by Mark Hyman, MD
Last Updated April 17, 2015

Last week I described a condition with symptoms so severe that you can’t leave the house, yet many doctors call it a “functional” or “psychosomatic” disease, suggesting it’s all in your head.

Unfortunately, it’s a very real problem for the almost 50 million people — that’s 20 percent of Americans — who have irritable bowel syndrome (IBS). These people become plagued with uncomfortable, often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain.

I have many patients with IBS, some of whom have suffered for decades without relief. Their previous doctors couldn’t find the cause of the illness, so they were told to simply add more fiber to their diet or take Metamucil, or were prescribed sedatives, anti-spasm drugs, or antidepressants.

That is NOT the answer. Most of those treatments don’t work, because they don’t address the underlying causes of why your digestion is not working. Emerging research has helped identify the underlying causes.

For about two decades I have been successfully treating IBS and other digestive conditions using a very simple methodology based on Functional Medicine.  This process helps identify and remove the underlying causes and restores normal digestive function and health.

Research tells us that there are two main causes of irritable bowel:  food allergies and overgrowth of bacteria in the small intestine.  But there may be many others, including a lack of digestive enzymes, parasites living in the gut, yeast overgrowth, zinc or magnesium deficiency, and heavy metal toxicity.

This is precisely why personalizing treatment based on the unique circumstances that exist for each person who suffers from IBS becomes critically important. The solution is most certainly not one-size-fits-all. But solutions can be found if we look carefully at the underlying causes and treat them.

In this follow-up blog, I want to provide strategies to reverse both of the most recognized underlying causes of IBS – food allergies and bacteria overgrowth, and then I will offer some simple strategies to improve your digestive health.

Addressing Food Allergies

If you suspect food allergies are the underlying cause for your IBS, then you can take one of two strategies to identify and eliminate these intolerances. One is to test for IgG food allergies using a specialized test that determines how your immune system reacts to proteins in common trigger foods such as gluten and dairy. IgG antibodies will become elevated in response to foods you are sensitive or allergic to.  It’s your body’s defense mechanism trying to protect you from something you have sensitivities to.  When I use this diagnostic test, I often see positive IgG food allergy test results for several foods that are common to the Standard American Diet.

A Functional Medicine doctor or Registered Dietitian can order the test and chart out a modified diet plan to eliminate the foods that test positive for 12 weeks.

If you can’t afford these tests, then just eliminate the most common food allergens for 12 weeks —dairy, gluten, yeast, eggs, corn, soy, and peanuts. And then reintroduce them one at a time to see if they cause symptoms.

To use just one example, for 75 percent of the world’s population, consumption of dairy products leads to digestive problems such as IBS.  Eliminating dairy and other reactive foods creates an effective way to isolate the foods that may be causing you problems.

I have created a simple program to follow based on a comprehensive elimination diet called The UltraSimple Diet. You might also choose to work with a Functional Medicine doctor or Registered Dietitian who specializes in food allergies.  These practitioners can help develop a long-term plan that eliminates problematic foods.

How Gut Imbalances Can Lead to IBS

Imagine the size of a tennis court. Believe it or not, that surface area is equivalent to the surface area of your small intestine, which is where your food is absorbed. Your small intestine is also the home of your gut-immune system – which accounts for about 60 percent of your total immune system. The lining of this sophisticated system is just one cell layer away from a toxic sewer where all of the bacteria and undigested food particles live in your gut.

If that lining breaks down — from stress; too many antibiotics or anti-inflammatory drugs like aspirin or ibuprofen; steroids; intestinal infections; a low-fiber, high-sugar diet; alcohol; and more – your immune system will be exposed to foreign particles from food, bacteria, and other microbes.

This will trigger and activate an immune response and will irritate your second brain (which I discussed last week), creating havoc that leads to an irritable bowel, an irritable brain, and other system-wide problems including allergies, arthritis, autoimmunity, and mood disorders.

The microbial ecosystem in the gut must be healthy for you to be healthy.  When your gut bacteria are out of balance — when you have too many pathogenic bacteria and not enough healthy bacteria — it makes you sick.   

Understanding and Fixing Gut Imbalances

If you have bacterial or yeast overgrowth or if you have bad bugs, parasites or worms, you can get IBS.

Most of the bacteria are in your large intestine, but sometimes, they kind of move up and go into the small intestine. That’s not very good, because the small intestine is meant to be sterile and needs to remain that way.

If the bad guys move in and take over— then they can start fermenting the food you digest, particularly sugar or starchy foods.

 

This is called small intestine bacterial overgrowth (SIBO), and it’s a major cause of IBS.

When you eat starchy foods—bread, cereal, pasta, rice, or sugary foods—the bacteria in your gut ferment the sugars in the food. It’s like the way apple cider blows up a plastic container when the cider goes bad. The fermentation process emits gas and everything expands.

That’s what happens in your gut.  The bacteria ferment the sugars in the food you eat, and then your gut blows up. That’s why you get bloating right after meals. We call that postprandial bloating or as one of my patients calls it – a “food baby.”

This is a very common symptom of SIBO. Most doctors never diagnose or treat this properly. But once it’s recognized, it’s a very common and very easy thing to treat if you use the right modality.

SIBO can be diagnosed by a breath test, which measures gas production by the bacteria, or by a urine test that measures the byproducts of the bacteria after they are absorbed into your system.

Yeast overgrowth is also common in your gut. It’s sort of like a garden where the weeds take over. Yeast overgrowth happens because of taking antibiotics, steroids, birth control pills, or acid-blocking drugs. It also occurs if you eat a lot of sugar, drink alcohol, or you are diabetic.

All these things tend to cause overgrowth of yeast, and that can be treated with an antifungal, such as Diflucan, Nystatin, or Sporanox.

I’m not a big fan of medication, but sometimes for irritable bowel, a good non-absorbed antibiotic called Xifaxan will clear out the SIBO (bacterial overgrowth) and stop bloating and diarrhea.

Using Xifaxan and an antifungal is almost like hitting the reset button on your computer; you reboot your gut and then you start over.

I also like to use herbs for cleaning out bad bacteria or yeast overgrowth. Besides antifungal herbs, such as oregano, I also recommend a blend of essential oils and herbal extracts – such as:

• Candibactin BR (two capsules, three times a day for a month) for bacterial overgrowth
• Candibactin AR (two capsules three times a day) for yeast overgrowth

Other bugs can also be a problem.

You can often identify if you have bad bugs in your system by reviewing your medical history and then treat the underlying issue using the simple steps outlined here.  If you don’t get better, then stool testing may be needed to identify parasites or worms. At The UltraWellness Center, we do innovative stool testing that examines your entire gut ecosystem. We are not only looking for infections but also imbalances in your ecosystem which are contributing to your IBS.

The bottom line is:  in order to reboot your gut, you need to get rid of the bad guys and put in the good stuff.

So let’s recap…

The first step is to get rid of unwanted visitors in your small intestine. You’ll probably want to work with your doctor or Functional Medicine practitioner for this.

Then you’ll want to repopulate your digestive tract with good bacteria. You can do that by taking very high-potency probiotics (look for at least 25 billion live CFU’s from diversified strains of Lactobacillus, Bifidobacterium, and Saccharomyces boulardii), taken twice a day for one to two months.  Start slowly and observe how the probiotics affect your gut.  In some cases, certain individuals may need to delay probiotics until their gut is more intact.

7 Strategies to Restore Optimal Gut Health

Now that we’ve identified the more obvious reasons for IBS, I want to help get you on the path to optimal gut health.  Remember, every case is different, so generalizing a strategy to eradicate IBS is not a one-size-fits-all situation.  Ideally, everyone is able to discover the root of their IBS by testing and proper diagnosis.  However, I find that nearly everyone does well when employing these strategies to restore good gut health and function:

1. Take digestive enzymes with meals. These help break down food while your gut heals. You may need these for two or three months, and many people benefit from taking them permanently.
2. Remove sugary, processed foods. Besides wrecking your gut, these foods contribute to diabesity. Take an afternoon to hunt and gather all these foods in your kitchen and throw it all out. Be merciless. Then replace the fake food with real, whole, fresh foods.
3. Eat an anti-inflammatory diet. Inflammation underlies IBS and many other gut conditions, so you’ll want to incorporate plenty of anti-inflammatory foods like wild-caught fish into your diet. We also use herbs like quercetin and turmeric to reduce inflammation and heal leaky gut and other gut conditions that can contribute to or exacerbate IBS. I recommend for my patients UltraInflamX and OmegaGenics 720 (fish oil) to reduce inflammation.
4. Take gut-healing nutrients. Other nutrients that help heal the lining of the gut including GLA (from evening primrose oil), zinc, vitamin A, and glutamine. You might also consider a supplement like this one that combines gut-healing nutrients.
5. Eat fermented foods. Include plenty of probiotic-rich foods like kimchi, kombucha, miso, or sauerkraut. Sometimes, you can also eat yogurt if you are not allergic to dairy. Try unsweetened sheep or goat yogurt. These are all foods that help your gut flora get and stay healthy.
6. Exercise regularly. Randomized controlled trials show regular, consistent exercise reduces IBS. Even 30 minutes’ vigorous walking can help, and if you want something more intense, try high-intensity interval training (HIIT) or weight resistance. Click here for a comprehensive, easy-to-apply fitness plan.
7. Reduce stress. If you struggle with IBS, you don’t need studies to tell you stress can exacerbate these symptoms. Regardless, such studies exist. Whether you employ yoga, meditation, deep breathing, or tapping, find something that works for you to control stress and do it regularly. My UltraCalm CD is a great way to melt away stress and anxiety.

By following this approach, most people can heal their irritable bowel and restore gut function. If you are not getting better, you may need medical help. You may need treatment for SIBO, food allergies, or other underlying conditions.

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