IBS - 5 Causes That Your Doctor May Overlook | Chris Kresser
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5 Causes of IBS Your Doctor May Not Be Looking For

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causes of IBS
Gluten sensitivity and other food intolerances are common causes of IBS.

This article was originally published in 2015 and has been updated in November 2018 to reflect the latest research.

Do you have gas, bloating, abdominal pain, and stool issues? Up to 20 percent of the U.S. population suffers from irritable bowel syndrome (IBS), a condition that adversely affects daily life. Instead of digging deeper to identify the underlying cause(s), conventional medicine typically offers medications to suppress gut symptoms. Read on to learn about five lesser-known causes of IBS that you may not be looking for.

Irritable bowel syndrome doesn’t have to be a lifelong sentence. Learn about five underlying causes of IBS you might not be looking for to help heal the gut from the inside out.

How Doctors Diagnose IBS

IBS is the most common functional gastrointestinal disorder. Yet it’s poorly understood—not only by those who suffer from it but also by many clinicians who try to treat it. (1) Symptoms of IBS include gas, bloating, and abdominal pain, accompanied predominantly by constipation, diarrhea, or both. Those afflicted report lower quality of life and activity levels and call in sick twice as often as the general population. (2) Depression and anxiety often accompany IBS, most likely through the gut–brain axis connection between the enteric nervous system of the GI tract and the central nervous system.

Diagnosing IBS isn’t straightforward. If you’re experiencing the above symptoms but you don’t have a more definable GI issue like inflammatory bowel disease (IBD) or GERD, then IBS might fit the bill.

Over the years, diagnostic criteria have evolved, but IBS is now generally defined as recurrent abdominal pain at least three days per month in the previous three months, associated with two or more of the following: (3)

  • Improvement with defecation
  • Onset associated with change in stool frequency
  • Onset associated with change in stool consistency
Finding the root cause of IBS isn’t always an easy or quick road. But there is hope for those suffering. I believe one of the greatest allies someone hoping to heal from it or any other chronic condition can have in their corner is a health coach. Coaches work alongside Functional Medicine practitioners to help people finally heal. If you’re passionate about helping others find health and happiness, a career in health coaching may be the right fit for you. Find out how to become a health coach.
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IBS Medications Aim to Tame, Not to Treat

Not that long ago, IBS was dismissed as a psychosomatic disorder that was “all in your head.” Fortunately, it is now recognized as a legitimate gastrointestinal disorder, although it’s often poorly managed. Current treatments focus on alleviating the symptoms of IBS instead of actually fixing the underlying problems—but that’s a common theme in conventional treatment of modern chronic diseases. Medications prescribed for IBS include:

  • Antidiarrheals
  • Anticholinergic or antispasmodic drugs
  • Laxatives
  • SSRIs
  • 5-HT3 antagonists
  • Mast cell stabilizers (also used to treat asthma)

But those who use these IBS medications report low satisfaction, with little relief from the condition, and many of these drugs induce side effects that are similar to IBS symptoms themselves! (4, 5)

Treating gastrointestinal symptoms without addressing the underlying gut issues is akin to repeatedly placing buckets underneath water dripping from the ceiling. The floor below may stay dry, but that won’t fix the hole in the roof. Over time, the leaky roof could lead to additional problems, like mold and structural instability.

5 Causes of IBS You May Not Have Considered

In order to properly treat IBS, you’ll need to do some investigating to determine the cause. This article will summarize five causes of IBS that you may not be looking for—but should be.

1. Gut Dysbiosis

Ever-growing research links the gut microbiome to bone health, heart health, autoimmune disease, thyroid health, and more. It should be no surprise, then, that IBS is directly related to gut dysbiosis, a change in the composition of the gut bacteria. Up to 83 percent of IBS patients have abnormal fecal biomarkers, and up to 73 percent have intestinal dysbiosis. (6) Specifically, those with IBS tend to have decreased levels of “good” bacteria, such as Lactobacilli and Bifidobacteria, and increased levels of harmful strains such as E. coli and Clostridia. (78) An increased ratio of Firmicutes-to-Bacteroidetes (two major classes of bacteria) is also common. (9)

Success in treating IBS with prebiotics and probiotics is further evidence that gut dysbiosis plays a role in IBS. A recent article reviewed 24 randomized placebo-controlled probiotic trials, the majority of which showed benefits of treatment. (10) Beneficial probiotic strains included B. animalis, L. rhamnosus GG, B. infantis, B. longum, and L. acidophilus. (11, 12, 13) Prebiotics, which act as food for the microbiota, can also help establish beneficial bacterial. (14, 15, 16)

Another strategy that can correct gut dysbiosis is a low-FODMAP diet, which eliminates foods containing certain carbohydrates that feed intestinal bacteria. (1718, 19) This method may help get the beneficial-to-harmful bacteria ratio back under control, but it works best as a short-term solution that is then followed by prebiotic/probiotic treatment. (20, 21, 22)

2. SIBO

Small intestinal bacterial overgrowth (SIBO) is a special subset of gut dysbiosis in which the small intestines harbor an abnormal number of bacteria. Compared to the colon, the small intestine should have a bacterial concentration that is considerably lower. Bacterial overload in the small intestine can interfere with digestion and nutrient absorption.

SIBO may be present in up to 80 percent of IBS patients, although a recent meta-analysis reported a huge range of estimates (between 4 and 78 percent) across 50 studies. (23) Part of the reason for the discrepancies is non-uniform IBS diagnosis, and the other part may be variations in SIBO diagnosis. I prefer the methane breath test over jejunal aspirate and culture, the conventional testing approach.

Antibiotics that are used to treat SIBO, like rifaximin, can also be effective for treating IBS, further evidence that SIBO may be underlying some cases of IBS. (24, 25) Or, SIBO may follow IBS incidence, especially if a person with IBS begins taking PPIs (acid-blocking medications) for indigestion. One of the many dangers of PPIs is the development of SIBO. (26, 27)

3. Gut Permeability

The GI tract is lined with a single layer of tightly packed epithelial cells designed to keep pathogens and other unwanted species out of the bloodstream. If the barriers between cells become permeable, undigested protein molecules and bacterial toxins can pass through and trigger immune reactions and inflammation.

Leaky gut and associated low-grade immune activation affect between 12 and 50 percent of people suffering from IBS. (2829, 30) Low levels of E-cadherin, a protein involved in regulating gut permeability, have been reported in IBS sufferers who experience diarrhea and/or constipation. (31)

Supplements that can help reestablish the intestinal barrier include:

  • L-glutamine
  • MSM and quercetin
  • N-acetyl glucosamine
  • Mucin
  • DGL slippery elm
  • Marshmallow
  • Chamomile
  • Cat’s claw

GI-Revive contains several of these in an effective blend. Supplementing with probiotics can also help repair gut permeability. (33)

4. Gut Infection

Gut infections are another lesser-known cause of IBS. Many studies have confirmed a link between a single episode of bacterial gastroenteritis and future development of IBS. (34, 35, 36) Parasites such as B. hominis, Giardia spp., E. histolyticaDientamoeba fragilis, and Trichinella spp. have also been correlated with progression of IBS, although causation has not yet been confirmed. (37, 38, 39)

Modern lifestyle has compromised the gut’s ability to resist infections from pathogenic bacteria and parasites. (High levels of stress, for instance, combined with factors such as the Standard American Diet, can easily lower our immunity.) Gut permeability, gut dysbiosis, and high stomach pH from chronic PPI use create more opportunities for pathogens to overwhelm or bypass the gut’s immune defenses.

5. Non-Celiac Gluten Sensitivity and Other Food Intolerances

The medical field once mocked non-celiac gluten sensitivity (NCGS), but the condition is slowly gaining acceptance even in conventional medicine. (40) Many of the symptoms—gas, bloating, abdominal pain, and changes in stool patterns—are indistinguishable from IBS, so NCGS can be difficult to identify. Brain fog and fatigue following gluten consumption are also very common.

In IBS patients, I see a number of other food intolerances, such as:

  • Dairy
  • Eggs
  • Peanuts
  • Seafood
  • Yeast
  • Soy

A large review of over 73 studies “confirmed that food allergy and intolerance should be considered as an underlying pathology for IBS.” (41) But bear in mind that food intolerances themselves are often symptoms of deeper causes like SIBO, gut infections, and/or gut permeability.

The cheapest tool to determine food intolerances is an elimination diet, which I outline in depth in my book The Paleo Cure.

What’s Your Experience with IBS?

IBS can be an unpredictable and even debilitating condition. Finding the root cause is not always an easy or quick road, but neither is a lifetime of symptom-suppressing medications with additional side effects.

In my practice, I have seen patients who have suffered from this condition for 20 years recover after we identify and address the underlying causes of IBS outlined above and fix their diets.

Now I’d like to hear from you. Have you discovered the cause of your IBS? Have you been able to stop your medications by implementing any of these strategies? Let me know in the comments!

393 Comments

Join the conversation

  1. Chris, thank you for addressing this and shedding some light on the murky diagnosis of IBS. I read most of your articles and appreciate your insight and expertise. I follow a fairly strict paleo-esque diet and I am also an exercise physiologist and health and wellness coach. I was diagnosed with IBS after a recent colonoscopy and suffer with a multitude of symptoms from bloating, gas, abdominal pain, abdominal pressure, and bouts of constipation followed by bouts of diarrhea. When you put all of those symptoms together and I’m sure others will agree, it’s a pretty miserable time, coupled with a lot of embarrassing situations. Furthermore, there’s a lot of anxiety and stress about going to certain places, wondering if there will be a bathroom nearby, or if some food will trigger and exacerbate symptoms. As we also know stress can be a contributing factor, so we now have a triple threat against us. Since no one person struggling with IBS is alike, you really have to tune into what foods are your triggers. Identifying them specifically is half the battle. I have also started taking some of your supplements the AdaptaGest Flex & Core as well as your Prescript-Assist Probiotic. My husband laughs at me when I pull out this wad of pills before every meal. My question to you is – how long on average do these supplements take to have an effect on your symptoms? I’m sure there are a whole host of contributing factors, but I’m curious what you have seen in your practice. Thank you again for your efforts!

  2. Hi Chris,
    I want to thank you for all of the great work you are doing regarding digestive problems, autoimmunity and leaky gut. I have cfs, and after many years am finally finding the source of the problem (multiple mycoplasma infections, blasocystis hominus , candida, and an underactive thyroid). All of your information has been so very helpful. Finding the root causes is just so crucial !!!

    Thank you 🙂

  3. I have all 5 of the causes of IBS. I’ve been to 9 gastroenterologists over the last 5 years and have been told everything from suspected inflammatory bowel to IBS. My symptoms are far too severe to be IBS as I have debilitating flares 2-3 times a year. All my labs and EGD/colonoscopies have come back clean except that I had a ton of bile in my stomach last time. The only help I’ve found is through a functional doctor. Folks I cannot recommend these angels highly enough! Her cure wasn’t fast or cheap but it has made a ton of difference in my life! Still haven’t found a gastro willing to work with her and I though, I’m still searching for one of those!

  4. I suffered from IBS for a few months, without getting any benefit after stopping gluten, sugar, coffee, lactose… Then a doctor told me to try green clay to drink, after one week all symptoms disappeared!
    Can’t advise you enough to try it, it’s totally harmless (can constipate if you do that more than 1-2 week without a break though). Check http://www.naturepurity.com/holistic/clay_internal.html

  5. I had no issues with digestion/gut until my endocrinologist put me on Victoza for diabetes. It not only didn’t help my sugar control (it actually increased glucose more than when I was not taking anything for diabetes – went from an A1C of 7.2 to 8.9 in three months). I was previously using fast acting Humalog insulin with meals.

    Within three days after starting Victoza, I started getting acid reflux, and my digestive system went on a frenzy. Bouts of constipation, then diarrhea. But the worse part is SEVERE gas. I was told to give it three months and the symptoms would subside. Well, I am off the Victoza and now my system is completely screwed up. I have tried Betaine HCL, several kinds of probiotics, digestive enzymes, etc. I already eat organic foods. It seems that veggies cause the most issues, especially salads. I am going to see my integrative doctor next week. Dr. Kresser, do you have any suggestions/recommendations?

  6. Why don’t you ever mention the possible side effects of using antibiotics to treat SIBO? There are several comments on your previous article from people who are seeking for help due to Rifaximin wiping out even more gut bacteria. Do you think it makes sense for people to use antibiotics to treat gut problem when most people with IBS have IBS from using antibiotics in the past? Is your logic to kill all bacteria in the gut? I do not understand why you keep promoting Rifaximin or any other antimicrobial treatments as godsend. Experimenting unproven protocols on patients need to be stopped.

    • There is a TON of research to show the effectiveness of Rifaximin! What many people don’t understand is that Rifaximin is non-systemic; unlike the antibiotics that can cause SIBO. What that means is, while other antibiotics will be absorbed into the rest of your body by your intestines, Rifaximin stays in your intestines only. And it works kind of like a “reset.”

      My husband had “cyclic vomiting syndrome” (a fancy term for, “We don’t know why you’re puking ‘randomly’, but you are, so here is your label.” The vomiting started every few months, for several years, then every few weeks, and kept getting worse and worse, and eventually came to the point where it was almost every day.

      He took Rifaximin (550mg 3x a day for 14 days), and BLAM… no more puking. And that was in January. 🙂

      You can tell his gut flora was changing because he said his stool started becoming a kaleidoscope of colours, and then eventually normalized.

      Rifaximin is a LIFESAVER. He almost lost his job and took it in the nick of time!

      • Sarah, Was your husband put on Rifaximin because of his CVS? My 19 yr. old daughter has had CVS for the last 6 years with episodes monthly and I wonder if this is something that would help her?

    • I think the idea is to re-inoculate with the correct balance of good bacteria. So you might kill everything but you can start over with better ones. Make sense?

    • I’ve written and spoken at length about the danger of antibiotic overuse. Do a quick Google search for “Chris Kresser antibiotics” and you’ll find numerous articles and social media posts.

      Not all antibiotics are created equal. Rifaximin is a non-absorbable antibiotic that studies suggest does not adversely affect the gut microbiota. In fact, some studies have shown that it increases bifidobacteria and f. prausnitzii, both considered to be beneficial species. Studies have also shown that taking rifaximin for up to 12 weeks at high doses does not cause resistance.

      So, while no drug is risk free, rifaximin appears to be remarkably safe and well-tolerated, and quite effective in many cases.

      My philosophy has always been to choose the most effective treatment that causes the least harm. 9 times out of 10 that won’t be a drug, but sometimes it is.

      Having said all of this, in our clinic we use a botanical protocol as our first-line SIBO treatment with good results.

      • I understand that you always weigh benefit vs risk ratio as a medical practitioner before giving a treatment to the patient. However, as you probably know, everybody’s body chemistry is different innately, just like the physical appearance. Rifaximin may be proven to have non-systematic effect in most cases, but that certainly is not true for some people, depending on what condition and genetics the patients have. Since you think that Rifaximin is relatively safe, I feel that it is necessary to address why this might be happening with Rifaximin and what people can do if they have severe side effects. These are part of comments from your article, Interview with Dr. Mark Pimentel. All these people’s health declined dramatically after using Rifaximin.

        “We actually already review Dr. Perlmutter’s book, and tried to make an appt. with him last year but couldn’t get in before he sold his practice. My wife started doing the probiotic enemas (PEs) as suggests in his book, which seemed to be working this past May and June until she had an iron IV upon advice from one of her doctors. This reinitiated the worst parts of her symptoms after making so much progress with the PEs. We believe the iron may have feed the infections onboard which caused increased inflammation in the brain thereby increasing her symptoms. From then on she was unable to use the PEs in the same manner. They started to cause her symptoms to get even worse. As for the inflammation in the brain, she has some sort of genetic issue that prevents her from taking quercetin. When she has tried it, out of desperation in the past, it set off her symptoms. She is a very sensitive person, and reacts very differently to treatments than most people. As for the fecal matter transplant (FMT), we have already researched that long and hard. We even received info regarding Tamount in the UK from Dr. Perlmutter’s office. We brought it up to one of her functional doctors who said it was an option but that it could cause some issues (increased inflammation), especially with her sensitivities and unusual reactions to treatments. He also mentioned antivirals, antibiotics. The real issue is having someone to work with that knows other alternative (non-allopathic) ways to approach this without antiviral and antibiotics, and who knows in what order to attack this (order definitely matters). Would we need to heal and seal the gut before addressing the infections, would we need to address the infections before trying the FMT, etc? We have been working on healing her gut for the past year with the paleo diet, and trying to implement AIP, but really need knowledgable guidance from someone who can bring all these areas together. Any assistance is greatly appreciated.”

        “My wife has been suffering for 15 months straight with severe neurological and psychiatric symptoms that started on day two of a 10 day course of rifaximin, which was prescribed for suspected SIBO. I’m a former Navy SEAL and have never seen anyone suffer as much or as long as she has. I am desperately looking for relief for her. We have seen many doctors (functional medicine, neurology, psychiatry, neuropsychiatry, acupuncturist, chiropractor, massage therapist, etc.) but they do not seem to have the skill set to handle this in a holistic way. Have you ever heard of anything like this, or know of anything that can be done? Any “Chris Kresser” type information would be greatly appreciated.”

        • I have had every test known to mankind and wrote about this is an earlier blog herein in June 2015.

          Since my IBS is so idiopathic I am now treated by a pain specialist and he suggested taking Gabapentin 300mg and have more celiac plexus nerve blocks

          The Gabapentin has been very effective while one procedure of a nerve block was not. Nevertheless, I am going to continue to have two more nerve blocks this time back to back. The Gabapentin takes some scheduling experimenting for the most optimal analgesic effects. You may seek further info on Google.

      • What is the name of the botanical or where can i get it that you use as the first line of defence against sibo. Many thanks.

    • The two things that make rifaximin better than at least other antibiotics is 1) It does not breed drug resistant bacteria (“super bugs”) and 2) It does not succeed in traveling down the digestive tract to reach the good gut bacteria. SIBO is a problem where bacteria that belong in a healthy colon have migrated to the upper small intestine, live and thrive there in a place that should have virtually no intestinal bacteria.

      • rifaximin In some rare cases it can cause C Diff. Found this out after talking to my Doctor. So that is something to be aware of.

  7. I was diagnosed with IBS many years ago. Pregnancy made the IBS worse and meant I gave birth to a low birth weight baby. Breastfeeding also made the IBS worse.
    I have a degree in chemistry and an interest in food nutrition and have always believed my symptoms were due to additives etc in food. So I started food eliminations. My breakthrough came when I discovered red Leicester cheese has a colorant called annatto in it. Switching to cheddar made me well. So when I started to google annatto, I found websites that gave lists of additives that have ‘hidden’ MSG in them. Eliminating any of these food additives gives me perfect health – absolutely no IBS – even through mild stress! It means I have to cook all my meals from scratch, no processed meals but I feel much better. I would definitely like to see some research into this as the amount of MSG that we are all consuming is much higher than what we can account for if we rely on the ingredients list of food packaging.

    • Hi Angela, that’s interesting! is there any chance you could please share a list of these additives with hidden MSG in them.

      Thank you!

    • Most functional medical doctors can deal with patients via phone, email, and/or Skype. You might want to check around the west coast of the USA as there are many over there I understand.

  8. Diagnosed with IBS after colonoscopy ruled out other causes. Suffer with constipation continually but I really suspect my job (longhaul pilot) is the root cause as my diet is clean, gluten free, grain free and low carb sugar free. Trying to get more fibre in and resistant starch with some progress but fighting a losing battle with constant circadian rhythm disturbance. Wish I had an exit strategy from my work but sadly don’t have one. Who knows what cosmic radiation is causing for me long term, too..

      • Along the lines of what Aaron has suggested, I’ll share that my IBS constipation symptoms improved once I re-introduced small amounts of white potato on a daily basis (I realize this is not purely paleo, but this approach has worked for me). Rice did not help me.

    • I have functional chronic constipation too. It started suddenly when I changed time zones and was overseas for 2 months. It’s been a year now and has never improved. Since you’re crossing time zones all the time I would imagine that is the cause for you. But as for me the change in circadian rythm seems to have permanently altered the function of my bowels. I’d be interested to know more about how this works. Dietary changes do nothing for my constipation that includes paleo, gluten free, fibre or FODMAPs diet.

  9. I have been dealing with IBS and multiple food and drugs intolerances for 20, years, after a trip to Mexico, from which I came back with Giardia, Blastocystis hominis and Dientamoeba Fragilis. I was treated by antibiotics but I never regained normal intestinal function. I can’t be treated by drugs, due to these chemical intolerances, and there have been periods when, since these food intolerances got so bad, I could only eat meat and white rice for weks. I cannot count the times when clueless doctors told me “it’s all in your head”–which is obviously moronic, since I told them over and over that it all started after this trip to Mexico. The only thing that made a difference is that after a stool analysis, it was discovered that I had big intestinal colonies of Candida glabrata. Then my doctor prescribed caprylic acid and probiotics, and that reduced my food intolerances quite significantly. I tried different probiotics and the one that helped most is Bifidobacterium Infantis.

  10. Got IBS after being diagnosed with arthritis about 16 years ago. The doctors did a gastroscopy and coloscopy. After nothing bad was found I was sent home. The symptoms got worse and I did a gastroscopy and coloscopy again. Found out myself that I was lactose intolerant and suddenly I could live almost normally again. Unfortunately, I then developed fructose and histamine intolerance. Each took quite a while to diagnose. Prebiotics and probiotics are necessary to reduce the pain.

    I still think that the underlying root cause for my problems is SIBO coming from cortisone and PPIs. But every time I try to change something with the PPIs my symptoms get way worse.

    So far doctors have been worse than useless in this regard.

  11. I WAS DIAGNOSED WITH FRUCTOSE MALABSORPTION 11 YEARS AGO. mY GP WHO IS ALSO AN INTEGRATED HEALTH DOCTOR PUT ME ON A LOW FODMAP DIET AND TOLD TO TALE OLIVE LEAF EXTRACT TWICE A DAY AND A PROBIOTIC. i T HELPS BUT i DO MUCH BETTER WHEN i ELIMINATE WHITE SUGAR AND i FEEL EVEN BETTER WHEN i EAT THE PALEO DIET. i ALSO TAKE AN ANTI-DEPRESSANT MEDICATION AND MINTEC IF i HAVE STOMACH PAIN. i WOULD LOVE TO BE ABLE TO EAT ANYTHING ESPECIALLY AS i AM GOING ON A MONTHS CRUISE. aNY SUGGESTIONS? THANK YOU…

  12. Diagnosed with IBS some years ago after suffering for 30 years. It completely spoiled my social life — no picnics in the country, hiking, trips to the beach. I ptefered doing everything on my own, as any activity involved having to find a toilet.
    This January I started making kefir. Within 2 weeks my symptoms subsided and now I can say I am IBS free. It was like being given another life.

    • Can you give more details about your kefir? Is it cow or goat or coconut water or what? And if dairy, is it raw or not? And what type of grains did you use?

        • Actually I own a herd share at a local organic family ranch for 2 qts weekly of raw all-Jersey cow’s milk and I also buy local raw goat milk weekly — both are amazing. I’d love to learn how to make kefir and yogurt and other ferments with them.

      • I have had great success with kefir as well. I found too many additives in store brands so I bought kefir grains on Amazon. I use mason jars to brew both milk kefir for my smoothies and water kefir using coconut water for my water bottle. Very easy, and endless recipes.

      • I also had a somewhat “magical” kefir experience. After 15 years of IBS-C and D, treatment with daily doses of dicyclomine, fiber therapy, etc., I was given some kefir grains by a friend to try while I was on a course of powerful antibiotics for a severe dental infection. Ordinarily, a dose of antibiotics destroys my gut within 3-5 days. I made kefir daily, adding it to my yogurt or my morning green smoothie. The antibiotics did NOT upset my stomach at all. Not only that, but I’m now withdrawing from the dicyclomine, finding that for the first time in 17 years, I’m totally regular. Had the flu a week ago, which caused a brief relaspse, so I upped the kefir and all is well again within 5 days. I make my own kefir, mostly with store-bought goat milk. I do throw in a day each week using cashew or almond milk (carageenan-free!), but making sure the “grains” are always well-fed and constantly growing. Interestingly, I learned that probiotics, prebiotics and even yogurt are “transitional” solutions that help only as long as they are transitting through the gut. Kefir, however, actually repopulates the intestine flora and makes it difficult for the bad guys to take over. That certainly is the case for my system. Wish I’d known this one 17 years (and many $$ worth of tests and medications) ago!! Highly recommend giving it a try, though I know EVERYONE is different! As for where to get grains, there are many websites you can join to find someone who will simply share theirs. You can buy online as well, Cultures for Health is a good website/source for a lot of probiotic cultures. I’m fortunate to have a friend in my same boat who makes all her own fermented foods and shared her live, active grains. Talk about a lifesaver!

  13. My husband has IBS which is well managed now after many years of ill health. He eliminated wheat and dairy from his diet, and Is sparing with the sugar. He also takes a pancreatic enzyme supplement at mealtimes. Relapses are managed with a probiotic powder – 3 lac – and if severe he takes a single dose of a systemic anti fungal followed by a few days of oral nystatin. We eat paleo and he drinks straight scotch! Almond and orange cake is a favourite.

    • Would you share the name of the systemic anti-fungal? I got ringworm at the local gym and have been having problems getting rid of it. My guess is that food sensitivities, IBS, etc. are making it difficult. I need to be careful about taking products with too many components. Simple is usually better for me.

      Thanks,

  14. Great article!Thank you,Chris!
    I have suffered from IBS for almost 5 years,from IBS-D to iBS-C.And of course,conventional medicine saw little success in me.Several months ago I got a food intolerance test,and it turned out that I am intolerant to many foods,such as wheat,rice,eggs,tomatoes,etc.Although I can manage my symptoms on my modified paleo diet,it seems that I just can’t eat out.Because of this,I applied for a one-year absence from my college.
    I am always hoping for a cure. I live in China,and I don’t know if there is any functional medicine practitioner I can work with here.I would really appreciate it if anyone could provide me with some information.Thank you.

  15. Dont rule out parasites with any gut problems. I bought fenbendazole for goats and took tsp a day for 3-4 weeks and finally got rid of chronic low grade diarrhea that i had had for over a year. I tried paleo diet and that seemed to help somewhat but only if i was nearly perfect and no cheating. I had lost 50 lbs of weight over 3 years and was beginning to get scared. Now my weight has stabilized. Still not digesting like i used to but great improvement. Doctors were no help, they just look at you like you’re crazy.

    • Yes I had a similar experience being diagnosed with IBS initially and then all symptoms clearing up after visiting an integrative ND who put me on a parasite cleanse. The 4 MDs I went to would not even entertain the idea it could be parasites or another gut infection.

  16. Thank you so much for your 5 causes of IBS.
    I’m an otherwise really fit 69 year old. My main symptoms are:
    a low grade gnawing pain/tenderness in the top of my gut; loose bowel causing 5-8 explosive motions during day
    and 3-5 during the night; and
    the consequent bouts of dehydration fatigue and unsteadiness;
    weightloss – 5 kilos in 6 months
    The bowel motions are virtually liquid.
    During the day I have time to get to a toilet.
    However, I have to wear thick tissues inside my underwear while I sleep in case it comes out before I wake up.
    Extremely disruptive of sleep as unconscious is always ‘listening’ for sign to wake up quickly and run to bathroom.
    I’ve had this loose bowel most of the time for the past 4 years,
    but it’s getting worse.
    I’ve been on such a healthy diet, so I’m at my wits end.
    All traditional GP wants me to do is have another colonoscopy.
    I don’t want that!
    Hoping if I can find a good functional GP here in Newcastle, Australia, I can start to heal following your guidelines.
    Is there a website listing functional practitioners in Australia?
    Your work is lifesaving Chris, never doubt it. I am mentally very resilient, but these symptoms with chronic sleep deprivation cause a dangerous despair at times.
    Best wishes,
    Luk Carlsen

    • You have an amazing physician in Australia, Dr. Thomas Borody, who is at the forefront of fecal transplant research. His is based in Five Dock – 61 2 9713 4011.

      I wish I could see him, but he is not taking patients outside of Australia. I believe he could potentially cure your gastrointestinal problem as the is regarded as one of the best.

      Godspeed.

    • I thought Australia was in the forefront of diagnosing and treating IBS. Definitely get the test for SIBO, lactose intolerance and fructose intolerance. Try the low FODMAP diet. It has definitely helped me eliminate explosive and unpredictable bowel movements. Also, Jarrows 299V probiotic has been a big help. You have to search for the right one for you. Align is supposed to be for IBS and I have taken many others, but the Jarrows formula is the only one with a noticeable difference.

    • Have you tried a parasite cleanse? There are several out there that are made from plants and tinctures. I got a parasite on an Alaskan cruise from eating raw oysters. Took a little over a year to figure out and cure. Lost nearly 30 pounds of mostly muscle mass. Hard to bring back muscle mass when you are nearing 60.

    • Sounds to me like a gall bladder issue.
      I suggest trying milk thistle and King Bio Homeopathic gallbladder homeopathic formula.
      Also, take a pancreatic enzyme with meals to help fat digestion

      • For my IBS pain, this worked like magic for me: get whole tapioca pearls (with no additives). Use one part apple juice and three parts water. Boil and add pearls. Simmer and stir constantly until pearls dissolve and become clear. Let cool and refrigerate. Amazing. I keep it around always.

    • Luk,
      I’ve been suffering similar symptoms with weight loss, and I’m a very slender female already.
      I believe I have found the answer to my IBS.
      I believe I have a histamine intolerance, or HIT. After doing extensive research and eliminating foods high in histamine from my diet and incorporating anti inflammatory and antihistamine herbs and foods, I’m noticing a dramatic difference. I’m not cured, but I believe I am finally on my way to healing. Look up ” the low histamine chef “, she has great insight.

      • The reason for the histamine intolerance is that you don’t have the right type of good bacteria in the intestines to break it down. I think Chris has talked about this.

    • Luk, with great concern and sympathy, I have been thru similar for 4 years. My cure was a colonoscopy. Probably the cleanse for it. After procedure heavy on fiber. No more problem. Try just the prep then fiber rich afterward. Hope for you!

    • Your comment is awaiting moderation.

      Luk, with great concern and sympathy, I have been thru similar for 4 years. My cure was a colonoscopy. Probably the cleanse for it. After procedure heavy on fiber. No more problem. Try just the prep then fiber rich afterward. Hope for you!

  17. I’ve been suffering with what I’ve been told is IBS for several years now but it has gotten increasingly worse in this past year. In Feb. I went to a new PCP who said I had BAM (bile acid malabsorption and gave me WelChol tablets – helped for a couple of months, now issues are as bad if not worse than before. New gastro gave me IBGard (peppermint oil) capsules which should help. Sorry, I’m STILL experiencing problems. Don’t believe there is a Functiional Medicine dr. in my area:((

    • Lisa
      Gluten is found in other items, that are not wheat. Such as couscous, Rye, Barley etc.
      Buckwheat contains NO gluten, so your idea to call it a wheat sensitivity would not be helpful.

    • Hi – have been diagnosed as ‘likely celiac’ after all the tests and
      changing diet from ‘totally Mediterranean’ to ‘totally confused’
      as I am eating oats for breakfast with no re-actions, am too scared to eat most things with gluten/wheat, but eat absolutely everything when I’m in USA and feel healthy with no re-actions.
      When I get back to Australia and get back into my ‘normal foods’ again – off I go with the bloating, urgent toilet visits, big burps and acid reflux!! Am fed up with doctors and diets. Any
      ideas anyone??
      Millie – from Melbourne (Australia)

      • Sounds like a Small Intestinal Bacterial overgrowth, SIBO too. Make you stay away from food that has been genetically modified …GMO’s.
        Maybe parasitic reaction…..
        Food allergies/sensitivities….
        Start making bone broths to calm the digestive tract…GAPS diet may help….but get to a Functional Medicine MD
        Don’t mess around with this too long.

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