Overcoming IBS
Take Control of GI Issues Like Irritable Bowel Syndrome
Dr. Aaron Hartman
May 21, 2024
If you’re struggling with Irritable Bowel Syndrome (IBS) or gastrointestinal (GI) issues, please know that you’re not alone. While 5 – 7% of adults in the United States receive a diagnosis, experts estimate that 10 – 15% of the population has IBS. GI complaints are one of the major reasons people go to their primary care doctor.
What is IBS?
Like any syndrome, IBS is a collection of related symptoms. In the case of IBS, the symptoms (pain, cramping, bloating, gas, diarrhea, constipation) primarily affect your gut. If you have enough related symptoms, your doctor may diagnose you with IBS.
But what exactly is Irritable Bowel Syndrome? What causes these common but terribly uncomfortable symptoms?
A Shifting Definition of Autoimmune Disease in the Gut
IBS is an inflammatory disorder of your GI tract that can affect many other systems in the body.
In full-blown inflammatory bowel diseases like ulcerative colitis and Crohn’s disease, the immune system is inflamed, and the body makes antibodies against itself. Some of the current literature is now looking at inflammatory bowel disease with diarrhea as an autoimmune spectrum disorder, and Quest Labs offers tests that look for those specific antibodies. Many doctors (myself included) have begun to categorize IBS as an autoimmune disorder. I believe that, in time, we will commonly classify diarrhea-predominant IBS as an autoimmune diseases.
What Causes IBS?
There isn’t a simple one-size-fits-all answer to this question. Your gut plays a central role in your overall health & wellness. Your gut contains an amazing ecosystem, your microbiome, that interacts with virtually every other system in your body.
Your GI Tract Does Not Function in Isolation
When we consider gut health in isolation, we are missing the big picture. We also need to consider the brain, the heart, the liver, and the immune system as these all affect and are affected by gut health. 90% of the communication between your gut and brain is actually FROM your gut TO your brain via the vagal nerve, not the other way around. Your gut also communicates with your heart. Gut health can cause palpitations and a racing heart, which can then feed into the the neurological system and affect things like anxiety and sleep.
When considering IBS, reflux, food allergies, etc, we need to take a holistic approach. How is the immune system being affected? How is the brain being affected? Do your GI issues have any neurological triggers like anxiety or depression? Do you experience heart palpitations? If you have a gut issue, we need to look at how all of your body systems interact.
That may sound overwhelming, but it doesn’t have to be. No, there isn’t a simple, singular cause of IBS … but that doesn’t mean there isn’t a cause. And with education and intention, you can find it. And you can restore your gut health.
No, there isn’t a simple, singular cause of IBS … but that doesn’t mean there isn’t a cause. And with education and intention, you can find it.
Inflammation & IBS
One particular cause deserves additional attention. If we recognize that IBS is an inflammatory disorder, then we have a valuable clue to what may be causing bowel distress. Inflammation is a dysregulation of your immune system. Either your innate or adaptive immune system is in overdrive and turned against itself.
In my article on Autoinflammatory & Autoimmune Disease, I note that 4 preconditions for autoimmune disorders (a severely dysregulated immune system): genetic predisposition, chronic infection, leaky gut, and a triggering event.
Let’s look briefly at the role of leaky gut.
Leaky Gut
In the context of IBS and GI issues, you may be thinking of a different kind of leaky gut. I’m referring to what your gut allows into your bloodstream (and through your blood to the rest of your body).
In the process of digestion, we absorb nutrients from food while eliminating various toxins, harmful bacteria, viruses, and other by-products. A special layer of cells line the small intestine and are responsible for absorbing nutrients and blocking harmful substances. Between each cell is a space called a “tight junction.” The health of the cells that line the small intestine, and the health of these tight junctions, are key to what is and is not absorbed into your bloodstream.
When this protective layer of cells becomes inflamed or damaged, they are no longer tightly connected and can allow toxins and harmful substances into your bloodstream. We call this Leaky Gut.
So what causes Leaky Gut? How do those protective cells become damaged or inflamed. Potential causes include: viral and bacterial infections, antibiotics and other medications, toxins, stress, inflammation, food intolerances, and imbalances in gut bacteria.
Inflammation is a Big Deal
You might notice that leaky gut is caused when the cells lining your intestine become inflamed. And by admitting harmful substances into your bloodstream, leaky gut causes further inflammation (throughout your body). Inflammation builds and leads to further inflammation. That’s one of the many reasons we make such a big deal about inflammation.
Solutions & Support
If we recognize IBS as an inflammatory disorder that exists on an autoimmune spectrum, there are several things we can do to address IBS depending on the level of severity.
Eating Real Food
Real food improves the bacterial balance in your gut, which then has a massive impact on how you digest your food. Conversely, eating processed foods with chemicals, refined grains, and sugars slows your digestion and causes more gut inflammation. I’ve created a free micro-course, “Real Food Diaries,” which introduces you to the foundations of eating real food. Get Started with Real Food Diaries.
Interval Fasting
Allowing a gap of 12–16 hours between dinner and breakfast has a restorative effect on your microbiome (the ecosystem of bacteria in your). This improves digestion and aids in liver detoxification. Simply resting your GI tract for that time during the fast helps you store up more digestive enzymes for the next day, so you actually digest your food better. Learn more about the benefits of different kinds of fasting.
Elimination Diet
Eating real food and and providing adequate space between meals is a critical first step. But you may suffer from specific food triggers. How do you figure out if specific types of food are causing inflammation and gut distress? An elimination diet is an important step in diagnosing and addressing gut issues. An elimination diet is a restricted diet for a focused period of time (we typically recommend 28 days).
An elimination diet serves two critical functions. First, it provides a focused period of detoxification. Second, it removes the six most common food triggers: wheat, dairy, eggs, nuts, soy, and seafood. Virtually everyone feels better after the 28 days, simply by virtue of detoxification. If you have also been suffering from food triggers or allergens, you will experience additional health gains. Then, by systematically reintroducing the six food types, you can pinpoint which food types are contributing to your GI issues.
If you’re interested in working through an elimination diet, I recommend talking to your healthcare provider to establish a plan.
For additional support, I’ve created a digital course, “ConnectedHealth: Gut,” which digs deeper into the topics in this article AND provides a six-week structure to work through an elimination diet.
Further Reading
The Immune System Recovery Plan
A Doctor's 4-Step Program to Treat Autoimmune Disease
Susan Blum MD
This is an overall general survey of the functional medicine approach to addressing autoimmune issues. Dr. Blum uses a modified 5R approach (actually a four-prong approach) in her book. This book, as well as Dr. Meyer’s, are general works that address autoimmune diseases but are not all-inclusive. Autoimmunity is a very complex topic and difficult to distill into one concise book.
Wheat Belly
Lose the Wheat, Lose the Weight, and Find Your Path Back to Health
William Davis MD
Dr. Davis is an integrative cardiologist who through years of clinical practice and research came to discover that wheat consumption, through the immunologic response to gluten and processed wheat products, is one of the leading causes of cardiovascular disease in our country today. This book is a thorough review of gluten-containing wheat and its cardiovascular effects. This is a great book to read in combination with Grain Brain by Dr. Perlmutter. It will change how you view bread and make you reconsider your daily grain food choices.
Clean Gut
The Breakthrough Plan for Eliminating the Root Cause of Disease and Revolutionizing Your Health
Alejandro Junger MD
Dr. Junger chronicles his own personal journey and how he developed Chronic Fatigue Syndrome starting during his cardiology training. After traveling to India and practicing there for two years he returned to the US and using his medical training and adding what he learned in India he created the Clean Program. This is a good read for those interested in gut health and how it relates to overall wellbeing.
