Do you suffer from IBS - irritable bowel syndrome?

If so, would you like to know more about the potential triggers behind your IBS symptoms?

Symptoms that many people say affect their mood, diet and lifestyle.

What is IBS

First, IBS (Irritable Bowel Syndrome) is the catch-all diagnosis that is given to those who are experiencing gastro-intestinal (GI) symptoms, usually chronic, that are not being caused by a known GI condition or disease.

IBS symptoms include, but are not limited to:

• abdominal pain
• bloating
• nausea
• constipation
• diarrhoea or alternating bowel movements
• heartburn

Sadly, many people suffer IBS symptoms in silence and resolve themselves to accept it as something they have to live with.

If this is you, trust me when I say, there are many ways to improve your gut health, but first it's crucial to work out what’s really causing your IBS symptoms.

Irritable Bowel Syndrome: 4 Common Causes of IBS Symptoms

Your digestive system relies on many processes to take place in a seamless and timely fashion.

Disruption to this chain of digestive events (whatever the nature), or the ecosystem living in your gut, can trigger IBS symptoms.

So what can go wrong?

1. Insufficient Gastric Juices (Digestive Enzymes, Stomach Acid & Bile)

The main digestive enzymes, Amylase, Protease and Lipase to help you digest carbohydrates, proteins and fats, are produced in the pancreas and small intestine, with small amounts from your salivary glands and the stomach.

There can be any number of reasons why your digestive enzymes may be low. One of which is age. As our production of digestive enzymes falls, our ability to fully breakdown food lessens.

Excessive gas, pain and bloating in the intestines can be due to inadequate protein digestion (causing some foods to ferment), or an inability to break down sugar and carbohydrates fully.

When food isn’t broken down properly, the formation of gas from undigested food particles will occur. Functional GI conditions like Small Intestine Bacterial Overgrowth (SIBO) and Leaky Gut Syndrome can also impact enzyme production in the intestine through inflammation and damaged cells.

Your stomach acid - hydrochloric acid (HCL) needs to be at the correct acidity level to digest your food properly.

If your pH levels are too high (alkaline) or too low (too acidic) your digestion will suffer.

Low levels of stomach acid can result in undigested food particles in your stools, gas and bloating, as well as overgrowths of unhealthy bacteria and yeast, like candida. All of which are causes of IBS symptoms.

Bile has a similar impact on digestion to enzymes and stomach acid.

If the gallbladder becomes clogged with stones or bile becomes too thick, you may experience extremely uncomfortable bloating and poor fat metabolism.

Floating stools are a sign that you’re not metabolising fat well, which is often caused by SIBO.

2. Gut Dysbiosis (Imbalanced Gut Microbiome)

100 trillion bacteria live inside us, forming an internal world known as “The Microbiome”.

There are over 1000 different species living within the microbiome and each can have an impact on our health.

In fact, so important is the microbiome, scientists believe it is not possible to be healthy without healthy gut flora.

In the digestive tract, there are trillions of healthy and unhealthy bacteria that compete, and when “bad bacteria” outweigh the good for one reason or another, an imbalance can trigger IBS symptoms. like abdominal pain, diarrhoea, constipation, bloating and excessive gas.

The microbiome in your gut consists of different bacteria, fungi and viruses.

They form the majority of your immune system, acting as a line of defence to protect you from invading microbes - the bad guys like parasites and bacterial pathogens.

Your microbiome is also fundamental to your digestion, breakdown of food and your absorption of nutrients.

That’s why probiotics are hugely popular. But of course it’s important to be taking the right strains to support your own personal ecosystem and gut health.

Lifestyle, diet and environmental factors can contribute to gut dysbiosis:

Other ways to wipe out your healthy gut microbes are through lifestyle and environmental factors such as stress, smoking and eating a highly processed diet with little fibre.

Often what also happens, I see this with new patients all the time - they’re on such a restricted diet in order to control their IBS symptoms.

While it's giving them symptom relief it’s also contributing to a decline in the diversity of their microbiome and the healthy bacteria residing in their gut.

This is why it’s important to seek help to overcome your IBS symptoms.

3. Small Intestine Bacterial Overgrowth (SIBO)

You may not have heard of Small Intestinal Bacterial Overgrowth (SIBO) before but IBS symptoms can be triggered by SIBO too.

SIBO is more prevalent than previously believed, and it occurs in many people suffering from IBS and certain other underlying conditions.

It’s described as excessive bacteria in the small intestine, or small bowel (1)

While bacteria naturally occur throughout the digestive tract, in a healthy digestive system, the small intestine has relatively low levels of bacteria, as it’s supposed to be at highest concentrations in the colon.

When in proper balance, the bacteria in the colon helps digest foods and the body absorbs essential nutrients.

However, when bacteria invade and take over the small intestine, it can lead to poor nutrient absorption, vitamin deficiency, symptoms commonly associated with IBS, and may even lead to damage of the stomach lining.

As food passes through the small intestine, the bacterial overgrowth interferes with the healthy digestive and absorption process.

The bacterium associated with SIBO actually consumes some of the foods and nutrients, leading to unpleasant SIBO symptoms, including gas, bloating, pain, and potentially diarrhoea and constipation.

There can be several causes of SIBO - low stomach acid, altered gut motor function, visceral hypersensitivity, antibiotic use, proton pump inhibitor or anti-acid medications, impaired immune function and post-surgical or post-injury abdominal adhesions.

So treating SIBO effectively means addressing the root cause(s).

The most common symptoms of SIBO include gas and bloating after meals, burping or reflux, chronic diarrhoea or constipation, or an alternating of both, and abdominal discomfort or pain.

4. Candida Overgrowth 

Candida is a fungus, which is a form of yeast. It is normal, and even beneficial, to have small amounts of candida.

Your immune system and the healthy bacteria in your gut normally keep your levels low.

However, when candida overgrows in the body numerous health issues can result including IBS symptoms.

Candida in the digestive tract aids with nutrient absorption and digestion. However, with candida overgrowth, it can cause leaky gut syndrome (intestinal permeability).

Leaky gut syndrome is a gastrointestinal disorder that occurs when holes develop in the lining of the gastrointestinal tract.

These holes allow harmful substances to pass through the gut wall and into the bloodstream.

A diet high in processed foods, refined carbohydrates and sugar and the consumption of alcohol can cause candida to overproduce in the body.

Taking prescription hormones such as oral contraceptives and antibiotics can contribute to candida too.

Another contributor to Candida overgrowth is stress.

Figuring Out the Root Cause(s) of Your IBS  Symptoms

As you can see there are many causes of IBS symptoms so before embarking on any treatment it’s really important to identify the trigger(s).

Everyone is unique. What may appear to be a common symptom on the surface can very well stem from a different root cause to someone else experiencing the same IBS symptoms.

For example, is your gas, pain and bloating due to motility and structural issues? If this is the case, it's likely visceral manipulation can help.

Or is the trigger due to low stomach acid levels that need restoring to kill off harmful bacteria?

Or do you have insufficient enzyme production to break down nutrients from your food?

Or do you have a candida overgrowth or  leaky gut syndrome?

Usually there’s more than one trigger behind someone's IBS symptoms.

Once one piece in the chain of digestive events gets disrupted, it can lead to a cascade of dysfunction and imbalance.

But functional health testing can be the missing link to helping you unravel your IBS symptom puzzle.

As I'm sure you can imagine, the overall picture differs greatly from one individual to another, further supporting the need for a personalised approach to addressing health concerns and optimising wellbeing.

Non-digestive health issues are very often connected to gut health too.

Even if you aren't experiencing digestive symptoms it doesn't mean that your fatigue, brain fog, weight gain or loss, low immunity or skin problems aren't down to the state of your gut health.

I hope you've found this blog post helpful, and do reach out to me if you'd like some help with your gut health.

Nicola x