In my last blog, I shared with you some background information about what a diagnosis of irritable bowel syndrome, or IBS, means. The symptoms and diagnosis are just the tip of the iceberg. The bottom line is, if you’ve been diagnosed with IBS, you will want to dig deeper in order to find out what is causing your symptoms, and modify the factors you CAN control in order to get your symptoms under control.
I’ve had countless patients go from having daily diarrhea and bloating to having happy bowels that no longer cause them daily anxiety and stress, once we find and treat the cause! This is a very personalized process, as what causes IBS for one person doesn’t necessarily cause it for another. Additionally, many times there is not just one cause, but a combination of factors that must be addressed.
When a patient comes in to see me with IBS, I have a running list of possible causes going through my mind, trying to fit the pieces of the puzzle together for that person as I listen to their particular story. Here are the top 5 causes of IBS that I consider. This list is by no means exhaustive! Working with a naturopathic doctor and ordering the appropriate testing will help you get long-lasting relief for your symptoms!
1) Food Sensitivities
Many patients’ IBS symptoms resolve or significantly improve after we identify specific problematic foods, either through IgG food sensitivity testing, or through an elimination diet. Food sensitivities can cause IBS symptoms since they increase inflammation in the gut and irritate the gut lining. It can be difficult to identify your food sensitivities just by keeping a diet diary, since you can notice digestive symptoms from a food up to 72hrs after eating it! The most common problematic foods tend to be gluten, dairy, eggs, corn, and soy.
2) Small Intestinal Bacterial Overgrowth (SIBO)
Bacteria can overgrow in the small intestine, as a result of many things, including lots of antibiotics, low stomach acid, and a dysfunction in the movement of muscles surrounding the intestines. It’s actually a very common cause of IBS, being present in from 35-80% of IBS cases! If your IBS symptoms come with lots of bloating, you’ve been on strong antibiotics or antacids, and probiotics make you feel worse, it might be a good idea to get tested for SIBO.
3) Lactose Intolerance
Many people figure this one out by trial and error, as drinking a glass of milk makes them run to the washroom within half an hour. However, many people go undiagnosed for years, as the symptoms can be just shrugged off as IBS. There is a test available for this as well, if you’re unsure.
4) Yeast Overgrowth
Just like bacteria can overgrow in the digestive system, so can yeast! Candida albicans is a yeast that is commonly found in the digestive tract in small amounts, but if the opportunity arises, it can overgrow and cause a variety of symptoms that can fall under the umbrella of IBS. The most typical triggers for Candida overgrowth are chronic antibiotic use and/or a diet high in sugar, but there are others, including chronic stress and the use of the birth control pill. If you’re a woman and have IBS symptoms along with frequent vaginal yeast infections, getting tested for Candida overgrowth would be an important step to find out if it’s causing your IBS symptoms.
5) FODMAPs Intolerance
FODMAPs foods are made up certain types of sugars and short chain carbohydrates that can be difficult to digest. The acronym stands for Fermentable-Oligosaccharide-Disaccharide-Monosaccharide-And-Polyols. Unlike food sensitivities that are due to a reaction to the protein portion of a food, in this case, you may be unable to break down and digest the carbohydrate portion of certain foods. Avoiding high FODMAPs foods has been shown to improve IBS symptoms. Sometimes, however, patients cannot tolerate these foods because they already have an overgrowth of certain bacteria or yeast which thrive on these foods and ferment them to create more gas! See how different causes can be related?
There are many other factors which cause or aggravate IBS, including chronic stress, low stomach acid, chronic use of certain analgesics, and a dysfunction in the action of the muscles surrounding your digestive tract (the migrating motor complex).
Do you want to get to the bottom of your IBS symptoms? In the next blog, I’ll be discussing in more detail about what crucial tests you should consider if you’ve been diagnosed with IBS.
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Atkinson, W., Sheldon, T.A., Shaath, N., and P.J. Whorwell. (2003). Food elimination based on IgG antibodies in irritable bowel syndrome: A randomized controlled trial. Gut, 53:1459–1464. http://gut.bmj.com/content/53/10/1459.full.pdf
Dainese R1, Casellas F, Mariné-Barjoan E, Vivinus-Nébot M, Schneider SM, Hébuterne X, Piche T. (2014). Perception of lactose intolerance in irritable bowel syndrome patients. Eur J Gastroenterol Hepatol., 2014 Oct;26(10):1167-7. https://www.ncbi.nlm.nih.gov/pubmed/25089542
Halmos EP1, Power VA2, Shepherd SJ2, Gibson PR3, Muir JG3.(2014). A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology, 2014 Jan;146(1):67-75.e5. https://www.ncbi.nlm.nih.gov/pubmed/24076059
Mann, N.S., and Limoges-Gonzales, M. (2009). The prevalence of small intestinal bacterial overgrowth in irritable bowel syndrome. Hepatogastroenterology, 2009 May-Jun;56(91-92):718-21. https://www.ncbi.nlm.nih.gov/pubmed/19621689
Dr. Tamar Ferreira is a Naturopathic Doctor in Brampton, Ontario. Her areas of focus include digestive health, hormone balance, and skin conditions.