How Gut Imbalances Can Lead to IBS
Imagine a tennis court. That is the surface area of your small intestine, where food is absorbed. Your small intestine is also the site of about 60 percent of your immune system. And this sophisticated gut-immune system is just one-cell layer away from a toxic sewer — all of the bacteria and undigested food particles in your gut.
If that lining breaks down — from stress, too many antibiotics or anti-inflammatory drugs like aspirin or Advil, steroids, intestinal infections, a low-fiber, high-sugar diet, alcohol, and more – your immune system will be exposed to foreign particles from food and bacteria and other microbes. This will trigger and activate immune response, allergy, and will irritate your second brain (the enteric nervous system) creating havoc that leads to an irritable bowel, an irritable brain, and other system wide problems including allergy, arthritis, autoimmunity, mood disorders, and more.
The microbial ecosystem in the gut must be healthy for you to be healthy. When your gut bacteria are out of balance — when you have too many pathogenic bacteria and not enough healthy bacteria — it makes you sick. You’ve got about 3 pounds of bacteria — 500 species — in your gut. In fact, there is more bacterial DNA in your body than there is human DNA! Among all that gut bacteria, there are good guys, bad guys, and VERY bad guys.
If the bad guys take over — or if they move into areas that they shouldn’t (like the small intestine which is normally sterile) — they can start fermenting the food you digest, particularly sugar or starchy foods.
This is called small bowel bacterial overgrowth, and it’s a major cause of IBS.
The major symptom it causes is bloating, or a feeling of fullness after meals. What causes this bloating? The overproduction of gas by the bacteria as they have lunch on your lunch!
Small bowel bacterial overgrowth can be diagnosed by a breath test, which measures gas production by the bacteria, or by a urine test that measures the byproducts of the bacteria after they are absorbed into your system.
Bacterial overgrowth is a real syndrome and was recently described in a review paper published in the Journal of the American Medical Association.(i) The condition can be treated. In fact, a major paper was recently published in the Annals of Internal Medicine that showed using a non-absorbed antibiotic called rifaximin for 10 days resulted in a dramatic improvement in bloating and overall symptoms of IBS by clearing out the overgrowth of bacteria.(ii) This medication is now under FDA review for approval as a new treatment for irritable bowel syndrome.
That’s great news for many IBS patients. But, unfortunately, not all patients with the same diagnosis are created equal. There’s more than one factor that leads to IBS. Another major cause of IBS is food sensitivities. Not true allergies, but low-grade reactions to foods that drive so many chronic symptoms including IBS.
A landmark paper, was recently published in the prestigious British medical journal Gut that found eliminating foods identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms.(iii) Another article, an editorial in the American Journal of Gastroenterology, stated clearly that we must respect and recognize the role of food allergies and inflammation in IBS.(iv)
So the research tells us that these are the two main causes of irritable bowel — food allergies and overgrowth of bacteria in the small intestine — but there may be others, including a lack of digestive enzymes, parasites living in the gut, zinc or magnesium deficiency, heavy metal toxicity, and more.
And this is precisely why it is so critically important to personalize treatment based on the unique circumstances that exist for each person who suffers from IBS — the solution is most certainly not one-size-fits-all. But solutions can be found if we look carefully at the underlying causes and treat them.
Which leads me back to Alexis …