Is It IBS or Not?


So you've been given a diagnosis of Irritable Bowel Syndrome (IBS). Beyond emergency bathroom visits, what does that mean? And what can you do about it?

First of all, your diagnosis was most likely based on something called the ROME IV criteria, a set of rules used by clinicians to classify a diagnosis of a patient with a gastrointestinal disorder. ROME IV is the latest iteration of the criteria, produced by the Rome Foundation, an independent, not-for-profit organization dedicated to the diagnosis and treatment of gastrointestinal disorders.

Your IBS diagnosis is based on a constellation of common symptoms that together define the syndrome. According to the ROME IV criteria, the signs that define IBS include abdominal pain at least one day per week related to defecation (i.e. pooping) accompanied by frequent diarrhea or constipation and changes in bowel habits. Symptoms usually are experienced as acute attacks that subside within one day, but recurrent attacks are likely. There may also be urgency for bowel movements, a feeling of incomplete evacuation, and bloating.

While the cause of these symptoms varies from one person to the next, there are some common themes among IBS sufferers.

The first is dysbiosis, meaning, a disruption in the healthy bacteria that live in the digestive tract. Over the past few decades we have learnt more about the crucial roles those bacteria play in a robust digestive system.

Dysbiosis includes the potential cause of many IBS cases, Small Intestinal Bacterial Overgrowth (SIBO). In a nutshell, the small intestine is supposed to have small amounts of bacteria, while the large intestine holds the bulk of the bacteria. When too much begins to grow in the small intestine, you may experience bloating, diarrhea, or constipation (sounds a lot like IBS right?)

Other themes include inflammation, nutrient deficiencies, food sensitivities, and gut motility issues. All of these likely play a role in the cause of many IBS-like symptoms.

So where do you go from here?

Well, the best place to start is figuring out the leading causes of your symptoms; this includes considering a combination of your medical history, lab tests, and physical exams.

Once the cause or causes have been determined, a treatment plan can be developed.  Treatment for GI dysfunction almost always includes a lifestyle change: stress management, diet, exercise, all of it. It’s not a magic pill, but it gives you your best chance of long-lasting relief. Also, there are some specific naturopathic strategies, like herbal preparations, supplements and acupuncture that can be very helpful. 

For more information, don't hesitate to contact me by phone or email, book an appointment, or stop by the clinic.

Thanks for reading,

Dr. Oake