Irritable Bowel Syndrome

IBS is a relatively common disorder that manifests itself with altered bowel movement habits and pain. It affects between 10-20% of the population. From a conventional medical standpoint, there is usually no identifiable damage or disease process in tissue. The disease is classified as a functional disease, where the only manifestation is in abnormal bowel function or activity. IBS has also been called allergic colitis, nervous colon, spastic colon, and mucus colitis.

Symptoms can include:

• Persistent constipation or diarrhea, or alternating constipation and diarrhea

• Pain can be relieved by defecation (bowel movements)

• Frequent mucus in the stool

• Sense of incomplete defecation

• Abdominal bloating and pain

• Heartburn

• Food cravings

A major contributing factor of this disease may be food sensitivity (IgG mediated) and/or allergy (IgE mediated). The second most common contributing cause is a deficiency in the digestive function (lack of enzymes), bacterial overgrowth (Small Intestinal Bacterial Overgrowth / SIBO), dysbiosis (not enough good bacteria), lack of stomach acid secretion, etc). These are assessable and treatable.

Stress can be an associated symptom, and patients will definitely find that stressful periods cause a worsening of symptoms. The gastrointestinal system has an abundance of nerve supply that is termed the enteric nervous system, and this group of nerves is highly sensitive to the balance between the fight-or-flight nervous system and the rest-and-relaxation nervous system (sympathetic vs parasympathetic). An imbalance or maladaptation within this chain of nervous systems can cause poor digestive function, with the result of food sensitivities or digestive deficiencies. Thus, stress management and the assessment of the body’s stress burden may be important.

 

Dr Eric Chan (ND) & Dr Tawnya Ward (ND) approach IBS patients

Depending on information obtained from the history and initial exam, we will recommend additional testing and/or treatment options.

We can use a blood test called ALCAT to monitor the white blood cells of the immune system and their response to foods, and whether their response is normal or over-sensitized. We can use a blood test called ELISA to look for proteins of the immune system directed against foods, thus screening for a large number of potential food triggers.

We can assess the digestive tract and its local environment, checking to ensure that its digestive function is optimal. This involves checking for problems digesting proteins, fats or carbohydrates, whether there is enough stomach acid production, whether the proper bacteria are growing in the small and large intestine, whether there are any yeast or parasite infections causing the disorder, etc.

Depending on what is uncovered as the major causes of the IBS syndrome for one particular patient, treatment is then individualized.

If you or someone you know of suffers from IBS, make an appointment with Dr Chan or Dr Ward to discuss your individual case and what diet, assessment and treatment options may be best for you.

 

 

 

References: IBS Food sensitivity (IgG), Non-Celiac Gluten Sensitivity & Celiac Disease

 

Karakula-Juchnowicz H, Gałęcka M, Rog J, Bartnicka A, Łukaszewicz Z, Krukow P, Morylowska-Topolska J, Skonieczna-Zydecka K, Krajka T, Jonak K, Juchnowicz D. 2018. The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls. Nutrients. 2018 Apr 28;10(5).

 

Aydinlar EI, Dikmen PY, Tiftikci A, Saruc M, Aksu M, Gunsoy HG, Tozun N. 2013. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013 Mar;53(3):514-25.

 

Infantino M, Meacci F, Grossi V, Macchia D, Manfredi M. 2016. Anti-gliadin antibodies in non-celiac gluten sensitivity. Minerva Gastroenterol Dietol.

 

Boettcher E, Crowe SE. 2013. Dietary proteins and functional gastrointestinal disorders. Am J Gastroenterol. 2013 May;108(5):728-36.

 

Sánchez-Vargas LA, Thomas-Dupont P, Torres-Aguilera M, Azamar-Jacome AA, Ramírez-Ceervanes KL, Aedo-Garcés MR, Meixueiro-Daza A, Roesch-Dietlen F, Grube-Pagola P, Vivanco-Cid H, Remes-Troche JM. 2016. Prevalence of celiac disease and related antibodies in patients diagnosed with irritable bowel syndrome according to the Rome III criteria. A case-control study. Neurogastroenterol Motil.

 

 

 

References: IBS & SIBO

 

Ding XW, Liu YX, Fang XC, Liu K, Wei YY, Shan MH. 2017. The relationship between small intestinal bacterial overgrowth and irritable bowel syndrome. Eur Rev Med Pharmacol Sci. 2017 Nov;21(22):5191-5196.

 

Ghoshal UC, Shukla R, Ghoshal U. 2017. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut Liver. 2017 Mar 15;11(2):196-208.

 

Salem AE, Singh R, Ayoub YK, Khairy AM, Mullin GE. 2018. The gut microbiome and irritable bowel syndrome: State of art review.  Arab J Gastroenterol. 2018 Sep;19(3):136-141.