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Could IBS, Irritable Bowel Syndrome, be at the ‘bottom’ of your digestive issues?

A blue ribbon that represents IBS Awareness

April is IBS Awareness month and it’s time to shine a light on one of the most perplexing digestive issues that we see in clinic.

It is the most commonly diagnosed condition by gastroenterologists worldwide and affects 1 in 3 people in the UK, with numbers on the increase.

So let’s take a look at the symptoms, how it is diagnosed, the potential causes, and most importantly what can be done to help.


What is IBS and how is it diagnosed?

IBS is most commonly considered to be a “diagnosis of exclusion” which implies that an IBS diagnosis is given only if other disorders that might be causing similar symptoms are ruled out.  But let’s be clear, although there is no definitive test for IBS, it is a recognised condition that can be diagnosed based upon a set of key symptoms which have been present for at least six months.

The key symptoms that your doctor will look for are abdominal pain or discomfort, or bloating or a change in bowel habits meaning how often you experience a bowel movement and its appearance.  Alongside these key symptoms, you might also suffer from other symptoms such as fatigue, nausea, and excessive flatulence.

In the presence of the key symptoms, the GP or gastroenterologist will want to find out if there are any potential “red flags” such as blood in the stool or unexpected weight loss and may wish to investigate the possibility of other conditions with similar symptoms, taking into consideration your age and sex and family medical history.

What causes it?

The cause of IBS is still unclear, and the potential underlying issues are both complex and varied with researchers still trying to “demystify” it.


Interestingly, IBS is almost twice as like to affect women than men and it is thought that a fluctuation in hormones during the monthly cycle might be implicated, influencing not only the function of the gut but its sensitivity to pain.  Many women experience discomfort and a change in bowel habits during their cycle but women with IBS report a significant worsening of their symptoms at certain points in the month and it has been found that these women also appear to have suffered with worse menstrual symptoms.  While studies have found the link between hormones, particularly oestrogen and progesterone, and IBS there is still uncertainty as to why and how this happens.


One clue might be the gut-brain axis.  If you’ve not heard of it, you might be surprised to learn that the gut and the brain are in constant communication and the conversation is orchestrated by various hormones and neurotransmitters, among them the sex hormones.  But there are other reasons why this conversation might become confused or even chaotic and stress and anxiety is likely to be trigger.  The stress hormone, cortisol has also been linked to IBS symptoms but a bit like the chicken and the egg, we don’t know which comes first, the stress or the IBS!  But whichever way around it happens, recent research suggest that managing stress can have a positive impact on symptoms.


However, at the centre of all of this lies that magical place, the gut microbiome, a hugely diverse population of microorganisms that, under normal circumstances, live harmoniously together but once disrupted, that clever communication system between the gut and the brain can break down and a chain reaction of symptoms and complications can begin.


There is an interesting area of research that suggests that genetics might play a role in the onset of IBS and it does appear to be a hereditary condition, although a genetic cause has not yet been found.  But having a genetic predisposition doesn’t necessarily mean that you will have IBS.  The saying “genetics load the gun; environment pulls the trigger” can hold true and so what is it that might pull the IBS trigger?


With or without a genetic predisposition, some of the triggers that we see most often are poor diets lacking in colour and variety, lack of exercise and a sedentary lifestyle, chronic stress, the long-term use of certain medication such as antibiotics, or even a bout of food poisoning, known as postinfectious IBS.


Research continues to unravel the complexities of IBS and increasingly there is evidence and an opinion, with which we agree, that the gut microbiome holds the key which will pave the way for some exciting new developments.


Now you have a diagnosis, what next?

Receiving an IBS diagnosis can feel a little frustrating because no-one can really explain to you why you are experiencing symptoms that can impact your quality of life.  This can have you going off in all different directions trying to find the answers and hopefully, something that might make you feel better.

But a word of caution – no-one else’s IBS is your IBS and a lot of the advice on social media and in newspapers and magazines often claiming to ‘cure’ your symptoms with restrictive diets or this or that supplement will very likely not lead you to lasting relief.

Please do not follow a restrictive diet, exclude foods, or take supplements without proper guidance from your doctor or a registered nutrition professional, especially if you have other health conditions and/or are taking medication.

You can however, try some stress busting techniques such as yoga or meditation to help with stress and think about eating more mindfully, chewing properly and practice some breathing exercises before your meals which will prepare your digestion to cope with what you have eaten more efficiently and effectively.

Most importantly of all please don’t suffer in silence – IBS can be isolating, embarrassing, and emotionally draining but it doesn’t have to be if you seek help from the right places – take a look at Guts UK that offers some great free resources including a 'Poo-torial' and then book a complimentary call with us - we see these symptoms in clinic week after week and just like Guts UK, we are on a mission to break the poo taboo!


We would love to talk to you about how we can help and how the tools that we have at our disposal can really help us to get to the bottom (sorry!) of your symptoms.  One of the “big guns” in our tool kit is functional testing, especially the comprehensive stool analysis, which can give us a real insight into what is going on in your gut, and allow us to unpick the possible causes of your digestive issues and to target them in a really effective way.


Our gut and all of the microorganisms that live there is the foundation on which our health and wellbeing is built which is why, if you’re suffering with IBS symptoms and don’t know where to go next, please do take advantage of a complimentary consultation with us here and find out how we can help.


IMPORTANT: Any changes to your normal bowel habits, such as black tarry stools , blood or mucous in your stools or unintentional weight loss-should be reported to your GP as soon as possible.

References: Guts UK, NHS, NICE, Chong et al. 2019, Henstrom & D’Amato, 2016, Mullin, 2021, Oka et al. 2020, So & Savidge, 2021

c 2024 True Food Nutrition All rights reserved

The information provided is general and has not been tailored to individual underlying health concerns or any prescription medication you may be taking. The information is for educational purposes and must not replace medical advice. If you have a diagnosed medical condition, you should consult a doctor before making any significant changes to your diet or lifestyle.

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