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“I have irritable bowel syndrome. What do I do about it? What causes it? How do I fix my leaky gut? Do I take drugs?”
Irritable bowel syndrome is a huge problem that affects almost 50 million Americans or almost one of every six people.
It’s one of the most common reasons for visits to the doctor, and yet, most doctors have no clue how to treat it or what’s really causing it.
That’s where functional medicine comes in.
Functional medicine is a not a new treatment or test or modality. It’s a whole new way of thinking about solving the puzzle of chronic symptoms and diseases.
Irritable bowel syndrome is a fantastic model for illustrating how functional medicine works.
So, what is irritable bowel syndrome, or IBS, anyway?
Irritable bowel syndrome is what doctors call symptoms of bloating or gas, distention, constipation, diarrhea, cramping—where your bowel is just irritable. When you look in there during a colonoscopy, you don’t really see anything. It looks normal.
There is no structural problem, no tumor or obvious cause. The root problem is dysfunction of your gut ecosystem. Most doctors often suggest eating more fiber or taking Metamucil. That’s generally not very effective.
IBS causes needless misery for millions of people.
But it is fixable!
The causes of irritable bowel syndrome
In functional medicine, we know that one disease can have many causes (or that one cause can create many diseases—think gluten).
If you have five people with IBS, the causes may be quite different for each person. In functional medicine, we focus on getting to the root cause of disease.
There are really only five causes of all disease: allergens, microbes or imbalance of the bugs in your gut, toxins, poor diet, and stress. All of these can trigger symptoms and create thousands of diseases.
Remember those five people with irritable bowel? Each one of them may have different causes for the exact same symptoms.
Let’s go through the causes of IBS and look at what you can do to get rid of it once and for all. It’s extraordinary how simple it is once we know the right thing to do.
There’s a funny joke I always tell about how important it is to know what to do. This patient got his appendix out and the doctor sends him a bill for $1,000, and the patient goes, “Wow! That’s lot of money for such a simple operation.”
The doctor is like, “You’re right.” And he sends him another bill: $1 for taking out your appendix, $999 for knowing what needs to be taken out.
Functional medicine is sort of like that. We know exactly what to do and how to take things out. We treat the system not the symptoms.
Food allergens or sensitivities
The first thing that can happen is that foods can irritate your bowel and digestive system.
They are called food sensitivities. It’s not a true allergy like a peanut allergy or shellfish allergy, but it’s a more mild food sensitivity. But it can cause terrible symptoms, and they are very common.
The most common thing in food that people react to is gluten. That’s the protein found in wheat, barley, rye, oats, and spelt.
It’s a very common reaction even if you don’t have celiac disease, which is a full-blown reaction to gluten. Even if your doctor tells you your tests for gluten antibodies or celiac are normal, you can still have a severe reaction.
Dairy, another big problem. This can be caused by the lactose, which about 75 percent of people can’t digest.
It causes bloating, gas, and diarrhea. But dairy can also create problems even if you don’t have lactose intolerance. Lactaid milk helps with lactose intolerance but not other dairy reactions.
Dairy contains proteins (like casein and whey) that also can cause irritation and inflammation in your gut.
There are many, many other foods people can react to, including soy, corn and eggs.
In my book, The UltraSimple Diet, I’ve created a comprehensive elimination diet to get rid of all the most common problem foods for one week.
It allows you to connect the dots and learn whether what you are eating is causing your symptoms. Most people don’t connect those dots very well.
There are also some tests available that you can use to assess food sensitivities and gluten reactions. Check out the “How to Work with Your Doctor to Get What You Need” guide for more information. It’s a great resource to help you figure out what tests you need, and it’s free!
Bad bugs in the gut
The second cause of IBS is imbalances in your gut ecosystem. You have enormous ecosystem of bugs in there—500 species of bugs. There are one hundred trillion bacterial cells in there.
There are 10 times as many bacterial cells as your own cells. You are only 10 percent human!
In fact, there is a hundred times as much bacterial DNA in you as your own DNA. So, you are only really 10% human! And these bugs have to be in balance for you to be healthy. We call this the human microbiome.
If you have bad bugs growing in there or an overgrowth of yeast, or if you have parasites or worms, you can get IBS.
Also, if you have bugs in the wrong spot, you can have a problem. Most of the bacteria are in your large intestine, but sometimes, they kind of move up and go into the small intestine. That’s not very good, because that should be sterile.
When you eat food that’s starchy—bread, cereal, pasta, rice, or sugary foods—the bacteria ferment the sugars in the food. It’s like the way apple cider blows up in the plastic container in your fridge when it goes bad. That’s what happens in your gut.
The bacteria ferment the sugars in the food you eat, and you blow up. That’s why you get bloating right after meals. We call that postprandial bloating or bloating after you eat or what one of my patients calls a “food baby.”
That’s a very common symptom of bacterial overgrowth. We call that SIBO, small intestinal bacterial overgrowth. It’s very common and a very easy thing to treat if you use the right modality. Most doctors never diagnose or treat this properly.
Yeast overgrowth is also common in your gut. It’s sort of like a garden where the weeds take over. Yeast overgrowth happens because of taking antibiotics, steroids, birth control pills, or acid-blocking drugs.
It also occurs if you eat a lot of sugar, drink alcohol, or you are diabetic.
All these things tend to cause overgrowth of yeast, and that can be treated with an antifungal, such as Diflucan, Nystatin or Sporanox. Antifungal herbs, such as oregano, can also be effective to reboot your gut.
I’m not a big fan of medication, but sometimes for irritable bowel, a good non-absorbed antibiotic called Xifaxan will clear out the SIBO (bacterial overgrowth) and stop bloating and diarrhea.
Using the Xifaxin and an antifungal is almost like hitting the reset button on your computer; you reboot your gut and then you start over.
Other bugs can also be a problem. Stool testing may be needed to identify parasites or worms.
Do you have enough of the good bacteria? Do you have worms or parasites or yeast or other bad bugs?
You can often treat these things based on symptoms or your medical history and then test if you don’t get better. The key is to reboot your gut by getting rid of the bad stuff and putting in the good stuff.
How to heal your gut
How do you heal your gut? First we remove the bad stuff (bad bugs, yeast, parasites, worms, food sensitivities). We replace the things that that are missing (enzymes, prebiotics from fiber). We re-inoculate with healthy bacteria (probiotics), and we repair the gut with the right nutrients.
We talked about getting rid of the bad stuff (bugs and food sensitivities).
Now, we have to add in the good stuff.
Replace digestive enzymes to help break down the food while your gut is healing. You may need those for two or three months.
Then, you need to re-inoculate your gut with healthy bacteria using probiotics including Bifidobacteria, Lactobacillus, and other strains of bacteria. They help to repopulate the healthy gut flora and allow your digestion to work better.
You can also eat probiotic-rich foods like kimchi, kombucha, miso, or sauerkraut. Sometimes, you can also eat yogurt if you are not allergic to dairy. Try unsweetened sheep or goat yogurt. These are all foods that help your gut flora get and stay healthy.
Vitamin A, zinc, omega-3 fats (fish oil), evening primrose oil, and glutamine all help repair the gut. We also use herbs like quercetin and turmeric to reduce inflammation and heal a leaky gut.
When your gut is “leaky,” food proteins and microbial proteins leak into your bloodstream, causing inflammation.
A leaky gut occurs when the gut lining is interrupted. Normally, your intestinal cells are stuck together like Legos.
But when they come apart or separate, food proteins and bacteria leak in and they start pissing off your immune system. This triggers inflammation.
Not only will you have irritable bowel but a leaky gut can also cause joint pain, fatigue, cognitive problems, depression, allergies, congestion, and rashes like eczema.
You name it; many symptoms and diseases are caused by leaky gut.
In Functional medicine, the gut is one of the most important systems to focus on and to get working well, because that’s the seat of your health. It’s connected to everything else.
Do an elimination diet to get rid of common food sensitivities. Get rid of dairy, gluten, and sugar. Try The UltraSimple Diet for two to three weeks. If you find you are better, then you may want to stay off the trigger foods long term.
Try herbs for cleaning out bad bacteria or yeast.
Consider testing for food sensitivities and for stool issues (see How To Work With Your Doctor to Get What You Need.) Consider Cryex 3 testing for gluten sensitivity when conventional tests for gluten are negative.
Add digestive enzymes for two to four months. Take two capsules with each meal.
Add probiotics. Use high potency probiotics.
Add nutrients for healing a leaky gut. These can be taken in a shake or as separate supplements. I recommend for my patients UltraInflamX (rice protein, turmeric, ginger, quercetin, zinc, and nutrients), two scoops a day as a shake, plus G.I. Integrity (glutamine), four capsules twice a day, and fish oil OmegaGenics 720, two capsules twice a day.
If you are constipated (not having one or two normal bowel movements a day) take magnesium citrate capsules 150 to 300 mg once or twice a day. If you take too much you will get loose stools so just take less.
By following this approach, most people can heal their irritable bowel.
If you are not getting better, you may need medical help.
You may need treatment for SIBO or bacterial overgrowth. I recommend Xifaxin (a non-absorbed antibiotic), 550mg twice a day for 10 days, and Diflucan, 100mg a day for three to four weeks to kill the yeast. Sometimes treatment for parasites or worms is needed based on the testing.
This post has been adapted from the original.
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Ed: Bryonie Wise