Many people are surprised when I tell them that irritable bowel syndrome (IBS) isn't just a digestive disorder, it can also affect your overall health—including your heart. For that reason, you don't want to just mask the symptoms with over-the-counter medications. My son Dr. Drew Sinatra, a naturopathic doctor, has developed a very successful protocol for getting to the root of IBS. So, I've asked him to write today's blog to share that information with you.
If you have irritable bowel syndrome (IBS), you’re not alone. It’s estimated that one in six people have IBS, and women are twice more likely to develop it than men. Not surprisingly, IBS is the top gastrointestinal condition diagnosed by doctors and accounts for 30% of all referrals to gastroenterologists.
IBS symptoms can vary widely from person to person. Some people are highly symptomatic, while others have few symptoms at all. But in general, IBS symptoms include vague chronic abdominal pain with irregular bowel habits including diarrhea, constipation, or a combination of diarrhea and constipation. IBS can also trigger heartburn (GERD), nausea, bloating, flatulence (increased gas), difficulty swallowing, and a decreased appetite.
Left untreated, IBS can also affect your cardiovascular system—leading to heart palpitations or a racing heart. The reason is that IBS can affect nutrient absorption, including your body’s uptake of magnesium and B vitamins which affect heart rhythm. IBS can also lead to an overgrowth of “bad bacteria” in your gut, as well as inflammation that can lead to heart disease.
For all of these reasons, it’s extremely important to not just mask IBS with over-the-counter remedies but to address IBS at its source. But before I get to the treatment for IBS, I want to explain what triggers it in the first place.
What Causes IBS?
Just as the symptoms of IBS vary widely, so do the theories about what causes IBS—and the research is still evolving. What scientists do know is that some people are genetically prone to developing IBS. Plus, people with IBS are more likely to have elevated numbers of lymphocytes (white blood cells), mast cells, and pro-inflammatory cytokines, which all indicate an active intestinal immune response.
There are also many biological and environmental triggers of IBS:
- Intestinal Infections: IBS can develop after an infection with an intestinal bug such as a virus, parasite, or bacteria (i.e., post-infectious IBS).
- SIBO or Small Intestine Bacterial Overgrowth: This is a very common condition where there is increased bacterial growth in the small intestine. This condition is broadly known as dysbiosis, or an imbalance of gut flora, and can be diagnosed with a breath test and treated with specific antibiotics or herbal anti-microbials.
- Medications: I always ask my patients about the medications they take, including antibiotics, NSAIDS, aspirin, steroids, laxatives, birth control pills, and acid-blocking medicines. All of these medications can affect the gut flora and lining of the digestive tract.
- Improper Carbohydrate Metabolism: If your body has difficulty digesting and metabolizing carbohydrates, it can contribute to increased intestinal permeability (leaky gut syndrome) which can trigger IBS.
The Best Treatment for IBS is Eliminating Gluten
Hands down, one of the best treatments for IBS is eliminating gluten from your diet. Gluten is a protein found in wheat, and it’s responsible for the destruction of the gut lining in patients with celiac disease. Gluten is also found in other grains, such as spelt, rye, barley, and malt—plus it can be “hidden” in foods like oats if they’re processed in the same plant as wheat.
Gluten can be a prime culprit in leaky gut syndrome and IBS. In a normal, healthy intestine cells are bonded together with Velcro-like connections. But gluten can disrupt those tight bonds, allowing food and bacteria to leak out into your bloodstream—activating the immune system, and setting the stage for IBS, autoimmune disease, and other inflammatory conditions to develop.
Some people can digest and break down gluten better than others. For someone with celiac disease, for example, gluten literally acts as a “poison” and must be avoided. For others, gluten is unknowingly contributing to health ills. And for some people, gluten literally has no effect, and eliminating gluten will have no effect on digestive symptoms.
Clinically, I have found that the majority of my patients feel much better on a gluten-free diet. They may report less fatigue, headaches, rashes, and joint pain and better cognitive function. Plus, taking gluten out of the diet can help tremendously with gas pain, bloating, and abdominal pain. If you’re unsure if you’re gluten-sensitive, I recommend eliminating gluten-containing grains for at least three weeks and seeing if you notice changes in your body.
Now, do all people with IBS have leaky gut syndrome? Probably not. But if someone is suffering from classic IBS symptoms (i.e., gas, bloating, diarrhea, constipation, etc.) AND they have other symptoms/conditions (i.e., allergies, eczema, malabsorption, brain fog, fatigue, joint pain, autoimmune disease, etc.), a leaky gut is more likely.
Unfortunately, we have very limited testing available for leaky gut syndrome, so the diagnosis is really based on clinical judgment. The gold standard in research to quantify intestinal permeability has been the Lactulose/Mannitol test, which measures the ability of these sugar molecules to pass through the intestinal lining. Unfortunately, this test has fallen out of favor in the last couple of decades.
Then there is Cyrex labs, which looks at the immune system’s response to lipopolysaccharides (LPS) and zonulin. LPS and zonulin should ideally be contained within the intestines, but with leaky gut syndrome, these molecules enter the bloodstream and cause the immune system to overreact. If you think you may have leaky gut syndrome, you can ask your doctor about these tests.
In addition to Cyrex Labs, many stool tests will measure zonulin levels which provide an indication of intestinal permeability. As with any test, there are limitations of relying on the presence of zonulin to diagnose intestinal permeability, so your doctor will likely assess other factors like symptoms, lifestyle, and history of present illness. The bottom line is not to rely heavily on a single factor like an elevated zonulin level to diagnose leaky gut.
More Natural Treatments for IBS
- Remove unwanted “bugs” from the gut. Sometimes yeast, pathogenic bacteria, or parasite species need to be removed before a leaky gut can be healed. If SIBO is present, then this condition needs to be treated as well. If this is the case for you, you want to work closely with an integrative or functional medicine practitioner to select the best antimicrobial substances.
- Eliminate trigger foods. Common allergens that can contribute to IBS and leaky gut syndrome include gluten, dairy, soy, and corn. Ideally, you want entirely eliminate these foods for a minimum of three weeks, and then reintroduce them one at a time to determine which ones may be a trigger for you.
- Take digestive enzymes. These enzymes help to assist the stomach and small intestine to break down foods and make vitamins and minerals more accessible. Take as directed with meals.
- Use probiotics to restore healthy intestinal flora. Look for a probiotics formula that contains at least one billion organisms per dose, and take one to two times daily with food. Plus, eat more fermented foods like sauerkraut, kimchi, and miso, which contain probiotics that help to support intestinal health.
- Fortify the gut lining with L-glutamine, aloe vera, and slippery elm: Take L-glutamine (3-5 grams three times daily), aloe vera (I like Lily of the Desert Inner Fillet gel; take as directed), slippery elm (400 mg two to three times daily).
- Colostrum from grass-fed cows can be incredibly healing for the gut. Although uncommon, some people who are dairy intolerant may get digestive upset with colostrum. If this occurs there are IgG (Immunoglobulin) formulas available that are dairy-free that in general are very well tolerated. The dose is usually 2 tsp per day of colostrum or 1 scoop of IgG.
- Increase your fiber intake to 30 or more grams a day. Fiber may help to improve some of the symptoms of IBS like diarrhea or constipation. Plus, fiber is broken down into short-chain fatty acids (SCFAs) like butyric acid that provide fuel for the intestinal cells and can help modulate the immune system. Note – some people with IBS may be intolerant to fiber and can actually benefit from a low FODMAP diet, which restricts certain fermentable fibers and carbohydrates. So, if increasing fiber leads to a worsening of symptoms then a low FODMAP diet may be warranted instead.
- Drink bone broth soups to help heal your gut. Bone broths are loaded with gelatin and other nutrients to help support the intestinal immune system, reduce inflammation, and help heal the intestines.
A healthy lifestyle is also important. Eat fresh, non-GMO, organic whole foods and eliminate processed high sugar foods. If you think about food as fuel, you want the highest quality octane foods to be put into your body to support and nourish the cells lining the digestive tract.
To reduce IBS, it’s also important to reduce stress by balancing the parasympathetic and sympathetic nervous systems. Yoga, Tai Chi, Qi Gong, meditation, and slow-paced breathing, are great ways to reduce stress and put our bodies more into parasympathetic (rest and relax) mode.