Four underlying conditions that may be causing your IBS

By Christine Bowen / Special to The Herald

Irritable bowel syndrome is nothing to laugh about.

IBS is a very common condition with life-altering effects. I have personally experienced the daily pain, urgent bathroom trips and inability to eat without getting sick. I know the misery that IBS can create.

If you have seen doctors who have suggested that having IBS is a long-term condition that you will just have to learn to live with, know that there are treatable underlying causes of IBS. The key to irritable bowel syndrome recovery is understanding what has caused it and then addressing those underlying causes.

IBS defined

The definition of IBS, according to the Rome Foundation, is “recurrent abdominal pain on average at least one day/week in the last three months, associated with two or more of the following criteria: related to defecation, associated with a change in frequency of stool, associated with a change in form (appearance) of stool.”

There are four IBS subtypes.

IBS-D: More than 25% of BMs are loose or diarrhea type and less than 25% of BMs are hard or constipated type.

IBS-C: More than 25% of BMs are hard or constipated type and less than 25% of BMs are loose or diarrhea type.

IBS-Mixed: More than 25% of BMs are loose or diarrhea type and more than 25% of BMs are hard or constipated type.

IBS-U: Undifferentiated type applies to people with IBS with a BM pattern that doesn’t match any of the above parameters.

Common causes

IBS is not all in your head. Yes, IBS symptoms might get better or worse depending on the stress or traumas that we experience in our lives, but stress alone is not the only cause of IBS. Out of the thousands of clients I have seen with IBS, there have only been two people who truly had only stress-induced IBS without other underlying conditions.

When I received my IBS diagnosis, I was told that I needed to reduce my stress. Despite quitting my job, my symptoms persisted. I was told to eat more fiber, which made my symptoms much worse. I was told to take probiotics and eat fermented foods — and those also made me sicker.

The common IBS treatments (medications, fiber) are not effective for everyone. If you are among the 10% to 15% of people with IBS who have tried and been unsuccessful in getting relief with these treatments, then I sincerely hope that understanding these common underlying causes of IBS will help you get the relief you are seeking. I will discuss each of these conditions in greater detail in the months to come, but here is an overview of each to get started.

Post-infectious IBS: If you have had intestinal infections (viral, bacterial, protozoal, or parasitic), foodborne illness or “traveler’s diarrhea,” and then you noticed that your symptoms started after this infection — it is not a coincidence!

When you have this type of infection, it can injure or change the function of your bowel and will likely also alter your microbiome (the bugs and their DNA that reside in your gut). Once you get an intestinal infection, it puts you at higher risk of getting future infections or even going on to develop other conditions like IBS, diarrhea, constipation, gas and bloating, reflux, heartburn, dyspepsia, small intestine bacterial overgrowth or even autoimmune disease.

SIBO: Small intestine bacterial overgrowth is a common underlying cause of IBS. Up to 60%, and likley more, of IBS cases are actually caused by this condition. Microbes from the large intestine sneak back up into the small intestine and start creating fermentation in the small intestine, which can cause diarrhea, constipation, abdominal pain, gas, bloating and many other uncomfortable symptoms. SIBO can be caused by many underlying conditions, including post-infectious IBS.

If you suspect that you have this condition, you may want to work with a naturopathic doctor to get a SIBO breath test. Some local gastroenterology groups may even offer this testing, but they are few and far between.

Food allergies and sesitivities: Some foods are common causes and/or contributing factors to experiencing IBS symptoms. You may want to get tested for IgE food allergens first with your primary care physician or asthma and allergy specialist. If that testing is unrevealing, consider doing an IgG food sensitivity panel with a naturopathic doctor. Identifying and eliminating these allergens could better help you to understand which foods trigger symptoms and help you to avoid those in your diet.

Dybiosis: This is an imbalance of the “good” and “bad” microbes in your intestines. When the gut bugs are out of balance, IBS-type symptoms or even food intolerances can develop. A three-day stool test with a naturopathic doctor or other holistic provider can help you to understand what is and is not in balance in your gut.

Getting tested

Intestinal infections are a commonly overlooked cause of IBS symptoms. If you have had a single stool test ordered by your doctor or gastroenterologist, they usually only look for the same five infections or signs of blood or inflammation.

I find that a three-day stool test that tests for normal bugs, overgrown bug populations or bugs that are lesser-known infections can be incredibly helpful in understanding why your gut is out of balance. Then you should work with a naturopathic doctor to resolve these infections or overgrowths accordingly.

Digestive imbalance can interfere with our lives! If you’re stuck in a restaurant bathroom while you’re on a date, have fear of eating certain foods, or have had to stop traveling because of your symptoms, know that these miserable or embarrassing experiences don’t define you and can easily be addressed. Correcting your imbalanced digestive tract can offer you freedom from being chained to the toilet or being afraid to eat certain foods.

The take-home message is that IBS has a number of underlying causes and that with the appropriate tests and treatments, you can completely resolve your battle with IBS. Don’t suffer needlessly and don’t blame yourself or your stress for creating this condition. Getting the appropriate treatment can help you get back to the important business of living your fullest life, instead of spending your life being ruled by your gut!

Dr. Christine Bowen of Everett is a licensed naturopathic doctor, keynote speaker and has been published in the Townsend Letter. In practice since 2005, Bowen specializes in holistic approaches for digestive health and autoimmunity. Go to www.bothellnaturalhealth.com for more information. Connect with her via Facebook drchristinebowen or Instagram @drchristinebowen.