An Integrative Approach to Irritable Bowel Syndrome (IBS)
An Integrative Approach to Irritable Bowel Syndrome (IBS)
Lizzy always remembers having a “sensitive stomach” that went along with constant changes in her bowel habits. She could never put her finger on what would cause these changes: diet, stress, travel, etc. She started seeing different doctors in her early 20’s, had countless tests and procedures done to try and figure it out. Lizzy was finally given a diagnosis of irritable bowel syndrome (IBS). She was somewhat relieved there was nothing seriously wrong with her but was then told there wasn’t much that could be done for her IBS diagnosis. Trial of a probiotic, fiber, and Imodium were offered for symptom management and minimal benefit was achieved. Lizzy continues to be a picky eater with frequent “stomach issues” that flare intermittently for no obvious reason. People like Lizzy need to know that WE HAVE MORE TO OFFER FOR IBS!
Irritable bowel syndrome is a common condition affecting about 15% of the American population. The cause of IBS is somewhat of a mystery to the healthcare community because unlike other diseases it can’t be seen on an x-ray, during a colonoscopy, or through laboratory testing. It will be diagnosed when all other conditions have been ruled out and has two main criteria: abdominal pain and changes in bowel habits including diarrhea, constipation, or going between the two; all of which need to be present for greater than six months.
Each individual case of IBS will be different and there are MANY treatment options to address these differences. Patients may appreciate dietary triggers, a disruption in the gut microbiome, or that stress and anxiety make their symptoms worse; or it may be a combination of these factors. Our team can help figure out the best strategy for you. Below is a closer look into the strategies addressing these triggers.
- Dietary. Foods that are high in certain types of fermentable carbohydrates or high FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) foods can be quite triggering. Implementing a low FODMAP diet can reduce symptoms significantly. The diet is two phases, an elimination phase and reintroduction. The guidance of someone trained in the diet is highly recommended because it can be overwhelming. The goal is not to live on this restricted diet plan but to find specific triggers and actually have the most diverse diet as possible.
- Gut Microbiome. As mentioned in previous blogs, the gut microbiome is a complex system comprised of trillions of microorganisms. There are various reasons the gut microbiome may become imbalanced; exposure to antibiotics, an unhealthy diet that is low in fiber, and stress can all contribute. Rebuilding the gut microbiome takes time but can be supported using a probiotic and incorporating prebiotics (the food for the good gut bacteria).
- Mind-gut Connection. The gut has been considered by some to be the body’s second brain. This gut-brain axis is a channeling system of communication with signaling happening through the vagus nerve. According to Dr. Emeran Mayer, author of The-Mind Gut Connection, “the healthier your mental state, the healthier the messages to the gut, and vice versa.” At least 80% of your body’s serotonin is produced in the gut, most people know it as your happy hormone, but it is responsible for several other functions as well. Serotonin in the gut is also responsible for peristalsis and pain sensitivity. As one could imagine when this channeling system gets disturbed by bad bacteria your mental health could take a downward turn. Thankfully there are therapies to address this disturbed mind-gut connection including gut-directed hypnotherapy, cognitive behavioral therapy, diaphragmatic breathing, and meditation.
We love the idea of individuals making changes to prevent triggers and get at the root cause of their IBS symptoms. However, sometimes it is very helpful to pair this effort with some of the wonderful new pharmaceutical options available to help reduce the frequency and intensity of symptoms. If rifaximin, amitiza, linzess, trulance, cholestyramine, nortriptyline, and viberzi don’t sound familiar, these are just some of the medications that can be wonderful complimentary options.
If you have IBS and have felt like Lizzy, please come meet with our team of experts that include a gastroenterologist, nurse practitioner, dietitian, and behavioral coach/counselor. We are eager to help you navigate these options. We will work with you to develop the best treatment plan for YOU and what YOUR needs are. Please call 224.407.4400 or visit www.compgihealth.com to make an appointment.