In our modern world, more and more people are suffering with some form of digestive problem. In my own practice as a naturopathic doctor, digestion-related issues definitely fall into the top three complaints my clients have when they first walk in the door. Because there is such a wide variety of underlying issues that could cause a digestive problem, I decided to write this current series of articles on digestive health. We’ll explore some of the most common conditions people struggle with, and look at various holistic approaches for treating them.
We’ll start the series by looking at irritable bowel syndrome – more commonly referred to as IBS. Even though an increasing number of people are being diagnosed with IBS (or have symptoms that make them suspect they may have it), in my experience as a naturopathic doctor, very few understand what IBS actually is. So, in this first article, I am going to explain what IBS really is, some of the potential causes, and why it’s so important to seek treatment. Then, in later articles in this series, we will look at some of the ways to treat this condition.
What Is Irritable Bowel Syndrome?
Many people throw around the term IBS without a clear understanding of what it is. The primary cause for confusion is that IBS isn’t a “disease” but an “umbrella” term for a collection of chronic symptoms that have their origin in the large intestine.
Because symptoms vary so widely from patient to patient, many people can suffer from IBS for years – even decades – without realizing they have the condition. Some may only be diagnosed with IBS after they have reached a crisis point that lands them in the hospital emergency room.
Common Symptoms of IBS
Below is a list of some of the most common symptoms associated with IBS. As you read through them, bear in mind that not all IBS sufferers will experience all these symptoms, AND having one or more of these symptoms does NOT necessarily mean you have IBS:
- Abdominal bloating
- Painful cramping or spasms in the gut or colon
- “Referred” pain (see below)
“Referred pain” means pain that shows up in a different part of the body from its origin. For example, some IBS sufferers experience unexplained back pain, not realizing it is referred pain from the large intestine.
Common Causes of IBS
Putting a label on your symptoms doesn’t tell you why they are happening. In fact, the underlying causes of IBS symptoms are just as varied as the symptoms themselves. Here’s a list of some of the most common ones I see in my naturopathic practice:
- Genetic predisposition
- Food allergies
- Food sensitivities
- Poor overall diet
- “Small intestinal bacterial overgrowth” (SIBO)
- Other physiological causes (e.g. low levels of digestive enzymes in the pancreas)
How to Diagnose IBS
Trying to treat IBS without first diagnosing the underlying cause(s) is like working in the dark, and your efforts to manage your IBS may have no significant positive impact. A list of some of the essential tests for IBS would include:
- Food allergy test
- Food sensitivity panel
- Blood work for Celia Disease
- Complete digestive stool analysis
- Breath test for small intestine bacterial overgrowth test (SIBO)
- Parasite testing
- Ultrasound (for gallstones)
Unfortunately, most medical doctors consider IBS a “diagnosis of exclusion”, meaning they may only diagnose you with IBS once they’ve ruled out things like cancer, ulcerative colitis, polyps, diverticulitis and Crohn’s disease. Many primary care physicians are unaware of all the underlying causes of IBS, and would not necessarily think to order the above tests for you. Some may be unfamiliar with many of the more “alternative” diagnostic tests on this list.
Like any other qualified naturopathic physician, I have been specially trained to look for the underlying cause of any condition. When a patient tells me they have been diagnosed with irritable bowel syndrome, I always perform a thorough and systematic review with them, so we can get to the root cause of their problem and create a healing regime that addresses their specific issues.
Long-Term Consequences of Untreated IBS
Left untreated, long-term IBS can sometimes lead to other serious health issues. One such possibility is an impacted bowel, especially in cases where the IBS symptoms include chronic constipation. An impacted bowel occurs when stool builds up in the large intestine. It is extremely painful and can cause other complications such as intestinal tearing, hemorrhoids and bleeding.
Diverticulosis (and subsequent diverticulitis) is another complication that can occur from IBS. Diverticulosis refers to a condition where there is a pouch or distortion of the large intestine; diverticulitis is the subsequent infection that can be caused by this distortion. When diverticulosis/diverticulitis causes severe damage to the intestinal tissue, it is sometimes necessary to have a portion of the large intestine surgically removed.
Another potential complication of untreated IBS is bowel perforation. This is when the large intestine tears and leaks bacteria into the abdominal cavity. If not treated rapidly, bowel perforation can cause death due to sepsis from a bacterial infection.
The Frustration of IBS Not Being Taken Seriously
The physical challenges of IBS are difficult enough, but it can also be the source of great frustration when other people seem to “brush it off” as something insignificant. Friends, colleagues and family members who have never experienced IBS may think it is no more than an upset stomach or a mild case of diarrhea. They might even say things like, “Oh, I get IBS sometimes too,” not realizing IBS is a chronic and often debilitating condition that can greatly limit your life, work and mood.
Even doctors will sometimes underplay the seriousness of IBS. As they don’t consider IBS to be a life-threatening condition (such as cancer, for example), they may dismiss it without giving proper care or advice. And, as mentioned earlier, if they don’t consider a patient’s symptoms to be a cause for concern, they may neglect to perform a thorough assessment or order the appropriate tests to determine the underlying causes of the patient’s condition.
IBS is often a debilitating condition that profoundly affects one’s quality of life. And yet, many physicians will nonchalantly dismiss it as a “sensitive stomach”. That’s why it is so important for patients to be educated about IBS – what it is, what causes it and how to be tested so you can create an effective treatment program for it. Your best bet is to work with an experienced naturopathic doctor who is trained to test, diagnose and treat IBS and related gut conditions.
The subject of treatment regimens for IBS is a big topic. That’s why we’ll be looking at different treatment options in detail in the next few articles in this series on digestive health. Next time, we’ll look at SIBO – small intestinal bacterial overgrowth. Please be sure to subscribe to this blog so you can receive the entire series. You’ll find the subscription form at the top-right side of your screen.
Also, if you or someone you know struggles with IBS or other digestive symptoms, I invite you to drop me a line on the “contact us” page on this site and request a free initial consultation to discuss your needs. I treat patients locally at my practice in Issaquah, Washington, and worldwide via phone or Skype.