What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is an umbrella term used to describe numerous digestive complaints that have no clear pathology[i]. IBS is very common, and the number of people experiencing it is increasing. The main symptoms are bloating, diarrhea, urgency, constipation, indigestion, abdominal pain and cramping, gas and mucus in stools. Usually, people will swing from constipation to diarrhea, but there will be one they experience more often. IBS-D is when diarrhea is the most common symptom and IBS-C is constipation[ii].

Recently, it has been suggested that a condition called SIBO is a cause of IBS in up to 78% of people with the condition[iii]. Other possible contributing factors are anxiety and stress (due to the gut-brain axis)[iv], post-bacterial infection, food intolerances[v], microbiome diversity[vi], pathogenic bacterial overgrowth, non-coeliac gluten sensitivity[vii] or a parasite infection[viii].

Diet and Irritable Bowel Syndrome

The low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet is commonly suggested to those with IBS. This is because the foods suggested to avoid typically exacerbate the symptoms of IBS in a lot of people. This is a very restrictive and therefore can’t be followed for more than a couple of months. Patients often find that their symptoms return once they start eating normally again. If you follow this diet, I suggest doing some gut healing support alongside it to help minimize any symptoms that might return when you start eating normally again. The FODMAP diet typically excludes some fruit and vegetables, dairy, sweeteners, legumes, wheat, other grains such as barley and rye and drinks such as beer, wine, and fruit juices.

Alternatively, you could focus on removing or reducing inflammatory foods and drinks. As nutritional therapists, we address the person as a whole, and believe that if you provide the body with the nutrients and health factors it needs then you will see an improvement in symptoms, without being too restrictive of foods (that offer lots of health benefits such as fruit and vegetables). Concentrate on including whole foods with minimal processing involved and reduce agents such as gluten, cow’s dairy, alcohol, and sugar, as these are all involved in inflammation.

If you want to include legumes and pulses, do so but go for dried versions and soak them over-night as this will help with digestion and minimize symptoms. Additionally, start with a small portion (1 tbsp) and slowly make your way up to a cup sized portion over a few weeks so your gut bacteria can adjust to the increase in fibre.

For IBS-D, stay away from stimulants such as caffeine, sugar and alcohol as they will only increase your stool transit time even further.

As anxiety and stress are often drivers of IBS symptoms, try techniques to manage them. Breathing exercises, walks in nature, calming yoga and massage can all help to sooth our minds and manage feelings of stress and anxiety.

Supplement recommendations for Irritable Bowel Syndrome

If you have IBS-C, try Viridian High Strength Synerbio Probiotic, Wild Nutrition Multi-strain Biotic, or Viridian Pro Care. These are a broad-spectrum probiotic that may help with constipation.

A specific strain called Lactobacillus Rhamnosus GG has shown promise in reducing constipation too.

If you have IBS-D, go for Saccharomyces Boulardii as this has been proven to help with loose stools and diarrhea.

Living Nutrition do a broad range of fermented products which are specific for different areas of gut health.

• Gold Spice has ginger and turmeric which offers lovely anti-inflammatory support
• Sensitive has lemon balm and peppermint, these help to calm the digestion and reduce gas

Digestive enzymes help us to breakdown food, which relieves pressure on the digestive tract and encourage proper absorption of nutrients from our food (a process which is often hindered in IBS). There are different options and different ways to take digestive enzymes so follow the instructions from a health provider based on the ones you choose.

• Wild Nutrition Digestive Enzyme Complex, Terranova Digestive Enzyme Complex, and Pure Encapsulations Digestive Enzymes Ultra are a blend of all three pancreatic enzymes amylase, protease and lipase (these work to break down fat, protein and carbohydrates) and some also have additional digestive enzymes added in.
• Viridian Digestive Aid is a gorgeous blend. It consists of amylase, protease and lipase, and additionally has ginger, betaine HCL and peppermint which work together to help all areas of digestion.
• Digestive bitters help to stimulate the digestive system, preparing it for digestion. This process involves our own digestive juices and enzymes. Viridian Digestive Elixir is a lovely blend of these bitters all in one to help get these juices ready!

For IBS-C (constipation), try adding in some extra fibre which will encourage your body to pass a stool:

• Viridian Complete Fibre Complex with F.O.S
• Viridian Kiwizyme with aloe vera
• Kiki Health Slippery Elm
• Pukka Triphala Plus
• Hericium Digestive Powder superfood – this is Lions Mane, a powerful mushroom rich in fibre and bioactive substances recommended for a healthy gut.

For general gut health improvement, try some Lions mane mushroom. This medicinal mushroom supports a healthy gut mucosal lining and also helps with the gut-brain axis as it is very supportive of cognitive health:

Functional Testing for Irritable Bowel Syndrome

Often, it’s a good idea to do some further investigation to identify the root cause, or leading offenders of our symptoms. Below are some testing options for IBS symptoms:

• Coeliac and Gluten Sensitivity Panel (finger prick test): this test helps differentiate between Coeliac Disease and gluten sensitivity by evaluating the serum titers of IgA and IgG for deamidated gliadin peptide, gliadin, and gluten. As gluten sensitivity is commonly indicated in IBS, it is worth exploring this, especially if you are experiencing diarrhea.
• Complete Gastrointestinal and Microbiome Test (stool sample): this profile provides the most advanced non-invasive ‘gold standard’ assessment of digestive function and gut microbial ecology including inflammatory markers, leaky gut markers and digestive enzymes. The test also provides a sensitivity panel to ascertain the most effective methods of addressing pathogenic microorganisms. Pathogenic organisms are often indicated in the pathogenesis of IBS, so discovering what microorganisms you have in your digestive tract could be key to your recovery plan.
• Microbiome test (stool sample): this test looks specifically at your microbiomes status and the vitamins they produce. Although it doesn’t provide information on inflammatory markers or digestive enzymes, it is very comprehensive and insightful and more cost effective than the Complete Gastrointestinal and Microbiome Test.
• Intestinal Permeability Profile (finger prick test): A simple and accessible test for looking at intestinal permeability (leaky gut) is to run a test to look at zonulin. Whilst there are more comprehensive tests that look at additional markers, this is a great accessible option to check in on the health of the gut lining which is often compromised in the IBS patients.