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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)


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)

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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.

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  1. I was diagnosed by a nurse practitioner one year ago; I’m female with three kids and age 34. After speaking to the NP, no tests were done, she just said to “learn not to stress out.”. I lost my Grandpa after the diagnosis and I wasn’t sick, almost lost my father two months later and wasn’t sick….doesn’t sound like stress is a factor for me.
    Nothing was offered in way of medication, advice or anything. She just said come back if it gets worse.

    I’m going to get a second opinion in the near future as I’ve been moving my life around IBS-D. And I’m not wanting medication, but good solid advice on what to do to make it better.

    I don’t eat (or only eat veggies/fruit for the most part) when I know I’m going to be out of the house. I can not eat fast food or ice-cream unless I willing to take the punishment. I have to eat small meals or I’m nauseous/sick. I’ve been a small person all my life (5’2″, 105lbs)
    My symptoms: nausea, bloated, diarrhea 1-3X day, sometimes constipated, headaches, stomach pain mostly upper middle/right, not gaining weight but not losing much either, some days are worse than others.
    Any advice? Right now a second opinion is probably my best option.

    • Try the low FODMAP diet. You might be lactose intolerant and most of the problem foods are with the vegetables. It took me years to get to this point. I am finally able to manage IBS-D. Stress does play a role, but it isn’t THE answer to the question. Diet does play an extremely important role. Good luck!

  2. My doctors have all ignored my chronic constipation symptom. In 2013 I experienced rapid weight gain of ten pounds in one month with severe bloating and stomach issues. I paid for several high cost tests, ct scan, ultrasound, endoscopy, and all I received was medication to help with mild gastroenteritis. I was Ali given a sample of linzess which made me very ill after one dose. My lips and hands were numb, loss of bowl control, dizziness, faintness, fatigue, severe cramps, more bloating, and nausea. My weight has continued to increase no matter what I try and I am 30 pounds over what I have been the rest of my life with chronic constipation That none of my doctors will address with anything other than a drug to relieve symptoms. I have hashimoto’s thyroiditis, allergies and asthma, endometriosis, neurological migraine disorder, and interstitial cystitis.

    • First of all eat more fiber in the form of veggie and fruits. You must avoid all standard allergens (esp.gluten, dairy, etc). I suspect you are in a very difficult place emotionally – that is when I get constipated the most. Is someone in your close environment being difficult to live with? Or even some family member being a disappointment? If there is something that you know you should let go of but can’t, find a way. Find some support and/or at least talk about it to someone you trust. Forget about those pills they are giving you, just eat clean food (no junk, not processed, organic if possible). Go out and enjoy nature as often as possible. Meditate, do yoga, whatever you like. Cooking is a good activity too!

      • Good advice…you can add flax seeds (ground), chia seeds in yogurt or smoothies, magnesium sulfate before bed (2), prunes and prune juice.

    • You have autoimmune disease. Have you had an ANA blood test? Also, check out Dr. Tom O’Bryan’s website, book and his new video series, “Betrayal” Perhaps you are a non celiac gluten sensitive person with the HLA DQ2 or 8 gene. You have lots to learn about how the gut and immune system interact. I have learned the hard way…by the same suffering. I have had gut issues since a child and I am 58 years old. Western Medicine’s lab result standards will show you when you have lupus or RA but the chronically elevated ANA levels Ihave had were a symptom for 24 years. I was told nothing was wrong and that women have this problem…just last month I had it retested…it was 4 times the number from last year. So, the digestive dybiosis/imbalances in the gut flora have caused leaky gut and now autoimmune disease. Hope this info helps you through my struggles in life.

  3. Back in May 29 of 1985, I had joined the United States Navy. I was one of those shipmates that slept less due to the work condition of sending all and covering aircrafts. I work for almost a full day; However, i’ve always had plenty to eat. When stationed on the USS Nimitz, I start having these underlining pain, but ignored it. However, my bowels were OK. They began, mostly, When I and other shipmates we’re screened a urinalysis drug testing. Because of possible test tampering, the navy test selectees must watch me urinate. I’m a very shy person and felt very uncomfortable urinating while another man watched my penis???,LOL. My pain worsened, so painful that I had to ask the drug enforcer if I could sit on a toilet just to urinate. It was very embarrassing time I had to experience in my life. Many years later, I went to the military Bethesda hospital to pursue a more understanding of pains in my stomach. my symptoms were my whole body will weaken, I’ll get dizzy, heavy breathing, and at times, pass out or followed by a seizure. This mainly happens when I’m on the toilet and strain. . I stop having them at the age of 29. Moreover, my stomach guts blew out and no attacks since I have had the gut. I am now diagnosed with seizure, PTSD, traumatic vertigo aggravated by my military experience.

    • Shame/humiliation can lead to trauma as in PTSD. i am curious as to why this was such a big issue to pee in front of some other guy since the army is such a close living quarter kind of place to begin with. You seem to have had major emotional issues, aggravated by all those experiences later in life. Maybe you could address that with therapy and get better? Do you come from a family of alcoholics? If not your parents, maybe your grand -parents?

  4. Hi. After the bad things were ruled out, I was diagnosed 2 years ago with IBS. The only significant symptom is the inability to pass gas to varying degrees, and the associated pressure and discomfort. Certain stresses did make symptoms worse. I went on a low FODMAP diet, which initially made things worse, but by also cutting out peppers and chilli, things did improve. When re-introducing FODMAPs, I seemed to have reactions to wheat bread and garlic. Now comes the twist! On two occasions I have visited the US on vacation from the UK, and within 24 hours I am totally symptom free! What’s more, I can eat ANYTHING including the wheat, peppers etc and remain symptom free! What’s more, some of the specific stresses that tend to increase symptoms at home (such as a major argument with the partner!) also have no effect when I am away. In fact, my average stress level on my most recent level was many times greater than that at home (getting lost, delays, jet lag, arguments, even an emergency root canal procedure!) so I do not accept the view that “you relax more on vacation so the IBS goes down”. Within 12-24 hours of returning to the UK, my symptom returns. What on earth is going on here? In my mind there must be some underlying environmental factor which acts as a catalyst with some foods, but what on earth could it be (water?!)?

    • I agree, I live in Ireland, and symptoms vanished when on holiday in France. Now, I’m a Herbalist and Naturopath and am on a gluten free diet, not really ketogenic, but nearly..my symptoms of loose stool are mainly controlled by diet and herbs etc but do need controlling. In France, instant reprieve, however, not in Belgium. The water is fluoridated here, but I use a gravity filter..

    • Exactly the same thing happened to me. I have had problems at home in Norway for many years. When I visited Southern Europe on two occations this year and last year, I was completely symptome (gas) free. I could eat sugar, ice-cream, overeat (it was holidays) and nothing made me bloated!

      Water where I live has no added chlorine and is very soft (low dH).

      I have some theories but I don’t know if there is any logic in them:
      * The chlorine water in Southern Europe is treated with kills the excess small intenstine bacteria
      * The calsium and magnesium present in hard water is good for my intenstine or my bowel

  5. Hi everyone, check out the low fodmaps diet developed by the GI scientists and medical doctors at Monash University. Google monash and fodmaps and you’ll find them. The information is free. I was sceptical, but it has done wonders for me. No catch, just science. Spread the word.

  6. Sir i have lose stool with colour changing stool sometimes yellow sometime brown semisolid not stick to pan and when i touch my stool and wash with only water and when i rub my finger it is more acidic like bubbing……i have low appetite from contious 2 months……wat is the problem sir my stool loooks over all ok but it is semisolid and even after taking medicine the condition remain the same

  7. Hello I am writing for my sister who suffers terribly from IBS. Yes you are right all the doctors do is throw medication at her problem for the symptoms and nothing to cure the problem. She has been on a lot of stuff but nothing has helped. I. Feel so badly for her and continue to look for the answer. Perhaps you have that answer. I hope and pray this is the case.

  8. I have had Severe IBS-D for all my life (over 40 yrs) and to say that my life has suffered is an understatement. I have done everything under the stars and have had numerous Barium Enemas and Colonoscopy’s and going for another one next week. The results are always the same and I am thankful that I am getting checked however I really do not want to go for this next one as it is a lot of prep work to go through and then the day itself is stressful and harmful in some ways. I found the Fodmap diet has somewhat helped but nothing significant and immodium is my ‘go to’ med. I have been prescribed anti depressants but refused as it is definitely not the answer. I do not have any other health issues and my weight and height are in sink (meaning not overweight or underweight). I do know my trigger foods and stay away from them but it doesn’t always work either. I am at a loss anymore and so sad. I can’t tell you how much I do not want to go for another colonoscopy and as far as rifaxiam (sorry-spelling) the drug you mentioned) they may be considering that for me. However I had an antibiotic for a root canal 5 yrs ago and was prescribed ‘clyndomicin’ and it gave me C Diff (health practitioner said I was her 3rd one that particular week prescribed with that antibiotic that ended up with C Diff from that drug). Great just what I needed. I have recovered from that within 4 months of diagnosis at the time but boy I would not wish that on anyone. I wish there was an educated medical practitioner that could help….as your article mentioned but I don’t believe one exists. Good luck to anyone with IBS as it takes your quality of life away and we only have one so try to find something positive in your life.

    • I have had amazing results with a natural supplement called IBS Formula, literally changed my life!

      • The problem is that everyone is different. The cause is different for everyone, and so are results from diets and treatments. What cures one person can severely incapacitate another. (unfortunately I know that one all too well) There are too many things going around the internet, and even in the medical profession that say one thing or another is the ultimate cause, or that one treatment or diet is the ultimate cure. It doesn’t work that way. All we can do is try different things and keep as accurate records on our own symptoms and treatments as possible so that we can come to conclusions about our own personal issues. And hopefully find something that works for us individually.
        I’m certainly still searching.

    • I think you may find Rifaxamin helpful. I’ve had to take it on two occasions. Once after 3 weeks strait of diarrhea along with fatigue, gas/ bloating, brain fog, and bouts of insomnia. After the first dose, (on an empty stomach!) the diarrhea stopped and I quickly fell asleep that night. It was wonderful and the first glimpse that started to show me my life again. I used that and a FODMAP diet to gain control. I think the Rifaxamin dose is usually a 10 days. It shouldn’t “hurt” you by taking it like when you had C-dif. Also keep up with a probiotic while taking the Rifaxamin. I’ve had pretty good success with it. When all else is failing, I say don’t worry about and take it. It is being prescribed by a doctor. It may be the thing that gives you your life back. Best wishes!

      • Thank you Eric.
        Yes my GI Dr did say he thought about Rifaxamin however it was a bit skeptical since having C Diff over 5 yrs ago. He said that I should wait a few more yrs before trying something like this. I am still feeling upset over the C Diff (which I shouldn’t be bitter) but I warned Dr and Pharmacist that I should not take a strong antibiotic especially from my root canal. But I guess these things happen. I appreciate your kind response and wishes. So very thoughtful of you but will definitely keep that in my back pocket. Take care

        • I had C Diff and was put on S. Boulardi and Prescriptassist for a couple of months. Heavy doses. Got rid of it.
          Just an FYI!

      • Thank you and yes because when I had C-Diff they were actually going to do it for me then. However when I seen my GI Dr this Aug he said I wasn’t a candidate because my colonoscopy was really good other than some scaring and aggregates which he assumes is from years of wear and tear and the antibiotic Clyndomicin. No polyps are cancers which is fantastic and no micro colitis or chrons. I may bring it up to him again though as gross as it seems to be it may be a good choice. I stay fit and trim and follow the low fod map diet as much as I can so maybe this is the only alternative. Thanks for bringing that to my attention! Cheers!

  9. Abdomen pain with normal stool – is this IBS? I has gastic flu the end of March, and since then had more good than bad days, however in the last 4 weeks Ive had abdominal pain, not localised or continuous more often than not but daily. Its not constant and not severe, generally feels like trapped gas, bloating slightly. I eat a normal range of foods as I have done, dont drink much alcohol or fizzy drinks and generally stay away from junk food. I have no acid reflux, normal stools.

    I went to the docs and did a stool test this came back normal, he did prescribe 1 week of 20mg Omeprazole twice a day. This made no real difference what I did notice was whilst taking this I felt extreme hunger pains about 2 hrs after eating a large meal. Since stopping the tablets this has reduced this hunger pain after eating quite a bit.

    Im clueless if I have IBS?, tapeworm? gastritis or something else – tempted to try DGL liquorice as Ive heard this works for gastric problems – anyone else had similar symptoms and found out what it is or a solution?

  10. While never officially being diagnosed with IBS (due to embarrassment of ever telling my doctor), I’m certain I had it. I work from home, which made it easier, and with some Imodium, I was usually okay.

    I recently decided to become a vegetarian, mainly for the negative impact of animal livestock on the environment. Within the first week I noticed a huge improvement in my symptoms. It’s now been a month, and I haven’t had any “tummy rumbles”, as my husband puts it politely. I feel 1000% better than before.

    I saw a nutritionist to make sure I was getting enough protein, vitamins, and minerals. I mentioned that my previous IBS symptoms had disappeared and she was really impressed. She said that I should eat some greek yogurt to make sure my probiotics were okay, but since I wasn’t having any trouble anymore, I might be okay without it.

    Becoming a vegetarian and cutting out all meats and fish has really made the biggest difference for me. It might not work for everyone, but I cannot tell you how happy I am to have finally discovered what works for me, and it was just as easy as eliminating meat and fish – which was a lot easier than I thought it would be. I was just going to try being a vegetarian for a month or so for the environment, but now I’m sticking with it since I feel so much better. I hope my experience can help someone else.

  11. I have been diagnosed with IBS, and it has become extremely debilitating. But having researched everything I could get my hands on…mine is different.
    Mine started overnight a few years ago. I am currently 57 and never ever had any gastro-intestinal problems previously. I had put my back out and was in very bad pain. Massage didn’t help, and I could not get into see a chiropractor. So I decided to try acupuncture. I know it has helped others. I went to one of the highest rated ones in town. The next day, I started getting nausea and diarrhea. It quickly became severe. After a few days it was not getting better. I spoke to the acupuncturist and he had said that since I seemed to be tolerating the treatment well, he gave me “extras”. So he said my body was cleansing itself of toxins and I would be fine in a few days. That was almost three years ago, and I have never gotten better.
    I had an endoscopy and then a colonoscopy, then a cat scan with dye. Nothing found anything. A zillion blood tests, stool samples…diabetes, celiac…and everything comes back normal. But my life is gone. I can’t travel, I have to be within running distance of a bathroom at all times. I am in constant pain. There are no flare-ups, or periods of remission. It is constant pain and fighing diarrhea. I take medications for the paid and imodium or lomotil for the diarrhea. That lasts for a day or two. I have tried different pro-biotics. You can tell they do something, but they do not help. Work gave up asking why I have to go to the bathroom so many times in a day. I still do my job, but it is very hard.

    I kept a food and symptom diary since almost day one. I have clearly identified the trigger foods, and they will cause instant distress…but no food is safe. The FODMAP diet does not help me at all. I avoid high fibre, leafy greens, and any cooked tomato products. One thing that made sense to me after all my research was the fact that this started the day after the acupuncture. Starting suddenly after age 50…blood being common, yet nothing found in the colonoscopy…overnight alarming weight loss, even without diarrhea…these were some red flags.

    When I researched acupuncture, one of the areas they treat controls the vagus nerve. That nerve is important, but one of the things it does it control digestion. It is just too much of a coincidence that this happened immediately after the acupuncture. I am convinced that the acupuncture damaged the nerve somehow, or at least the way it reacts. How I would prove this, I have no idea. And I have never found anything that would reverse the damage. Avoiding trigger foods helps, but only to a point. The pain medication helps, but again…only to a point. Life still sucks, and probably always will.

    I’d be curious to know if anyone else had this start after acupuncture or nerve damage?

    • I have had IBS for a number of years…. However, receiving acupuncture for IBS specifically, after several sessions, DID MAKE IT WORSE – and also caused other vagus nerve problems, such as heart palpitations… Never had such problems in my life! Finally figured out there must be a correlation and I quit the acupuncture. I have found that peppermint oil is helping me – it is the only medication that has ever helped. My gut is better, after only a few days of the peppermint oil ( IBGard ) and the palpitations are nearly nonexistent. I thought I was crazy, which is what most doctors seem to think of us IBS sufferers anyway – I am very happy you’ve made this correlation as well.
      I hope you may try peppermint oil and see if it is helpful for tour condition, if so then we may be on to something.


      • Thanks Katie. I’m glad that you feel better. Yes, I have tried peppermint oil ( and almost anything else I have heard that might help). It does help with nausea, but doesn’t help the IBS symptoms any unfortunately. My Doctor doesn’t think I’m crazy as he can see the effect this has had on me. But he is at a loss to as there is no reason found so far as something he can actually treat end this. All he can do is treat the symptoms. I did talk to him about my thoughts about the acupuncture causing this. He did find it very interesting, but impossible to prove as the reason. He didn’t discount it though and agreed it might be plausible it had at least some effect because I never had any gut issues before.

        • Sounds like crohn disease… See another doctor , dont like the answers go to another ans another til someone finds cause, u could also be impacted and have looose stool going around impacted mass, adhesions could be another cause… Get a second opinion

          • I do agree that the symptoms sound more like Chrons to me than IBS, but I have seen many Doctors, including two different gastro-enterologists. I had a colonoscopy (although it was a few years ago). They didn’t find anything, so I don’t get another one for 10 years after the first one ( gotta love OHIP). I also had a Cat Scan with dye, and they didn’t see anything either. Obviously things can change, and a chronic condition such as this can cause damage. But seeing another Doctor is something someone in my position has probably already done if at all possible. With the Doctor shortage here, it isn’t always possible for some, but I have at least been able to see others. I’m pretty persistent.

    • Have you tried going back to Accupuncture? I go twice a month and have never had any issues with it. Go to someone new though. One time I went to a bona fide Chinese medicine acupuncturist and it was the worst experience of my life! But I am so sorry nothing is helping you! I know you said you found triggers but have you been able to embrace any healing foods? Sweet potatoes really helped me with my ibs along with taking collagen in tea everyday. Hope you find something that helps

      • Thanks for your comments. Other people have mentioned going back to another acupuncturist as well. To be honest…to me that is kind of like being in a firing squad, having them just wound you, and then telling them to reload and try again. You could say I’m a bit leery to go back 🙂

    • Have you tried a low oxalate diet? a diet high in oxalates has been linked to ibs. I hope you find relief somewhere, for me just cutting out grains and sugar reduced my symptoms greatly.

      • Hello KD. I have tried every diet known to man I think 🙂

        Grains are definitely a problem. I cannot eat whole grains of any kind. Even seeds on a bun will cause trouble. I can only digest plain white bread. I hate plain white bread, but that’s all I can handle. And I do need it. If I stop bread completely, I lose too much weight and can tell I am missing something.

        I have never had a sweet tooth, but some sugar is a necessity. Besides the energy, it gives me much needed calories. I can only eat certain things though. Chocolate Ice Cream has been a Godsend. It helps maintain my weight, is instantly digested, and gives me some energy.

        So I do need both, but have to be very specific in how I get it.

    • Validating acupuncture as a possible onset for IBS-D. I was having acupuncture for neck pain, I’m also late 40’s in age. During this treatment over a few months, I had to discontinue due to severe onset of digestive issues (Had perfect digestive health). Over the next 2.5 years tried everything for SIBO, infection, candida etc. etc. Nothing worked. Recently diagnosed with IBS, took loperamide and it was 100% better. Confirms an overactivity in digestive tract, I believe it is vagus nerve related. Now I wonder if there was damage due to acupuncture – very plausable and interesting! Now how to fix? Any ideas anyone?

      • I don’t think you can fix nerve damage. I have tried every possible remedy no matter how outlandish it sounds. Nothing has ever done anything but ease the symptoms. Some things will kind of reset things, but it just goes back to full onslaught of all the symptoms within a few days. I swear if someone ever does find a cure for this I’ll give them an American Strat and a Marshall!

        • Iodine and magnesium help with nerve damage (see a naturopathic practitioner). There is a medication called gabapentin or neurotin that helps with pain from nerve damage

          • B12 is THE go-to for any sort of nerve damage, not iodine or magnesium. And gabapentin or neurontin (or “neu-rotin” as you more appropriately called it), are worthless as all they do is temporarily suppress symptoms, until the freakin’ pill wears off and you have to take another one.

            B12. You’re welcome.

    • Hi Lynn! This is absolutely terrible. Your story touched me. I cannot imagine living like that. I truly hope you find an answer, never stop searching.

    • I used to have terrible diarrea ( for 10 years) due to a parasitic infection, but finally got relief going gluten free etc and taking appropriate herbs. Do a food Intolerance test ( infections cause disruption of gut functionality IMHO) , are not the initial cause so to speak in many cases…but still needs to be dealt with. It’s hard work to restore bowel function, but it can be done, even though it may remain a slightly weaker area. Best go to see a Naturopath who studied nutrition, Herbal Medicine and Chinese Medicine. Start drinking raspberry leaf tea for instance ( minor aid)…

  12. I have had IBS all of my life – mother had it – IBS-D and two of the three of my siblings have IBS-C – I tend to take after my mother – Over the years, all of my docs have mostly shrugged their shoulders when I listed my symptoms and poo-pooed (sorry about the pun) my requests for a referral to a gastro doc – my latest doc won’t refer me until I practice meditation as I told her that stress really exacerbates my IBS – as for food diaries – well – been there done that and what would not cause my IBS one day will trigger it the next. I have found that relying on anti-diarrheal pills at the onset mostly nips my diarrhea in the butt (sorry again for the pun) – have even toyed with the idea of taken anti-diarrheals prophylactively. (I can hear your screams.) So there’s that. Thanks for even asking for feedback on this – most people don’t want to talk about this.

  13. You can’t rely on a regular fecal sample, you need a functional medicine practitioner to order a comprehensive stool sample from a lab like Genova Labs. I prefer the CDSA plus parasitology Purge/ Random test. This will show good bacteria levels and possible pathogenic “bad” bacteria levels. Some of the bad bacteria are actually fine if they’re at a small level but if your good bacteria collapses and the bad bacteria have an overgrowth, that can be a pathogenic level. Western medicine doesn’t consider many of the bacteria pathogenic, but they will still cause symptoms. This lab will show all of that and it will have different substances sensitivity towards a bad bacteria overgrowth. They explain the results and explain everything and offer suggested solutions for the practitioner to discuss with they explain the results and explain everything and offer suggestive solutions for the practitioner to discuss with you. They also offer a delayed reaction and immediate reaction food sensitivity test with a 6 month rotation diet to desensitize you from certain of your food sensitivities. Find a good functional medicine practitioner to help.

    • Do they give u a food rotation diet as well.. i react to most of the thing on the igg test .. dont know what to eat to keep up my weight, keep symptoms at bay

  14. I’ve had IBS-D and Acid Reflux since I was a teen. I’m now 33. For some unknown reason two years ago I became extremely sick. I was up all night vomiting and extreme diarrhea. I did this almost nightly for 8 months. During these episodes I would “pass out”. I thought so anyways. Long story short my husband, whom works nights, happened to be home and see. It’s seizures. I went to the hospital for fluids and potassium 4 times and to a GI Doctor several times. He told me it was stress due to having a disabled child. It is not! Once my husband witnessed the seizures, I was put on Dilantin and Thank God, have not done that again! But, I still have a lot of symptoms. I lost 45 lbs during that time. My symptoms now are still diarrhea (which will not stop! even when nothing is left, I will still cramp and have a small about of bright yellow stuff), nausea, and vomiting every single time my bowel cramps get bad. I also have extreme fatigue, Brian fog, intention tremors, itchy/crawling feeing all over my body, pain in my head, neck, and shoulders, tingling in my hands and sometimes toes. Sometimes I get a tight feeling on my stomach that feels like o have on a gurgle. I’ve had every test possible. MRI of my head was clean, EEG was clean, CT of my stomach was clean, many blood test have been ok. Fecal sample, colonoscopy, endoscopy. All ok.. gallbladder function test was 98%. I’ve been on Xifaxin, Librax, Bental, Zoloft.. None helped. The only help I’ve found is to take Imodium 1 to 3 times a day to keep my stool solid so I don’t get going so bad, Zantac before every meal because PPI’s cause severe cramps. I also take verapamil and Dilantin. The verapamil is for MVP. When I start getting sick my heart rate goes extremely high, this medicine has really helped me not have so many tachycardia episodes. No doctor cares to figure out why I’m suddenly so sick. They do a few test and then are done. One even says, well this is just above my pay grade and wants to send me on. The Neuro I went to didn’t even touch me. He said if my scans were clean (which he didn’t look at, just took the GP word for it), then take depakote because he didn’t like Dilantin. I did that and it made me shake even worse. So they put me back on Dilantin. The only way I can be somewhat normal now is the meds and I have a very limited diet. No raw veg or fruit, no popcorn, nuts, fiber foods, dairy other than lactose free, onions, garlic.. Any of these things and I’m up all night extremely sick and in pain. The only thing my doc said was that I had a little inflammation in the ileum? May not say that right and some somewhere else. A lot of bile also. He said all was normal and that’s it. I do not feel very normal. I am so sick of being sick! I have a 12 year old with non verbal autism and a 10 year old typical son. I also have a fantastic husband. This isn’t stress. My life isn’t perfect but, it’s pretty darn good! ☺️ I just suddenly “went down”. And I can not get back. I literally have to nap every single day. Between 1pm and 5pm I can’t hardly think and I feel like I weigh a ton. I can’t go on, (even with coffee) with out sleeping for at least 30 min. I was not someone who naps before this.. It annoys me so much. I just wish I could get answers. Right now I live day to day on meds. I wear sea bands for nausea every day..
    Sorry so long.. Just so fed up!

    • I should add, Doctor also placed a Merina IUD. Just by chance that it was hormone related. Since I do seem most symptomatic with my cycle. It’s been 6 months and this hasn’t changed anything.

      • Sounds like a severe food allergy. Have you had food allergy testing? Also, don’t eat wheat or gluten as they irritate the gut lining. Get a stool test to see what the flora in your intestines is like. Sounds like you have trouble digesting polysaccharides. You need to see an excellent Integrative Medicine GI doctor. Gerald Mullin at Johns Hopkins or Dr. Farshid Sam Rahbar in Beverly Hills, CA could help you. You may have genetic issues related to your Intestines. Also, Stanford University Hospital has a new department called the Center for Human Microbiome Studies…you should call them to see if you can become a part of their study. I have volunteered myself. I have not been able to balance my gut flora for 7 years and have systemic tissue fungal overgrowth and hyphal fungus lining my stomach and intestines. Perhaps you have issues with Oxalates. I would get to a Functional/Integrative Medicine MD because the regular GI doctors don’t always have the answers because of what they didn’t learn in school. They aren’t taught to figure out why the person is having problems, they only are symptom based medicine where they treat with drugs…and some are very bad for humans. You genetically may have a problem in the gut.

        • Thank you for the information. I’ve had a fecal sample and they said it was fine.. The blood test for gluten was ok also. I haven’t thought about going to an allergist. Maybe that should be my next route. I appreciate you mentioning that. I have almost completely lost my sense of smell and taste and at times I loose it completely for a month or more. I went to an ear nose and throat doctor and he scoped my sinuses and said it was all fine. I don’t want anything big deal but, I have to say I’m quite tired of Nos.. Something has to be going on. They just don’t seem concerned. It’s crazy to me! I’m in Tennessee. I may just need to branch out father. Like Vanderbuilt. That’s 4 hours from me. I may try the allergist next though. Being rural is something I’ve always loved, until now..

          • The only test I’ve had that had any kind of results, and I’ve had a ton of different blood testing done, was blood sugar. But, just twice in the two years I’ve been sick. When this all first started I called my mother in law to help me. I had passed out. Which I now know was a seizure. But, we didn’t know then. She checked my sugar with her monitor and it was 230ish. I went the next day and they did an A1C. It was normal. I started checking it after that and never saw anything or of a normal range again. Then later on a doctor took my blood to test my thyroid and a few other things. They called me and said all was fine except my blood sugar was 32! They were telling me to watch that and seemed very worried. Again, I’ve been testing it and I have had nothing but, normal results! It’s usually 80 in the mornings and around 100-120 after meals. I have checked two hours after meals for reactive issues and it’s still normal.. It’s very strange. Maybe they both were just flukes but, it’s the only thing that’s shown up on any testing..

            • You could have an autoimmune disease too! Have you ever heard of Diabetes 1.5? It happens later in life where the immune system attacks the pancreas. You would have to find a Dr. who knows the special blood tests to check for it….this maybe what you might have. I forgot what the test is called…Antigen something. Most PCP’s, like mine had never heard about it…maybe the specialists have like an Endocrinologist. Try eating more Paleo meals, with less grains because the gut lining gets irritated by grains and inflammatory foods. Bone broth is great for healing the gut. Just trying to help. Something is irritating your immune system, possibly.

          • You could be a non celiac gluten sensitive person like myself. I have the HLA DQ2 gene. An Integrative medicine MD will know how to check for gluten sensitive individuals. Regular western Medicine MD’s do a celiac test but have to have been eating wheat, gluten foods for the test to show anything.
            The stool tests that were done…who did them? Western or Integrative Medicine? Do you have a parasite? Integrative Medicine is who you should go for for those tests. Also, have you ever had any lyme disease testing? Do you have Candida? Lots to look into as well.

            • I agree with the suggestion to be tested for Lyme, especially if some symptoms mimic MS

          • Zinc deficiency will cause a loss of smell and taste. I don’t know about the rest, if you’re having trouble with food you might not be absorbing enough zinc. Zinc orotate is the best absorbed

      • I because sick after a Mirena coil was fitted. I became absolutely suicidal just before my period. Doctor insisted it couldn’t be Mirena because hormone dose was so low but she removed it and immediately all symptoms disappeared. Small things can have a huge impact on some people. I have IBS-D since antibiotics in my 20s .. nothing seems to fix it permanently. One thing that did help which took me years of trying every diet under the sun, was cutting out anything raw.. especially salad. It makes sense – vegetables are high in roughage and clearly my gut couldn’t tolerate it.

    • Please research histamine intolerance / mast cell activation / mastocytosis. You may find answers. Good luck.

      • I looked in to some of those foods with high histamine and every single one of those foods make me sick! I can not handle processed meats like lunch meat or hotdogs at all! Hmm.. I don’t drink fermented drinks and have not been able to eat anything fermented my whole life. Any think like wine gives me bowel issues and really bad neck pain.. I’ll read more in to that! The symptoms are very similar! I stay stuffy and cough and can smell and taste very little. I’ll have to see if I’m eating anything like that still. I don’t feel like I do, but I’m going to be reading more now.. Thanks so much for this.. Y’all don’t know how much I appreciate any and all possible help! My doctor leans towards MS and I was too. I don’t want it to be that but, at this point.. ?? So, I hope these things y’all have listed can give me answers..

        • Also look up Yasmina Ykelenstam, The Low Histamine Chef. Her blog has helped me beyond belief. She suffers from histamine intolerance and has learned through her journey to heal herself with food containing high antihistamine and anti inflammatory properties, along with herbs containing same properties. The information I’ve learned from her blog has helped me tremendously. It was overwhelming initially. Take it one day at a time. Best wishes.

        • Britt, you can reverse autoimmune diseases and put them into remission by changing the way you eat. Get Sarah Ballantyne’s Book and Cookbook. Costco carries them…”The Paleo Approach” and her two new cookbooks. Please get the diet a try. I notice for myself i am sensitive to polysaccharide foods (bloat and gas), oxalates (spinach, nuts, etc.) and histamine foods (like wine, yogurt) It has to do with not being breast fed and not eating a healthy nutrient dense diet long ago, grains, sugars etc. and not eating any probiotic foods. It takes 18 years from birth to develop a complete immune system in the gut and mothers milk starts the process of all the good bacteria forming in our intestines. Over time with being given antibiotics as a child and teen and adulthood, the good bacteria was destroyed. I had Mitral valve prolapse and was told to take the antibiotics before and after dental appointments, I also, had a misdiagnosed tick infection back around the same time in 1990-92. I was put on Cipro and clindamycin antibiotics that wiped out everything and was never told to take probiotics after wards. The candida infection I got in 1989 must have come from a combination of things, antibiotics, not being breast fed, getting a parasite (blastocystis hominis in the colon) and being bit by a tick from hiking and jogging at the nearby county parks (and not even knowing this until 24 years later). Its been a nightmare for me too! Medicine is so far behind on things its sad for some of us who have lived a poor quality of life, because of Medicine’s greed. The FDA, and pharmaceutical company’s have been not much help with this…but I think now there are so many miserable and sick people with gut dysbiosis due to over prescribing antibiotic usage in the past, they now have to find a cure.

    • Sounds like you don’t have the right good bacteria in your gut and possibly have SIBO. Can you have a breath hydrogen test to check for this? Also, Dr. Pimental at Cedar Sinai Hospital in Los Angeles can help you with this, hopefully.
      Chronic stress early on in ones life suppresses HCL acid…taking PPI’s and OTC drugs for heartburn will suppress HCL production…this will set you up for not digesting your food properly and thus a bacterial overgrowth.

    • Have them check you for MS. These are my same symptoms. I finally had a spinal tap done and they found oblicolonal band “o bands” and it was MS. This was after years of searching, hurting, 10 colonoscopies, numerous doctors endocrinologist and ALL the signs were there.

    • So sorry to read about your condition. I have IBS-D and have been researching and trying various things. One thing that has helped me tremendously is Metagenics Candibactrin AR and BR. These supplements, when taken several times daily help a great deal for me. I found a study that was done with these herbal products against Riflaxamin and the herbs had better results. Also many parasite tests will come back negative even when a person is infected. I am currently doing a diatomaceous earth cleanse just in case I have parasites. It’s all natural and high in silica. I know you have probably tried everything under the sun but maybe one of these things would help you.

  15. I have been diagnosed with Blastocystis hominis. I’m wondering how Dr Kresser would treat this. I’m not wanting to go on antibiotics as I think I have leaky gut and fear that would make it worse. I am hoping there may be a more natural way of treating it with western or chinese herbs. Thanks.

  16. I can’t believe the amount of people suffering with this disease. Many years ago people including myself did not have this problem, when water was pure and the air and food were clean. What happened? Well I don’t think it is any one thing that is a cure but perhaps a few things can help believe me I know after having suffered with IBS-C for many years now turning into IBS-D. Hypersensitivies are an issue but finding the right probiotics, herbs, supplements can be the biggest hurdle. Not all supplements and products are created equal. Some are just plain bad and a few should win an award. Here are some things I have found that have really helped.
    (American Biologics Micro Plex Probiotic Powder), Juicing Greens daily, Aloe Vera Georges Juice & Cape Aloe Powder from Africa, Yoghurt (White Mountain or Mountain High) mix micro plex powder in and eat daily, American Ginsing, Ginger, Peppermint, Pau d’ Arco, Magnesium Malate (still looking for a good one since mine was discontinued of many years), and if all else fails Chinese Herbs and combinations for stomach disorders. Eat small means and live food daily, lots of fresh water and stay active. Good luck beautiful people!

  17. I mentioned ARD (adhesion related disorders) earlier. Adhesions can be caused by many things. One of which is endometriosis, which is very underdiagnosed.

    I used to think that it had been ruled out in my case since I had my uterus removed, and also had had an exploratory laparoscopy a couple of decades ago. And a myomectomy with a large incision that I know really made my adhesions worse.

    There is a lot of information on Endometriosis Awareness out lately. There are also a lot of long held myths about it- what causes it, how it should be treated, or that menopause or pregnancy will eliminate it. The more that I learn about it, and the more that I read about the many symptoms that so many women have, I am seriously thinking that I actually do have it. And maybe PCOS- I developed severe cystic acne after what I believe was a burst ovarian endometrioma or dermoid cyst which can cause pain that can be even more severe than a burst appendix. But I was immediately thrown under the IBS bus at my very first Dr appointment after it happened- no tests or anything was done. PCOS and endo often occur together.

    It sounds like the average gynecologist is not very good at diagnosing and treating these things. Like in my older sister’s case, where all of the emphasis was on fibroids. She wasn’t diagnosed with endometriosis until she had an ectopic pregnancy. Since I never had the chance to even try and get pregnant (I was too miserable to even consider it) I don’t think that any gynecologist really put much effort into finding it. Now that I am in menopause and don’t have a uterus, gynecologists have no interest in seeing me.

    From what I have read, there are very few surgeons who have the proper skills to diagnose and treat it. Endo can have many different appearances, it can hide throughout various organs outside of the reproductive tract where most gynecologists are not comfortable dealing with, and the only effective treatment is excision surgery- but most gynecologists don’t excise it and the endo comes right back. They just remove the surface. Endometriosis causes adhesions which also need to be addressed but many surgeons only deal with the endo lesions.

    I have read that endometriosis is very often misdiagnosed as IBS, which would explain why a larger percentage of women get the IBS diagnosis than men.

    • Endometriosis is classified as an autoimmune disease. You can purchase, Sarah Ballantyne’s “Paleo Approach” book at Costco, Amazon, etc. also her cookbooks to put autoimmune disease in remission. Autoimmune disease is related to leaky gut. You need to heal the gut to put autoimmune disease in remission.

    • I hear you 11 years of Endo, adeno, IBS. Last year, worsening skin/food reactions and 5 episodes of overnight vomiting marathons that needed up with finding masses at the bottom of my small intestine. Bowel reaction was advised and I asked for a GYN to be there as I was pretty sure Endo was also back enough, as 10 years since last lap. Yep, Endo back in force AND it turned out the masses were Endo through and in the bowel lining in 2 areas. No on picked up on it prior to surgery although I pointed out to every specialist that at least 3/5 vomiting episodes were on day 2. Now? I haven’t felt this good in 11 years, my digestion is better than I can ever remember it good luck with your journey

  18. Does anyone have experience with Rifiximin, and whether it kills good bacteria causing GI issues? I have Ulcerative Colitis, which is in remission, but I also have strep and staph bacteria in my guts and my integrative doc wants me to try Rifiximin. I’m scared, because two years ago a round of amoxicillin for strep throat threw me into the worse colitis scare ever. It was awful, can’t go back there. …

    • Please try Metagenics Candibactrin AR and BR before trying Riflaxamin. It’s herbal and has been studied in a controlled test to outperform Riflaxamin…no drugs is better! My chiropractor keeps me in good Supply of the stuff. I feel so much better when I’m taking it. It kills bacteria overgrowth just like Riflaxamin but better. Do some research on Riflaxamin versus Candibactrin. 🙂

  19. I have been diagnosed with IBS-C, and exactly like you said, it was a diagnosis that came from ruling everything else out. My doctor suggested it was an imbalance between a fast digestion, and a slow bowel. Which equals an insane amount of bloating. A year of visits to a naturopathic Doctor pointed to dysbiosis and leaky gut, (based on my insanely low iron and B12 levels), which we treated. Then we thought it was low acid production (I took Zantac for 20+ years and only stopped after adopting a paleo diet). Then it was gluten intolerance (which I still have but control with my paleo diet). Then it was FODMAP intolerances, which persist to this day, but are reduced. Ultimately, the best way I have found to control, and hopefully eventually cure, is through a ketogenic paleo diet. The low amount of ‘fibre’ foods has not been a problem, in fact, after a 2 week adjustment period, bathroom trips have completely normalized without the use of magnesium–something that never happened on a typical paleo diet (I think I was severely overdoing it on the veggies before). The diet naturally keeps my injestion of FODMAP foods at a low and tolerable level. A ketogenic-paleo diet is naturally free of most irritants to the gut. And perhaps, if continued long term, it may even slowly starve off the SIBO which may also be present. For the first time in many, many years there is no 2pm bloat. I am so, so happy with the success!

    • I get very bad pains in my stomach I can’t Handel the. Pain it sometimes wakes me up out of my sleep . Always happens in late hours at nite really scary. I have been dignosed. With ibs

      • Try not to eat late at night and try to figure out which foods agree with you and those that don’t. It’s a long process but you might want to also look into a few things like probiotics, HCl and digestive enzymes. Read about the microbiome and how to balance the good guys. But most importantly, avoid processed anything. Good luck!