4 min|Rhiannon Lockhart

Taking A Holistic Approach To Irritable Bowel Syndrome (IBS)

Health, Gut Health

Approximately 18 percent of Canadians experience irritable bowel syndrome (IBS), and 70 percent feel that their symptoms interfere with daily life, some of whom miss work and school. (1)

There are four subcategories of IBS (2):

IBS-D: mostly diarrhea and abdominal discomfort
IBC-C: mostly constipation and abdominal discomfort
IBS-mixed: alternating constipation and loose stool with abdominal discomfort
IBS-U: Undefined with varying symptoms

There are no tests or imaging used to diagnose IBS. However, there are classic symptoms medical professionals will use to diagnose IBS including: (2)(3)

Pain or discomfort in the lower abdomen including cramping or abdominal pain
Frequent or urgent diarrhea or constipation
Bloating
Gas
Mucus in stool
Urgency
Incomplete evacuation

Symptoms may vary and may not be persistent, although some people experience IBS symptoms for extended periods of time. Note: IBS differs from Inflammatory Bowel Disease (IBD). Although there are crossover symptoms, IBD will cause harm to intestines via inflammation and includes symptoms such as rectal bleeding, weight loss, fever, malnutrition.

While obtaining a diagnosis of IBS can feel validating, many people will be frustrated by the lack of guidance in treating their symptoms. This is because IBS can feel like a blanket diagnosis that does not look to the root cause.

As we learn more about the gut microbiome, we can make more connections to the root of many cases of IBS to manage and reduce symptoms.

Common Causes IBS:

1. Post-infectious IBS:

It is understood that about 10 percent of cases of IBS in Canada are a result of an acute enteric infection. (4) This means that there was no history of gastrointestinal symptoms prior to the introduction of a pathogenic bacteria. Irritable Bowel Syndrome can develop from this due to underlying and persistent subclinical inflammation, and alterations to intestinal permeability and gut flora.

2. Digestive abnormalities:

Digestive abnormalities like bile acid malabsorption can be essential to maintain proper balance of the gut microbiota, as well as balance glucose and lipid metabolism. (5)

3. Motility issues:

Motility refers to how fast our food travels through our intestinal tract. In those with IBS, it is often too fast or too slow. Slow motility often results in gas and constipation. Fast motility often results in looser stools or undigested food in stools. In both cases, there can be environmental, lifestyle and dietary factors that influence this.

4. Small Intestinal Bacterial Overgrowth:

Small intestinal bacterial overgrowth (SIBO) is a common reason people experience IBS as prevalence is significantly increased compared to controls. (6) (7)

Learn more about SIBO and IBS here.

5. Food sensitivity:

Many people experiencing symptoms of IBS can benefit with dietary changes, whether short or long-term. Common food food triggers for IBS are high-FODMAP foods and gluten or wheat containing foods as there is overlap in IBS and non-celiac gluten sensitivity (8)(9)

6. Trauma:

Both physical and mental trauma have been correlated with IBS – this can include anything from a natural disaster to mental abuse. (10) IBS and mental health have a two-way relationship. High degrees of stress and anxiety, from trauma or high levels of stress, can trigger IBS symptoms. And, as symptoms of IBS can impact a person’s daily life, many of those with IBS will then experience anxiety and depression around their syndrome.

The holistic approach to managing IBS

The first step to managing your IBS is to understand what may be the root of your issue. In some cases, using herbs or prescription medication can make a world of difference, while others need support from a trauma-informed counsellor.

Whatever the root may be, working with a naturopathic doctor who can support your body as a whole is your best approach to minimize symptoms.