good guts series - IBS or BS?

Written By Greta Leeson

It’s time to talk about IBS, and whether your IBS diagnosis is BS.

Up to one in five Australians will be told they have IBS in their lifetime. But what does this mean?

IBS is a ‘diagnosis’ given to a particular group of gastrointestinal symptoms when no overt cause can be determined by the diagnosing practitioner. Bloating, food and FODMAP sensitivities, diarrhoea, pain, and constipation are common under the IBS umbrella.

But it’s important for us to know that IBS is a syndrome.

This means it’s not an actual, diagnosable ‘disease’ - it’s a collection of signs and symptoms that commonly correlate together (it’s only when symptoms have a definitive cause that they step over into a ‘disease’).

So if you’ve been told you have IBS, you’re essentially being diagnosed with ‘gut ain’t great, don’t know why’ disorder. More technically, it’s labelled as a functional disorder - no visual signs of disease but all the symptoms to make it one - or a ‘diagnosis of exclusion’, for these same reasons.

So, if it’s not a disease, and they don’t know what causes it - what do you do?

The first thing to note is that just because whoever diagnosed you with IBS couldn’t find a reason for your symptoms doesn’t mean there isn’t one - and it’s exactly why our adage is test, assess, treat.

Testing allows us to look deeper into the why of what’s going on with your gut. We may do microbiome testing to see what the composition and diversity of your microbes are doing; breath testing to assess the overgrowth of bacteria in the small bowel - or functional marker testing to see whether there’s latent inflammation or permeability wreaking havoc on your gut.

Common ‘why’s we see in clinic include:

  • SIBO (small intestinal bacterial overgrowth) - where colonic microflora move up to the small bowel and overgrow, fermenting FODMAPs and causing bloating, pain, diarrhoea and constipation

  • Coeliac disease or NCGS (non-coeliac gluten sensitivity) - which changes the motility (movement) of your bowel and may cause nutrient deficiencies and damage to the intestinal lining

  • Intestinal hyperpermeability - the tight-gap junctions in your gut allowing LPS (little molecules) to travel where they shouldn’t (aka, into the blood stream) and wreak havoc, causing inflammation and immune activation

  • Adulterated migrating motor complex - the muscles along your gastrointestinal tract moving slower or faster than they ought

  • Adulterated gut-brain axis - the signals along the superhighway of your nervous system causing changes to your intestinal function (often seen in chronic stress and trauma)

… and the list goes on.

Figuring out exactly why your gut is up to no good can feel like a nigh impossible task - but this is where we step in to take away the false-starts, misinformation, and confusion.

The main thing to note is that there is always room for improvement. Often an IBS diagnosis can leave you feeling hopeless due to lack of conventional recommendations and treatment, but know that you don’t have to live in fear of onions forever.

Feeling overwhelmed? Book in a free discovery call to see how we can help.

Greta Leeson