Irritable Bowel Syndrome aka IBS is easily one of the most common presenting “conditions” I see in clinic and the most common gastrointestinal complaint seen by GPs. Those that have either seen me as a patient or have heard me speak about it, know that I think it is not a diagnosis, it is blanket diagnosis for someone that has a list of common symptoms that don’t reveal anything through investigations such as blood work, endoscopy and/or colonoscopy.
It is not a diagnosis. There is a reason you have the symptoms you do and just because there are no visible markers to be seen, it doesn’t mean you should be put in the too hard basket and sent on your way with a referral to a dietician and a list of low FODMAP foods to follow.
A low FODMAP diet is the number one treatment for “IBS”, so let’s talk about why it works (and more importantly why your symptoms return when you stop).
The FODMAP Diet
FODMAP stands for fermentable oligosaccharides disaccharides monosaccharides and polyols which are short chain carbohydrates that are typically poorly absorbed in the small intestine and then passed through to the large bowel (or colon) where they ferment and absorb water.
What happens when things ferment? They produce gas. What is the result of gas in the intestines? Bloating. This is where I like to use the analogy of a balloon blowing up – the intestine is only one cell thick, so think of it like a balloon. When you blow up a balloon, the rubber stretches to the point that it becomes incredibly thin, and nearly bursts. (If we blow it up too much it does). OUCH! So therefore, when we remove these foods, the fermenting disappears and so does then the bloating.
The removal of these foods, also often helps to reduce the other symptoms of “IBS” such as:
Constipation and/or diarrhoea
Excessive (often smelly) gas
The reason that the symptoms typically resolve with the low FODMAP diet is largely because it removes all fermentable fibres (or prebiotics) aka food for bacteria. And often, it is an imbalance of good and bad bacteria (dysbiosis) that leads to the majority of “IBS” like symptoms. So eating foods that are good for our beneficial bacteria, are not only feeding the good guys, but are also feeding the bad guys.
But what happens when the good bugs need food too?
By removing all FODMAP foods, the bad guys lose their fuel source and more often than not you feel much better, The unfortunate thing is that by being on a FODMAP diet (either short or long-term), we are continuously starving not only the bad bugs, but also the good bugs which have pretty significant roles to play in our overall health. Think immune function, mental health, hormones, metabolism, reproduction, sleep and more!
Despite what you may have been told, following a low FODMAP diet for more than 6 months being ok is misleading information and can lead to many more long-term health consequences - purely because the good bugs which are maintaining our overall health, don't have any food!
So what are the leading causes of “IBS”?
Small intestinal bacterial overgrowth (SIBO)
Hormonal Imbalances/conditions (particularly endometriosis)
Low stomach acid and poor digestive function
Food poisoning or travel bugs
When it comes to “IBS”, it is important to take the time to thoroughly investigate the root causes which is what will ultimately give you long-term relief and resolution.
If you’re over the bloat and other symptoms, there are various functional tests that we can do such as a GI-Map which gives you an individualised blueprint of your gut and a detailed breakdown of what you have living inside of you; the good, the bad and the sometimes a little confronting!
So, if you have been diagnosed with “IBS” and you’re struggling to find your answers, just know that they are out there and functional medicine is here to help you find them.
Book your free 15 minute discovery call today https://www.vitalaspects.com.au/copy-of-book-online
As Hippocrates said over 2000 years ago, “All disease begins in the gut”.