IBS, or Irritable Bowel Syndrome, is a chronic functional digestive disorder that can include a collection of recurrent symptoms, with the most common symptoms being diarrhoea, constipation (or both), bloating, and pain.
This common condition affects more women than men and can impact all areas of life, limiting work and social activities while causing embarrassment and discomfort.
While IBS presents in the digestive tract, factors outside the digestive system also play a role in the triggering and persistence of symptoms. This is why our IBS specialists conduct a thorough health assessment of each patient to understand the underlying causes and factors that might be contributing to their IBS. This truly personalised approach to treating IBS delivers a high rate of success with patients that we’re proud to offer.
Wondering what irritable bowel syndrome is, or what the symptoms of IBS are? The diagnosis of IBS is given to those with 2 or more of the below symptoms persisting over 3 months or more:
The symptoms identified come from a list titled the Rome IV criteria. They are:
Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria*:
*fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
Often when a patient is assessed for IBS, the practitioner may also consider inflammatory bowel diseases (IBD) Crohn’s disease and Ulcerative Colitis. Irritable bowel syndrome symptoms differ from IBD, which are characterised by chronic inflammation throughout the digestive tract and are generally diagnosed by endoscopy, colonoscopy or sigmoidoscopy. IBS is often diagnosed when other conditions such as IBD have been ruled out.
IBS is broken into 5 major subtypes:
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
The exact cause of IBS is unknown, however, it is believed to be related to a combination of factors, including gut-brain communication issues, stress, diet and more recently gut microbiota imbalances.
More research will help illuminate all of the precise irritable bowel syndrome causes, however so far, research has identified that a disturbed microbial make-up, or dysbiosis of the microbiome, can be a feature of IBS. Chronic stress, anxiety or mood disorders are known to alter digestive function, which can disrupt the pH of the microbiome, affect the function of bile acids and compromise fat and carbohydrate absorption. These changes can alter species of bacteria in the small and large intestines, the numbers of microbiota and the diversity. The resulting reduction of short-chain fatty acid producing bacteria such as Roseburia and Eubacterium rectale can have an impact on the inflammation of the colon, and contribute further to the severity of symptoms of irritable bowel syndrome.
Alongside strong connections to stress and anxiety, other physiological causes include pathogenic parasites, disorders of gut-brain interactions (DGBI), low stomach acid SIBO (small intestinal bacterial overgrowth) and intestinal hyperpermeability (AKA leaky gut).
Food sensitivities or intolerances such as FODMAPs can cause or exacerbate symptoms, and in some cases, intestinal permeability can create further intolerances to foods that were not previously known as triggers. This can create a confusing cycle of symptoms and a growing accumulation of intolerance to foods that were previously well tolerated.
Allergic reactions and poor clearance of histamine can trigger an immune response that can further exacerbate or trigger symptoms. In perimenopause and menopause, the reduction in the protective effects of oestrogen and progesterone can prevent the effective clearance of histamine produced by mast cells in response to an allergen. This can in turn create more food and environmental allergies (pollen, dust, animal dander etc.) which can trigger or exacerbate IBS symptoms.
SIBO or small intestinal bacterial overgrowth is also commonly found with IBS, where some microbiota species such as Enterococcus, E. coli, and Klebsiella which are usually found in the large intestine, have migrated to occupy the small intestines. As a consequence, both IBS and SIBO can share a myriad of symptoms such as abdominal pain, bloating distention and diarrhoea.
Other risk factors of IBS include:
Once diagnosed, the conventional approach to IBS involves dietary modifications such as the FODMAP diet, counselling to help reduce the effect of stress on the gut-brain connection, and pharmaceutical treatments for the suppression of symptoms. Drug therapies can include antispasmodic, antidiarrhoeal or laxative treatments that may have undesirable side effects such as mineral deficiencies or, in severe cases rendering the colon incapable of peristalsis. More recently, IBS treatments including psychological therapies such as CBT (Cognitive Behavioural Therapy) are becoming popular to improve stress-related IBS symptoms.
IBS symptoms can become worse over time if not treated effectively, and avoidance of some food/nutrient groups can lead to malnutrition if the person is not under the supervision of a nutrition expert. Haemorrhoids and anal fissures can also occur if IBS is left untreated.
Many people find their IBS symptoms don’t subside with these approaches, partly because the broader range of underlying factors aren’t widely understood in the conventional medicine space. Thankfully, IBS functional medicine natural treatment has been shown to have greater symptom management and higher quality of life outcomes for IBS patients.
Functional testing can provide insight into the causes or contributing factors of IBS, and along with a detailed case history, can deliver a more targeted, effective approach to solving your digestive concerns. Our functional medicine practitioners will analyse your test results to determine factors contributing to IBS.
Testing may include;
At Melbourne Functional Medicine, we seek to establish the root cause, or causes, of IBS, and focus treatment strategies on resolving these underlying issues.
Via thorough investigation, our IBS specialists will consider:
We’ll walk you through our holistic understanding of your particular case, explaining the factors we’ve identified as contributing to your IBS using the most up-to-date scientific insights.
Your IBS treatment may include a range of science-backed strategies depending on the factors influencing your condition to ensure your success. They may include:
One of our Melbourne IBS specialists, Mark Payne says “The gut is the seat of all health”, and helping to restore digestive function can provide relief for symptoms that may seem unrelated such as mood disorders, depression and anxiety, pain, skin conditions and more.
At Melbourne Functional Medicine, we pride ourselves on innovative delivery and clinical excellence, designed to empower and educate you to restore your health. In addition to working with a functional medicine practitioner, you’ll also have the ongoing support of a health coach. Your health coach will help you implement your personalised treatment plan, and provide you with the encouragement and support you need to be well again.
We’ve helped people just like you to be well, and symptom-free. Have a look at our patient success stories.
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(Lola is a real patient but we’ve changed her name and image to protect her privacy)
This case study follows Lola’s journey through the healthcare program. Her aim was to regain control of her persistent skin conditions, hormonal imbalances, and gut health issues that had been impacting her daily life.
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The best IBS diet depends on a variety of factors. There are some common foods to avoid for those with IBS, such as FODMAPs (certain fruits, vegetables, dairy and wheat), caffeine, alcohol, spicy foods, artificial sweeteners and histamine foods.
It is best to get assessed by a functional medicine IBS specialist before attempting to create an irritable bowel syndrome diet. Using a combination of functional testing, personalised assessment and IBS functional testing, our IBS specialists will seek to determine the root cause of your symptoms and tailor-make a health plan to get you feeling well again.
Absolutely. Lifestyle changes such as regular exercise, a balanced diet, adequate hydration and good sleep hygiene can significantly improve IBS symptoms.
Herbs such as peppermint, chamomile and lemon balm can help reduce cramping and pain associated with IBS, and ginger can help to calm the digestive tract by reducing inflammation, and it can also reduce bloating. These herbs can be taken as teas, and can also be prescribed in targeted IBS formulas.
As stress is a trigger for IBS flares, deep breathing and meditation can help calm the nervous system to then calm the digestive tract, alongside other stress management techniques, such as stimulating the vagus nerve.
IBS flare-ups can last anywhere from a few hours to several days or even weeks, depending on the severity and individual triggers.
Typically, they subside within 2 to 4 days, but stress, diet, and other factors can prolong the duration. Managing symptoms often requires identifying triggers and making lifestyle adjustments.
Chronic stress, whether extreme or mild, can alter the pH of our gastrointestinal tract, which then determines the number, diversity and individual species that thrive there. This disruption can affect brain chemistry (as many of our neurotransmitters are made by our microbiota) contributing to how we manage stress, which can further disrupt the microbiome, leading to a vicious cycle.
Stress, mood disorders, and anxiety that impact the species of the microbiome can also then contribute to inflammation, due to chemical messengers called cytokines, changing gut motility (how our waste is moved through the bowel) and contribute to bloating, reflux and increased sensations of pain in the abdomen called visceral hypersensitivity associated with IBS.
More research is needed, however, there are some indications that irritable bowel syndrome may have a genetic component that runs in some families.
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