Irritable Bowel Syndrome

We see many patients who have been diagnosed with Irritable bowel syndrome (IBS). Almost all of them have been dealing with the symptoms that have been labeled as IBS for many years and usually have seen many healthcare providers without much benefit. 

If you have found your way to our website, you are no doubt familiar by now with one of the peculiarities of the diagnosis – it is one “of exclusion”. This means that the diagnosis is only applied after others have been ruled out. Patients who have been diagnosed with IBS usually have a combination of symptoms including abdominal discomfort and changes in bowel frequency and consistency. After exams and tests by doctors fail to find any specific cause for these symptoms they are given a diagnosis of IBS.

In the majority of cases we see, the tests that have been run do not directly assess the health of the gut. These often include a complete blood count and metabolic panel. The metabolic panel is a test that reflects the function of liver and kidneys but not gut! The patient is often reassured at this point that nothing appears to be wrong. If symptoms persists, it seems inevitable that the individual will have an upper and lower endoscopy. We are puzzled by the popularity of these latter tests – they virtually never are helpful except in cases of more serious illness like inflammatory bowel disease and there is a much better screen for this illness called calprotectin. Why would such an unhelpful and invasive test be used so frequently to so little good effect? The appearance of the lining of the gut tells us nothing about how well the gut is functioning. 

There are many tests we run as we try and understand which of the many functions of the digestive system have gone astray. The tests help us determine if the stomach is making adequate acid, if the pancreas is making adequate digestive enzymes, and if the liver is producing adequate amounts of bile.  They also help us understand if the ecology of the gut favors a healthy and abundant sea of bacterial flora or is populated by bacteria or yeast that produce toxins that interfere with normal functioning. 

How We Work With These Problems:

The lining of the digestive system is one of two lines of defense against the invasion of toxins,the second line of defense being the liver. It is also the location of the most important and abundant of our immune defenses: the Gut Associated Lymphatic Tissue or GALT. Loss of integrity of the cell barrier between the inside of the gut and the bloodstream is called leaky gut and is associated with food sensitivities, toxin overload, and auto-immune illness. Leaky gut can be identified and treated, in part with an elimination diet.. However, an elimination diet alone will only lead to new food sensitivities. The leakiness must be addressed simultaneously and this must usually be accomplished by identifying the factors that led to its occurrence. Abnormal flora (SIBO or dysbiosis), stress, antibiotics, alcohol, and many medications are important reasons why people have leaky gut. 

There are functional measures of the ecology and function of the gut that tell us about an individual’s diet and these can be very helpful as we design treatment programs to nurture and repair the breakdowns discovered during the testing phase of our work with you. Do you have good levels of short chain fatty acids that nurture the cells that line your colon, are you absorbing nutrients, are there dangerous levels of inflammation? Do you have allergies that are upsetting your gut function or abnormal functional levels of serotonin or other neurotransmitters (this is why the gut is sometimes called the second brain). Are your cortisol levels normal? This steroid hormone can have profound effects on the physiology of the gut. 

You can see why our approach to helping individuals is often called “functional medicine”. We look for the reasons for disease by testing to see where the body’s normal functioning is broken and by looking for the causes of the breakdown. One of the most beautiful aspects of this approach is that there are many ways to support the body’s innate wisdom and capacity to heal itself by approaches that don’t require the use of medication. Specific and individualized diet, exercise, stress resiliency, supplements, and looking at ways to minimize exposure to toxins and maximize their successful removal can be more powerful than medications. This approach also creates more lasting effects on the overall health and well-being of the individual and leads to less reliance on expensive medical procedures and technology.

If you have Irritable Bowel Syndrome Durham NC symptoms and have not responded to other approaches call our office today to schedule a no-charge welcome call with Kathleen – our health coach – to discuss how we might work together to address your symptoms and put you on a path to lasting wellness.