Have you ever noticed your belly look so bloated and very gassy right after a meal? Or ever wake up with a flat belly but by the end of the day feel as if your six months pregnant? Or even yet, that rumbling, uncomfortable feeling that makes you rush to the bathroom immediately? Well, it sounds like there could be something going on between your brain and gut barrier. Perhaps a miscommunication between the two, causing abnormal motility and functioning of the colon (large intestine). This is what is known as Irritable Bowel Syndrome or IBS. IBS is considered a chronic functional disorder, and I say functional because it can mean that the problem lies with the way a normal body function is usually carried out. What happens with IBS is that the colon is extremely sensitive and starts to spasm when it gets stimulated when you eat food or are stressed out. It’s also referred as a spastic colon or nervous indigestion (Bauman, 2017). IBS is considered one of the most common gastrointestinal complaints in individuals. When the muscle spasms after eating, food either moves very quickly through the digestive tract causing diarrhea or it can get stuck in the colon causing constipation. This can either cause pain or a lot of discomfort. Yikes! But wait, there’s more to it. When individuals think of IBS, most assume that it only affects your bowels and your stomach, but it actually affects a lot more than just your gut. It can affect the body psychologically and emotionally with a cluster of symptoms such as anxiety, depression, feelings of embarrassment, or feeling extremely fatigued. Other signs and symptoms include:

IBS is a lot more common in individuals that you may think. Statistics show that 60 million people, that’s an estimated 20% have IBS (Hyman, n.d.) It’s also more common in women than in men, usually under the age of 45. IBS is also classified into three categories: diarrhea-dominant (IBS-D or D-IBS), Constipation-dominant (IBS-C or C-IBS), or Alternating conditions: IBS-A, M-IBS if mixed (Bauman, 2017). Individuals with IBS experience a wide range of symptoms, making it very difficult for doctors to treat because the underlying root cause is still unknown. As a result, doctors often mislabel IBS as IBD, lactose intolerance, parasitic infection, bacterial infection, malabsorption, metabolic disorder, endocrine disorder, psychiatric disorder, drug interaction, or intestinal pseudo-obstruction. These conditions can also mimic the symptoms of IBS as well. (Bauman, 2017). This is why it’s often labeled as a misunderstood condition and not to mention, every individual is different. Treatment is usually geared towards a one size fits all approach, not tailored to the bio-individual.

Today, many integrative and functional medicine doctors believe that its related to gut imbalances. Let’s dive a bit deeper into what constitutes the gut. The small and large intestines work together to absorb nutrients and excrete waste. They each have specific additional functions. If one doesn’t function properly, neither will the other. The small intestine plays a huge role in regulating the immune system. The small percentage of the bacteria found in the small intestine play an essential role in digesting the foods we eat, nutrient absorption, protecting against pathogenic microorganisms that are ingested, fighting infection, and maintaining normal muscular activity that creates waves through peristalsis to help move the food ingested through the gut (Bauman, 2017). Because the small intestine houses 60% of the immune system, if the mucosal lining is destroyed from things like stress, NSAID’s, infections, low fiber diet, too much sugar, excessive alcohol use, and other factors, the immune system gets compromised and is exposed to pathogenic microorganisms, which eventually triggers an allergic reaction, irritates the enteric nervous system, causes poor immunity, IBS, inflammation, arthritis, and mood disorders, just to name a few (Hyman, n.d.) The large intestine also known as the colon is also affected. Here is where most our gut flora is housed. Imbalances can cause abnormal elimination, improper storage of food residue and absorption of water, causing dehydration, poor motility, growth of pathogenic bacteria, waste building, just to mention a few, wreaking havoc on the body. Other contributing factors include:

Contributing Factors and Triggers (Bauman, 2017 and Hyman, n.d.)

This is why it’s so important for the gut to be healthy and colonized with beneficial flora.

When your gut bacteria are out of balance, and there are more pathogenic bacteria then there is good, symptoms appear and you get sick. These types of bacteria start to feed on the food you are digesting like sugar and starchy foods, they ferment, multiply, and damage the cells mucosa lining causing small intestinal bacterial overgrowth, aka SIBO, which is a major cause of IBS. The fermentation that the bacteria is doing is what’s causing the gas, bloating, and the bowel disruptions. So how do we address this? There are several assessments and functional testing that can be recommended for the client suffering with IBS. These include food journals, food sensitivity exams, blood work, and other medical diagnostic testing.

WHAT IS THE 4R PROGRAM?

THE 4R PROGRAM FOR IBS GI SUPPORT

Remove the cause of problem: Contributing factors previously discussed, such as food sensitivities and allergens, pathogens, toxins, pharmaceuticals, and stress management.

Replace missing factors: Nutrients, fiber, water, bitters, enzymes, HCL. For IBS, increasing micronutrients that contain Vitamin C, B complex, and magnesium through food sources and therapeutic supplementation if needed. Using ACV, betaine HCl, or taking digestive bitters to increase HCL levels, and enzymes such as Amylase to help break down carbs into simple sugars. Foods that contain enzymes include pineapple, papaya, avocado, kefir, sauerkraut, miso, and ginger.

Re-inoculate beneficial intestinal bacteria with prebiotics and probiotics through food and therapeutic supplementation if needed. Foods rich in prebiotics include Jerusalem artichokes, onions, garlic, asparagus, leeks, bananas, and chicory. Foods that contain probiotics include fermented foods such as sauerkraut, kimchi, miso, tempeh, natto, and pickled veggies. One thing to consider is the condition the person is in because not every individual will tolerate pre and probiotics. Prebiotics are wonderful, but they promote bacterial fermentation which can worsen IBS symptoms. Another thing to consider is that there are different types of probiotics and different strains so it is best to test which probiotic supplement is right for the individual. According to Kresser (2017), individuals who have “SIBO associated IBS often don’t tolerate probiotics containing lactic acid bacteria but do well with a soil-based probiotic…. The key is balancing short term goals, such as symptom alleviation, with the long-term goal of restoring healthy intestinal flora. Prebiotics are an important tool for achieving that goal but will likely be most useful in combination with probiotic, antimicrobials, and other strategies [such as digestive enzymes and HCL].

Repair the GI lining: with demulcent herbs such as aloe Vera, L Glutamine, flaxseeds, green powders, MSM

IMPORTANCE OF DIET

Diet: For those who suffer from IBS, a nutrient dense, whole foods diet high in fiber, free of refined carbohydrates, sugar, artificial sweeteners, hydrogenated oils, processed foods, trans-fats, and stimulants such as caffeine and food additives are recommended. Following the eating for health model by Dr. Ed Bauman is a great guide to get balanced nutrition. It represents a system and not a diet, which promotes high quality foods that are catered to individual needs, tastes, and ethnicities, which also takes into consideration the biochemical individuality of a person along with lifestyle factors (Bauman, 2017). In this case IBS! Within the eating for health model, the eating for health building diet direction is ideal for chronic sufferers to help boost their immune system, provide tissue healing protein and recovery.

To improve gut health adrenal boosting foods that are rich in vitamin C (bell peppers, acerola cherries, rose hip, guavas, thyme, kale, kiwis, lemons), B complex (wild caught salmon, spinach, collards, eggs, legumes, nutritional yeast), B5 (wild caught salmon, sunflower seeds, portabello mushrooms, lentils) and magnesium (spinach, dark chocolate, avocado, almonds, brazil nuts, legumes) are ideal. Bone broth is an excellent food that provides nourishing ingredients that help heal the gut, supports the immune system, fights inflammation, and contains vitamins A, K, and minerals such as calcium, magnesium, and zinc. In addition, raw apple cider vinegar should be included before meals. ACV which helps boost hydrochloric acid levels in the stomach and aid in motility. According to Bauman (2017), diets such as the Specific Carbohydrate Diet and the No-Starch Diet have both been shown to be helpful for individuals who have IBS. Foods that contain gluten, and dairy which can cause allergies should be removed from the persons diet. If an individual is classified with IBS-D, sugar alcohols such as xylitol should also be avoided.

References

Bauman, E., Friedlander, J. (2017). Therapeutic Nutrition. Part 1. Penngove, CA: Bauman College

Hyman, M. n.d. 5 Simple Steps to Cure IBS Without Drugs

https://drhyman.com/blog/2010/09/16/5-simple-steps-to-cure-ibs-without-drugs/

Jade, K. (2017). Melatonin Benefits for IBS sufferers. Retrieved from https://universityhealthnews.com/daily/digestive-health/4-studies-reveal-melatonin-benefits-for-ibs/

Kresser, C. (2017). 5 Ways to Treat IBS without Drugs. Retrieved from

https://kresserinstitute.com/5-ways-treat-ibs-without-drugs/

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