A Functional Medicine Guide to Treating Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome (IBS)?

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder that affects the large intestine, characterized by a range of symptoms including abdominal pain, bloating, gas, and altered bowel habits like diarrhea or constipation. Unlike structural conditions, IBS doesn’t cause permanent damage to the intestines but can significantly impair daily life. Functional medicine views IBS not as a single disease but as a syndrome—a collection of symptoms that may stem from various underlying imbalances in the body.

Symptoms of IBS

Common symptoms of IBS include:

• Abdominal pain and cramping: Typically relieved by bowel movements.
• Bloating and gas: Often a result of poor digestion or dysbiosis.
• Diarrhea (IBS-D): Frequent, loose stools.
• Constipation (IBS-C): Infrequent, hard stools.
• Mixed (IBS-M): A combination of diarrhea and constipation.
• Fatigue and brain fog: Often linked to gut inflammation or dysbiosis.

These symptoms can be triggered by stress, certain foods, hormonal changes, or infections, and vary greatly from person to person.

How Functional Medicine Tests for IBS

In functional medicine, the goal is to identify and address the root causes of IBS symptoms through comprehensive testing:

1. Celiac Blood Work: To determine if gluten sensitivity or celiac disease is contributing to symptoms. Many IBS patients find symptom relief by removing gluten from their diet, even if they don’t have celiac disease.
2. Inflammation Markers: Blood tests such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) help identify systemic inflammation, which can contribute to IBS symptoms.
3. GI-MAP Stool Test: A comprehensive stool analysis that assesses gut health by looking for pathogens, bacteria, yeast, parasites, and markers of gut inflammation. This test provides a detailed picture of the gut microbiome, helping to tailor treatment. It also has the option of adding on “Zonulin,” a protein responsible for gut permeability. Zonulin is often high with IBS, and can suggest a “Leaky Gut” presentation
4. SIBO Testing: Small Intestinal Bacterial Overgrowth (SIBO) breath tests can determine if excess bacteria in the small intestine are causing IBS symptoms, particularly if bloating is profound. This test assesses for hydrogen and methane overgrowth directly, and can assess for hydrogen sulfide overgrowth as well. 
5. Food Sensitivity Testing: Identifying food intolerances or sensitivities that may be triggering or exacerbating symptoms, allowing for a more targeted dietary approach.
6. Autoimmune Panels: Since IBS often overlaps with autoimmune conditions like celiac disease or ulcerative colitis, functional medicine practitioners may run autoimmune panels to identify potential triggers.

A Whole-Body Approach to Treating IBS

Functional medicine addresses IBS by viewing the body as an interconnected system, focusing on the gut-brain axis, immune function, and overall lifestyle. This comprehensive approach includes:

1. Restoring Digestive Health

Functional gastroenterology aims to restore the natural functions of the digestive system by focusing on key areas:

• Saliva Production: The mouth produces saliva, which begins the breakdown of carbohydrates.
• Stomach Acidity: The stomach must be acidic to properly break down fiber, protein, and fat, and to destroy harmful bacteria.
• Bile and Enzyme Release: The gallbladder and pancreas need to release bile and enzymes to digest fat and protein.

Supplementation and nervous system practices can help retrain the body to function efficiently.

2. Dietary Interventions

• Gluten-Free Diet: Removing gluten can be transformative for many IBS patients, even those without celiac disease, by reducing gut inflammation and improving digestion.
• Elimination Diet: Systematically removing and reintroducing foods helps identify and eliminate triggers like dairy, soy, or FODMAPs.
• Nutritional Support: Incorporating anti-inflammatory foods, probiotics, and prebiotics restores gut health and reduces symptoms.
• Meal Timing: Strategically spacing meals and snacks can enhance digestive peristalsis.3.

3. Lifestyle and Stress Management

• Nervous System Support: Mind-body practices such as meditation, yoga, and deep breathing can help manage the stress that often exacerbates IBS. Vagus nerve stimulation can also be beneficial in regulating digestive tone.
• Exercise: Regular physical activity supports digestion, reduces stress, and promotes overall health.
• Sleep Optimization: Ensuring adequate, restful sleep is crucial for supporting immune function and gut health.

4. Medications and Supplements

• Low-Dose Naltrexone (LDN): This medication reduces inflammation and acts as a pro-motility agent, making it particularly beneficial for patients with IBS-C.
• Herbal Support: Herbs like marshmallow root, slippery elm, and aloe vera can soothe the digestive tract, reduce inflammation, and alleviate IBS symptoms.
• Digestive Support: A combination of digestive enzymes, probiotics, and additional supplements like L-glutamine, short-chain fatty acids, and gut-healing blends supports proper digestion, restores a healthy gut microbiome, and helps heal and seal the gut lining—essential steps in managing IBS effectively.

Addressing Underlying Conditions:

• SIBO: Treating bacterial overgrowth with antibiotics, herbal antimicrobials, or dietary changes.
• Leaky Gut Syndrome: Repairing the gut lining through diet, supplements, and lifestyle changes.
• Autoimmune Diseases: Managing conditions like Celiac disease,Ulcerative Colitis and Hashimoto’s that fall under the IBS umbrella.
• Autonomic Nervous System dysfunction: Regulating the balance of sympathetic (“fight or flight”) and parasympathetic (“rest and digest”) nervous system is essential for all digestive complaints. 
• Common CorrelatingConditions: Hypermobility Syndrome, Dysautonomia,  and Mast Cell Activation Syndrome (MCAS) can negatively impact the gut lining and require specialized care. Dr. Alicia McCubbins is an expert in addressing these complex conditions.

Related Conditions and Autoimmune Connections

IBS is often linked to other conditions, including:

• Ulcerative Colitis: An inflammatory bowel disease that causes chronic inflammation and ulcers in the colon, often with symptoms overlapping those of IBS.
• Celiac Disease: An autoimmune disorder triggered by gluten, causing damage to the small intestine and symptoms similar to IBS.
• Leaky Gut Syndrome: Increased intestinal permeability can lead to systemic inflammation and exacerbate IBS symptoms.
• SIBO: An overgrowth of bacteria in the small intestine is a common contributor to IBS.
• Thyroid Conditions: Gut health and thyroid function are closely interconnected, with each influencing the other. Inflammation in the gut, constipation, nutrient deficiencies, and adrenal health can all impact thyroid function, while thyroid imbalances can, in turn, affect gut health.

Functional medicine practitioners consider these related conditions in the treatment of IBS, ensuring a holistic and personalized approach.

Functional Medicine Support for IBS

Functional medicine’s approach to IBS is rooted in individualized care, focusing on:

• Root Cause Identification: Using advanced testing to uncover the underlying causes of your symptoms.
• Personalized Treatment Plans: Tailoring diet, lifestyle, and supplement recommendations to your specific needs.
• Ongoing Support: Working closely with you to adapt and optimize your treatment plan as your symptoms improve.

How Vytal Health’s Functional Doctors and Nutritionists Can Help

At Vytal Health, our functional medicine doctors and nutritionists are dedicated to helping you manage IBS through a comprehensive, personalized approach. We offer:

• Expert Testing: Utilizing advanced tools like GI-MAP, Lactulose Breath test, food sensitivity tests, and autoimmune panels.
• Customized Care Plans: Developed specifically for your unique symptoms and health history.
• Comprehensive Support: Guiding you through dietary changes, stress management, and lifestyle adjustments to ensure long-term relief.

Our goal is to not just manage your symptoms but to empower you to live a healthier, more balanced life by addressing the root causes of IBS.

Our gut health expert, Dr. Irene Carr, specializes in treating IBS with a functional medicine approach. She provides personalized care and insights that can make a real difference in your health journey. Have a listen to her recent podcast where she dives into all things gut health. Please schedule a call with a care coordinator here to learn more about getting started with Dr. Carr.