Why Do I Have IBS?
May 30, 2017
IBS, which affects 11% to 14% of the population, is a puzzling condition with multiple models of pathophysiology including altered motility, visceral hypersensitivity, abnormal brain-gut interaction, autonomic dysfunction, and immune activation.(Lin, 2004)
IBS is recognized as a Functional disorder, not a disease itself. It is a diagnosis of exclusion, whereby 95% of all related GI-specific procedures (endoscopy, colonoscopy) are normal. IBS is considered an umbrella diagnosis, meaning symptoms are produced by a number of underlying factors which lead to poor gut function or ‘dysfunction’.
Why Do I Have IBS?
The exact cause of irritable bowel syndrome (IBS) is unknown, but most experts identify problems with digestion and increased sensitivity of the gut as the underlying dysfunction. In addition, many causes have been suggested, including:
- Poor diet, although none have been proven to directly lead to IBS.
Addressing the Underlying Cause
Identifying and addressing the underlying cause, rather than just managing symptoms, becomes the key to restoring digestive function. These include:
- Dysbiosis and/or SIBO, is a common cause of IBS. In one study, 84% of patients with IBS, were shown to be positive for SIBO using the hydrogen breath test. Of these participants, 74% of them had their symptoms resolved when the SIBO was treated.(Peralta, 2009)
- Low stomach acid (hypochlorhydria), which can stem from H.pylori infection or even from the use of a PPI (proton pump inhibitor)
- Altered activity of the central nervous system may contribute to changes in gastrointestinal motility and sensation. This may be understood as consequences of the
host response to SIBO causing increased sympathetic drive and immune activation (Lin, 2004)
- Structural changes and organ malfunction – inborn alterations or changes from an injury or surgery can alter the digestive tract, which predisposes the gut to poor digestion
and motility, contributing to bloating, gas and constipation, commonly found in IBS.
- Alterations may include the;
o Ileocecal valve patency
o Migrating motor complex dysfunction
o Exocrine pancreatic insufficiency (EPI)
o Bile acid malabsorption
- Stress. There is an interesting connection between the gut and the brain – research shows that communication between the two is bidirectional, whereby the gut can alter the brain
and vice versa. The gut is packed with nerve endings, so much so, that it is referred to as the second brain.
o Stress, worry and anxiety are shown to alter the lining of the gut.
- Infection and other pathogens (mold, parasites, candida) Persistent infections and dysbiosis are shown to cause inflammation of the gut and alter immune function. This
can lead to not only chronic digestive complaints but systemic symptoms as well, such as fatigue, poor concentration, chronic sinusitis, headaches and even poor sleep. Between 7-
30% of those with IBS have their first signs after a bout of gastroenteritis.
o Certain infections, Camphylobacter jejuni, secrete toxins that impair muscle and nerves (within the migrating motor complex) leading to poor motility. This is experienced as ‘sluggish bowels’ or constipation
- Environmental toxins, which are ubiquitous, bombard the system and have been shown to disrupt hormones and the nervous system altering gut function.
- Undigested foods – food intolerances and sensitivities that are undiagnosed commonly cause loose stool, bloating, gas and abdominal pain.
- Prescription drugs – especially antibiotics, which alter the gut microbiome
- Chronic disease may affect gut motility. These may include hypothyroidism, diabetes (diabetic neuropathy) and sclerosis.
How to Restore Gut Function
The key to restoring gut function is to identify the cause. This can be done through a number of tests:
- Stool testing – to rule out IBD, infections, dysbiosis, pancreas dysfunction
- Zonulin – for leaky gut
- Food sensitivity testing – for food allergens
- Breathalyzer test (CH3, H2) – for SIBO
Reach out to us at The IBS Academy to find out more at [email protected]
In best of health,
The IBS Academy
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