Irritable bowel syndrome (IBS) is usually diagnosed by symptoms alone, which leads thousands of people living with an incorrect or incomplete diagnosis.
IBS can be diagnosed with as little as recurrent abdominal pain, diarrhea or constipation.
There are many other conditions that have the same symptoms of IBS - like ulcerative colitis, Crohn's disease, food sensitivities or low stomach acid. Through a thorough evaluation and targeted testing, a clearer medical picture of your health can emerge.
Too many people needlessly suffer through irritable bowel syndrome symptoms which have a clear cause and easy solution.
A diagnosis (evaluated properly with the use of lab work and complete patient history) is the beginning, not the end of clinical inquiry.
Many patients have discovered that their IBS diagnosis was an incomplete one, and by eliminating their gut infection, removing their food allergen, reversing deficiencies or changing their diet - their symptoms have been eliminated.
There are many potential causes of irritable bowel syndrome - here are just a few.
Contributing Factors of
Irritable Bowel Syndrome
Food Allergies or Sensitivities
Most people associate a food allergy with the anaphylactic reaction of a peanut allergy (throat constriction, swollen tongue, trouble breathing), but the reality is that food allergies and sensitivities can cause a wide range of severe symptoms.
Headaches, migraines, fatigue, sleep problems, diarrhea, abdominal pain, constipation, bloating, rapid heart rate (especially after eating), dizziness, anxiety, panic attacks, excessive sweating, and chronic pain are just a few symptoms that can be caused by food sensitivities and allergies.
Your diet will be assessed to see if there are any likely suspects causing your digestive issues and you may be put on an elimination diet (a trial period without a certain food) to see if you are reactive.
Testing can be used but often the guidance of a functional medicine doctor familiar with your symptoms is enough to guide you toward a the right symptom free diet.
The vast majority of patients I see suffering from IBS symptoms have an infection somewhere in their digestive tract.
While a healthy immune system fights off infections all the time, there are certain factors that can debilitate your body's natural ability to maintain homeostasis in your digestive tract.
Antibiotic use clears away all bacteria - 'good' and 'bad' - and can give aggressive 'bad' bacteria a foothold in your intestines.
Every person with IBS needs to be tested for infection (parasitic, viral, fungal and bacterial) and have their microbiome assessed. Usually this is done using a comprehensive stool analysis and a small intestinal bacterial overgrowth (SIBO) breath test.
Stressed Gut Syndrome
Perpetual stress can cause the nerves in the stomach, small intestine and colon to either speed up or slow down, resulting in diarrhea or constipation.
Constant stress will affect the vagus nerve which directly impacts motility and digestive enzyme production and secretion.
Those with stressed gut syndrome tend to emotionally eat when they are stressed or depressed because the vagus nerve is not working correctly. This vagus nerve impairment contributes to an imbalance in dopamine and serotonin in the gut.
Too much serotonin in the gut can actually cause the depletion of serotonin in the brain. It is not uncommon for IBS suffers to have anxiety and depression symptoms for this reason.
High carbohydrate and sugary foods cause dopamine and serotonin to be released which is why these cravings are common when the vagus nerve is impaired during stressful times.
Testing adrenal gland function is a good way to determine if the amount of stress you are under is affecting your digestion. There are also ways to test the health and function of your vagus nerve, as well as targeted procedures to optimize vagus nerve function.
I am seeing liver dysfunction increasingly in patients with the popularity of high fat diets like Keto and Paleo. While these diets can be effective for some people in some situations, an overburdened liver is a common side effect of a diet with excess dietary fat. This excess fat drastically strains bile production and bile secretion.
Usually these patients are also not ingesting enough fiber to compensate for this higher fat intake. A removed gallbladder can have the same effect. Certain telltale symptoms and testing can determine if a persons liver is impaired to the point of causing digestive upset.
Usually we adjust the diet, optimize stomach digestion and support the liver with high quality supplementation.
Crohn's and Ulcerative Colitis
Crohn's disease and ulcerative colitis are inflammatory bowel diseases characterized by constipation, diarrhea and stomach cramping.
A comprehensive stool test can be used to determine whether significant levels of inflammation are present.
If inflammation is high in the stool test, then more intensive diagnostic procedures such as colonoscopy, endoscopy, and imaging must be done to diagnose inflammatory bowel disease.
The treatment for Crohn's disease and ulcerative colitis must be comprehensive, identifying and addressing the underlying causes of the persistent inflammation.
Read more about Crohn's and ulcerative colitis
Low Stomach Acid
Low stomach acid is common and it can lead to problems losing weight, fatigue, diarrhea, constipation, abdominal pain, heartburn, GERD, and indigestion symptoms.
Low stomach acid can feel like your stomach never fully empties, especially after you have eaten beef or other animal protein.
It can be caused by chronic stress, nutrient deficiencies, genetic predispositions and the use of antacids.
Incomplete digestion of food in the stomach can stress the small intestine, causing digestive symptoms.
A helpful test when I suspect low stomach acid is the organic acid test. This test evaluates stomach acid digestion capabilities in addition to any bacterial imbalance.
It also includes a vitamin and mineral assessment which is used to determine the exact amount of supplemental nutrition is needed as well as what dietary changes need to be made.
Functional Medicine can help IBS
Your 'new patient' functional medicine appointment will be an hour long. If you are out of state (or out of the country), our clinic offers functional medicine consultations with Dr. Lum.
During this appointment a full patient history, symptom list, family history and complete supplement and medicine list is assessed.
If you need testing, many kits can be sent directly to your home for collection and our testing is run through your health insurance.
Most of our diagnostic testing is at a fraction of the cost if you were to go through a hospital or your primary care physician. Unlike many clinics, we do not 'up-charge' testing - what you pay is what the testing costs.
Many of my patients suffering from IBS have had a full resolution of symptoms. A thorough investigation into symptoms is required for those with IBS as it can be mistaken for many other conditions.
Taking immune-suppressing medication or suffering through symptoms should not be your first course of action. Finding the cause of symptoms can ensure we address the root cause of your IBS.
Read more about the Functional Medicine Testing we offer.