Dr Gigi Chow

IBS: One Diagnosis, Many Causes

In Diet, Hormonal Health, Stay Healthy on August 15, 2013 at 6:17 pm

As many as 20 percent of American adults have some symptoms of irritable bowel syndrome (IBS), according to the National Institute of Health. IBS is an umbrella term for a wide range of symptoms that affect the entire digestive system. Sufferers commonly report symptoms such as alternating constipation and diarrhea, painful cramps and spasms, abdominal bloating, nausea, acidity, heartburn or a sensation of fullness very soon after eating even a small meal. For many, trips to the GI doctor, colonoscopies and medications offer little relief to their digestive symptoms because the cause(s) of IBS have not been identified. It is important to look at the potential triggers of IBS since proper identification will lead to greater success in treating this uncomfortable condition.

Stress
The link between emotional states and physical symptoms is well documented and this is particularly apparent with gut problems. There are a multitude of nerve endings in the gut and it is often called the second brain for this reason. Emotional stress, particularly if prolonged, will have negative impact on the gut. Nonetheless, the presence of IBS symptoms is likely to cause stress, depression or anxiety so then the vicious cycle between stress and abdominal symptoms continue. Nutritional supplements, yoga, meditation and acupuncture can all help alleviate and improve the stress response.

Food Intolerance
Intolerance to one or multiple foods can be a factor in IBS. Food intolerance is different from food allergies.  Most people have food intolerances and not food allergies. When you’re allergic to a food, it means that when you eat it, your immune system misidentifies it as dangerous and sends out antibodies to fight off its proteins. You suffer allergic symptoms such as scratchy throat and swollen tongue as a result of the battle between the allergen and the immune system. Meanwhile, if you have food intolerance, your body has trouble digesting the foods. Your inability to break down large food chunks results in unpleasant side effects such as bloating and abdominal pain. It can be frustrating, confusing and time-consuming trying to figure out food intolerances on your own. Getting a food intolerance test to identify your food intolerances may be very helpful.

Leaky Gut
The lining of a healthy gut wall is designed to allow through tiny molecules that we obtain from food digestion. These molecules, such as glucose and amino acids, are used by the body to convert into energy or as building blocks for hormones and muscle cells. However, if the gut becomes damaged or “leaky” and  inflamed, larger than usual food molecules are able to pass through its lining. When these food particles come into contact with the blood, they can provoke an immune reaction. Leaky gut undoubtedly can play a role in IBS. Many supplements can assist in repairing a leaky gut.

Low Stomach Acid
Stomach acid is secreted by the stomach to digest food, especially protein. Stomach acid protects us from parasites and other infections as well as helps with the absorption of minerals such as calcium, magnesium, iron, copper and zinc. Stomach acid may decrease with age and stress. Prescription and over-the-counter medications such as Nexium and Prilosec can also suppress stomach acid. Without enough stomach acid, food is not digested properly and undigested food can sit in your stomach and intestines for a prolonged period of time and lead to bloating and pain.

Intestinal Flora Imbalance
Also known as dysbiosis, gut flora imbalance can result from the use of antibiotics, GI infections from overseas travel, GI surgery, the use of acid-suppressing medications, chronic constipation, chronic mental/emotional stress, the use of oral birth control pills, poor diet, cigarettes/alcohol or food sensitivities/imbalance (please see above). Once the flora is out of balance, undesirable organisms including yeasts and parasites may start to multiply and crowd out the “friendly” bacteria even further.  Bacterial balance can be positively influenced by the right foods and supplements.

Yeast Overgrowth
Normal intestinal flora contains some yeasts but for some people, yeast becomes problematic as it develops into a form which can spread through the gut and elsewhere in the body. Candida albicans is one such yeast and its presence can contribute to a range of physical and mental symptoms including bloating, gas and many other symptoms related to IBS. The presence of candida can be assessed by an elimination diet as well as stool/urine tests.

Parasites
If your stomach has never been the same since traveling abroad, parasite infection could be a factor in your symptoms. A test known as Comprehensive Digestive Stool Analysis (CDSA) can be helpful here because this test can detect hard to find parasites, the presence of candida and incorrect bacterial balance.

Hormonal Imbalance
Lots of women notice that their IBS symptoms are worst just before their periods. Why this occurs is not clear, but it may have to do with the balance of progesterone and estrogen during the second half of the menstrual cycle (that is, from ovulation onward). Progesterone is relatively high at the end of the cycle, then drops off suddenly just before menses. Progesterone in general slows gut motility and many women notice more constipation and abdominal discomfort in the week or two prior to the onset of their menses. It’s possible that when the ratio between these progesterone and estrogen is off and sluggish bowels could in turn worsen pelvic congestion, cramping, and abdominal distention. Salivary hormone testing here can be helpful in determining whether your hormones are in balance and whether an imbalance is a potential cause of IBS symptoms.
Please feel free to contact me via my website if you have any questions or if you would like to schedule a consultation to discuss your IBS symptoms, testing and treatment.

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