IBS: When Food Becomes Foe

ID-10076296IBS. It’s one of the acronyms that gets thrown around a lot, casually in many cases. But for the millions of those who count “IBS” as a part of their life, there is nothing casual about it. Whether or not you have an official diagnosis, 1 in 6 people suffer from the symptoms of IBS.1 It could be anything from mild stomach discomfort to frequent diarrhea w/ gas, pain, and bloating. In many cases it disrupts normal life and can make social situations tricky to navigate.

Given that “IBS” seems to be so ubiquitous these days, it might be helpful to clarify the definition. Not everyone who has digestive symptoms has IBS. It could be something much milder or something much worse. First, your doctor will probably want to rule out other conditions such as Crohn’s Disease, Ulcerative Colitis and possibly even Colon Cancer. The Rome Foundation, an organization that provides criteria to assist with diagnosing functional GI disorders, lists a few key symptoms that typically must be present to properly diagnose IBS:

Recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months associated with 2 or more of the following:2
1. Improvement with defecation
2. Onset associated with a change in frequency of stool
3. Onset associated with a change in form (appearance) of stool

This could describe the symptoms of many people, if you think about it, but usually the symptoms are frequent and persistent enough for someone to consult their physician and it represents a change in stool patterns that the patient and doctor find to be abnormal and ongoing. Based on your symptoms, you might also be classified as a particular type of IBS (IBS-C, IBS-D, IBS-M, IBS-U). They mainly differ based on stool consistency. You can read more about those subtypes here.

Now I’m sure after all that, inquiring minds want to know, what is the cause of this ailment? Why does the digestive tract, and the colon in particular, suddenly start to misbehave? Well, like with many disorders that encapsulate a variety of symptom manifestations, there are many routes by which a person’s digestive system can get off balance. The cause for each person is different and for the most part, unknown. Not exactly the news you want to hear if this is your diagnosis. There are theories on possible causes, however. Those include brain-gut signaling problems, gastroenteritis, hormonal fluctuations, stress, abnormal colonic motility caused by nerve dysfunction, small intestinal bacterial overgrowth (SIBO), mental health problems, aaaand, wait for it…… food sensitivities.3 You knew I was going there, didn’t you?

The thing with IBS is that for many of the potential causes, we can test for them and treat. The key is finding a good doc that will explore each area to find the one that most likely contributes to your symptoms. BUT, there is one area most docs don’t adequately address. You guessed it, food sensitivities. Those are the people who end up in my office. They have tried e-v-e-r-y-t-h-i-n-g, meds included, to solve their digestive complaints. Unfortunately, coming at it from a food-immune dysfunction perspective is seen as a last resort, and in many cases as “alternative” medicine. No friends, this is an immune system problem and should not be relegated to Naturopaths and Integrative Nutritionists alone. This should be mainstream medicine, but it’s not. Certain foods are being viewed by the immune system, most often involving T-cell activation (Type IV Hypersensitivity), as foreign invaders. This can cause very unpleasant side effects in the gut. What is one excellent way to get rid of something your immune system deems as dangerous? Dilute the antigen with fluids. Increase peristalsis. And what do we get? Diarrhea, the classic symptom of IBS. Constipation can result as well, although it is far more rare when food sensitivities are concerned.

Now don’t get me wrong. Many physicians do recognize that certain foods play a role. They may tell you to avoid coffee, dairy, spicy foods, and gas-producing foods. For the people I typically see, however, these foods may exacerbate symptoms but they are rarely the sole cause if the body is truly having food-immune reactions. So the question becomes, how do we know what foods are provoking symptoms?

For every IBS client I see I recommend food sensitivity testing, Mediator Release Testing more specifically. This helps us drill down on exactly which foods are causing immune system reactions and which foods are not. Then we have a path forward towards healing. This is definitely no easy path, though. This journey takes time and dedication. It takes sticking to a restricted diet, getting tested for other potential gut imbalances such as SIBO, candida, etc, and healing the gut with appropriate probiotics and additional supplements as necessary. It can literally take months for issues to resolve, but for the clients I’ve walked through this with, it works. In the words of one of my IBS clients that just emailed me today, this process “has truly changed my life.”

If you or someone you know has IBS and they have tried “everything,” consider looking at it from a food sensitivity perspective. An elimination diet can be a first place to start, but if you want to get to the root of the issue quickly and accurately, Mediator Release Testing is the route I recommend. You can read more about it at my web site, www.FoodSense.net, or via Oxford Biomedical at www.nowleap.com.

1. http://www.nlm.nih.gov/medlineplus/ency/article/000246.htm
2. http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf, pg 889.
3. http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/

Image courtesy of Ohmega1982 / FreeDigitalPhotos.net

Danielle VenHuizen, MS, RDN

Registered Dietitian, Certified LEAP Therapist