gut function can also be a cause. Some individuals may go to the toilet 10 times before leaving the house in the morning, others may not go for a week.
  • The ‘Rest and Digest’ parasympathetic arm of the nervous system is opposed by the ‘Flight and Fright’ sympathetic arm, commonly overly stimulated in modern busy lifestyles. This can ‘switch off’ digestive innervation and enzyme function resulting in IBS type symptoms and food intolerances.
  • Assessed by physical examination and a detailed history and possible Stress Hormone Testing

# 5 Intestinal Hyperpermeability (Leaky Gut)

  • The intestinal wall acts as a permeable membrane to allow nutrients to cross to our blood stream and filter unwanted substances such as undigested food, bacteria or pathogens.
  • If this barrier function or it’s complex immune sampling is altered, we see a host of symptoms, both locally in the gut and systemically.
  • Intestinal permeability can be affected by all the above causes of IBS so doesn’t just occur in isolation.
  • Repair to the lining of the gut (from mouth ulcers, stomach, small intestine and down to the large bowel) gives many patients symptom relief.

My approach is to be open minded and thorough. Functional digestive issues such as these, that can cause IBS can be resolved. If you would like to get to the bottom of what causes or contributes to your IBS symptoms, book an appointment or a complementary 10 min phone call to see if working with me is right for you.

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