If you've ever been diagnosed with Irritable Bowel Syndrome (IBS), you might have felt frustrated or confused about what it really means. The term IBS is often thrown around without much explanation, leaving many people wondering if it's just a vague diagnosis or a real medical condition. It's estimated that up to 45% of certain populations globally suffer from IBS, making it one of the most common gastrointestinal disorders.1

People are told IBS will never go away, and that it is a condition they will have to manage long-term. The truth is, that many people diagnosed with IBS have a treatable underlying condition causing the symptoms.23

Let's explore the symptoms, causes, diagnosis, and treatment options for IBS that you do not hear from mainstream medical sources. We'll also discuss practical tips for managing its impact on your daily life for lasting relief.

What is IBS?

IBS is a chronic gastrointestinal (GI) disorder that can be debilitating for some people, often lasting for years or even decades. Symptoms can include:

• Abdominal pain or cramping, relieved by a bowel movement
• Bloating and gas
• Diarrhea (IBS-D), constipation (IBS-C), or a combo of both (IBS-M, for mixed)
• Changes in bowel habits
• Urgency to have a bowel movement

A physical examination, routine testing, and procedures like colonoscopy show that everything is normal. There are no underlying anatomical or structural abnormalities that explain the symptoms.4

When IBS patients receive their diagnosis, it is often disappointing because it does not explain why they have this problem. The diagnosis basically states the obvious - you have symptoms of an irritable bowel - how frustrating!

How is IBS Diagnosed?

The Rome IV Criteria was created to classify IBS as a distinct condition. It states that a person has had symptoms for 6 months or longer. But here's the problem - even with an IBS diagnosis based on the Rome Criteria, you still don't have answers as to why you have IBS.

Furthermore, patients may endure invasive and expensive procedures like colonoscopy to rule out more serious problems like Inflammatory Bowel Disease (IBD) or cancer. Lactose intolerance testing, blood testing for conditions like celiac disease, and basic stool testing might be ordered, only to be told nothing is wrong and they have IBS.

For most people, the journey ends there - no further workup.

Conventional diagnostics and the Rome Criteria tell us someone has IBS, but they don't tell us why.

Are IBS and IBD the same?

These acronyms are commonly mixed up - even clinicians can confuse them. IBD is Inflammatory Bowel Disease, an umbrella term for Crohn's Disease, Ulcerative Colitis, and other diseases which can have very serious symptoms and cause damage to the GI tract. While IBS is a serious condition that can ruin a person's quality of life, it's not associated with the extensive GI damage and inflammation that comes with IBD.

What causes IBS?

You may wonder, if no physical abnormalities are detectable, then what's the origin of the IBS pain? What's causing the diarrhea, constipation, or gas?

IBS is grouped under the classification 'disorders of gut-brain interaction' (DGBIs), which means there are changes in the way the brain and gut communicate. This can affect intestinal muscle contractions, and how pain is perceived. People with IBS also have changes in their gut microbiota (dysbiosis) and gut barrier breaches (leaky gut) leading to low-grade inflammation.6

These changes can be linked to several root causes:

• Post infectious IBS, or PI-IBS begins after an infection.7 A common experience is that a patient traveled to another country, had a bout of diarrhea, and has never been the same since. Or they remember eating something at a gathering and everybody got sick. In these cases, the original infection usually clears but it sets off a long-term cascade of factors that result in ongoing damage and IBS symptoms.
• Small intestine bacterial overgrowth, or SIBO is a form of dysbiosis that has been studied as one of the root causes of IBS. Some research shows that up to 78% of patients with IBS might actually have SIBO as the underlying cause!8
• Food intolerances happen when exposure to certain foods have a damaging effect on the intestinal lining and create symptoms. Eliminating these foods improves IBS symptoms.9
• Stress can also be a trigger which may speak to IBS being a DGBI.10 There is a connection between IBS and anxiety, depression, and posttraumatic stress disorder.11 Learn more about the gut-brain axis and its influence on mental health.

Is it IBS or Something Else?

Many IBS patients are fed up with endless suffering and continue searching for answers. There are many other conditions with symptoms that overlap with IBS.

Comprehensive stool testing is not commonly included in standard medical assessments and goes beyond the scope of a typical assessment by examining a variety of markers that explore several functional areas potentially contributing to symptoms. Markers of digestion and absorption, inflammation and immune status, and bacteria, yeast, and parasites can all provide insight into the root cause of symptoms. These are treatable findings that can resolve a patient's condition! In fact, one study showed that more than 80% of tests run on subjects with IBS-like symptoms had potentially treatable conditions that produced the IBS-like symptoms.

Abnormal values suggesting dysbiosis, food allergy, parasite infection, exocrine pancreatic insufficiency, or gastrointestinal inflammation were the most common findings.12

How is IBS Treated?

When the causes for a condition are vague or cannot be identified with conventional testing, it is challenging to know how to treat - many clinicians just end up treating the symptoms. Current conventional treatment options for IBS include soluble fiber, laxatives, antidiarrheals, antibiotics, antidepressants, and other medications.13

Stress management, a food diary, and exercise might also be recommended.14

7 Tips to Help You Find the Root Cause and Heal From IBS

Relief from IBS may be within your reach. Improving gut health with targeted treatments, and diet and lifestyle modification can lead to improved quality of life. If you are searching for causes for your IBS symptoms, consider the following steps:

1 - Consider Testing

There are a few tests that can provide answers to why you have IBS symptoms. All the conditions revealed with this testing are treatable and can result in substantial symptom improvement.

• Comprehensive gut testing: A Gut Health Test involves a stool collection and can provide insights into your gastrointestinal function. Markers like pancreatic elastase 1 can identify exocrine pancreatic insufficiency which can lead to problems digesting your food. Calprotectin can distinguish IBS from IBD. Eosinophil protein X can show if your gut is responding to food allergies. Comprehensive parasite testing may reveal a protozoan infection.15
• SIBO breath testing: A simple SIBO Breath test detects gases produced by overgrown bacteria. Treatment may involve addressing bacterial overgrowth through dietary changes, probiotics, and antimicrobial therapy. Dr. Alison Siebecker is a SIBO expert and has a wealth of information on her website.
• Food sensitivity testing: A bloodspot Food Sensitivity Test can help you identify foods that your immune system may be reacting to that can result in gut symptoms. Studies show that food elimination based on IgG antibody testing reduces IBS symptoms.1617

2 - Keep a Food Diary and Remove Triggering Foods

You might try an elimination diet for 3-6 weeks or longer to identify hidden or unknown food triggers. Common culprits include gluten, dairy, soy, eggs, corn, and artificial additives. Some doctors recommend a low FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet for IBS, which is also a treatment for SIBO.18 The low FODMAPs diet is not a good long-term solution because many of these foods are important for feeding the healthy bacteria in your gut.

3 - Heal Your Gut

Start by removing harmful factors that damage the gut and adding foods that repair it.

• Minimize factors that cause leaky gut like alcohol 19, chronic NSAID use (i.e., aspirin, ibuprofen, etc.)20, Western-type diet (high consumption of red meat, animal fat, high sugar and low fiber food)21, and prolonged and strenuous exercise.2223
• Consume a diet rich in fiber so the good bacteria can produce beneficial short chain fatty acids (SCFAs) that reduce inflammation. SCFAs contribute to the healthy structure and function of the intestinal lining.24 A Gut Health Test measures SCFAs levels - many people have low levels due to the lack of fiber-rich diets. The types of foods that support SCFA levels include whole grains, beans, nuts, seeds, fruits, vegetables, and potatoes.

4 - Consider Supplements

In some cases, supplements may be necessary to address specific gut imbalances or deficiencies, such as digestive enzymes or probiotics. Glutamine is a supplement that heals leaky gut and decreases IBS symptoms.25 It is best to discuss supplements with a practitioner who is well-versed in gut health.

5 - Manage Stress

Chronic stress can trigger IBS.26 Stress disrupts microbiome balance and leads to leaky gut.2728. Incorporate stress-reduction techniques into your daily routine, such as meditation, yoga, deep breathing, or physical activity.

6 - Excercise Regularly

Physical activity can help improve digestion and relieve stress. There are many studies showing improvement in IBS symptoms with exercise.2930

7 - Seek Professional Guidance

If you need help navigating a holistic approach to IBS, consult a healthcare professional, such as a functional medicine practitioner for personalized guidance and treatment options.

Conclusion

IBS is a complex condition with multiple underlying factors. Rather than being a single diagnosis, it has been suggested that IBS should represent an 'umbrella' diagnosis made up of different, treatable conditions.31

While conventional medicine often focuses on symptom management, functional medicine offers a more comprehensive approach that addresses the root causes of IBS. By understanding and addressing factors such as SIBO, food sensitivities, leaky gut, dysbiosis, and stress, root cause medicine aims to provide long-term relief and improve the overall health and well-being of individuals with IBS.

Additional Resources

If you would like to learn more about the difference between IBS and IBD, and Genova's stool inflammatory markers, check out GI Inflammation... What Now? from The Lab Report podcast - a great resource to learn more about functional medicine and addressing the root causes of disease.