Irritable bowel syndrome (IBS) is one of the most common complaints we hear about at Nordic Clinic, but what exactly is it and why is it so annoying for people that have it? Well, it is a common functional gastrointestinal disorder affecting between 10-20% of the population throughout the world.1 As a syndrome, IBS is marked by varying presentation of symptoms and individual causal drivers. Common symptoms include gas/bloating, abdominal pain, irregular stool habits, and changes in bowel consistency. No wonder patients often report their quality of life is impacted.
Unlike diseases that have a clear cause, factors that cause IBS in one individual may be completely different from another, hence why the medical system finds it hard to treat. Many patients are told they just have to live with it and there is no cure. Current best evidence indicates that IBS is normally caused by a breakdown in one or more parts of the gut-brain axis, a highway of communication between your digestive system and your brain.2
A number of factors predispose individuals to IBS. This includes:
Genetic predisposition – It’s clear that genes play a role in a person’s risk for IBS. A recent paper comparing genes and stool frequency found that genetic polymorphisms (different ways in which genes can work) in enteric motor neurons (the controllers of the movement of our intestines) and neurotransmitter signaling (signal molecules that control digestion) predispose people to IBS.3
Early life stress – Early life stress (ELS) is linked to IBS in humans. Mechanistic studies in rodents find that ELS reprograms the gut by changing cellular physiology and increasing sensitivity to abdominal pain (visceral hyperalgesia). It also increases serotonin production, which may be one of the “feel good” neurotransmitters in the brain but in the gut it actually impacts how your gut works as well. 4
Microbial dysbiosis/SIBO – Our microbiome plays an important role in how we break down our food, food tolerance, and in regulating the gut-brain axis. When our microbiome is thrown out of balanced state, or too many bacteria live in the small intestine (SIBO), this alters gut function, impacts our mood, promotes food intolerance, and increases our risk for IBS.5
Post-infectious IBS – IBS can also occur after an acute bout of gastroenteritis caused by a digestive infection, like salmonella. Data indicates that this is likely due to long term changes in neuronal signaling that can last 2 years or more.6
In an ideal world, the role of the healthcare provider in treating IBS is to identify the causal drivers in each individual and aid in developing a personalised plan for managing the condition. This really underpins the thinking behind Functional Medicine – it aims to understand why you have a given condition like IBS and solve it at the root cause.
Genes, early life stress, microbial dysbiosis, and GI infection predispose individuals to IBS. We cannot control all of these factors, but some we can, like microbial dysbiosis. There are also many other contributing factors to IBS than just these four I have discussed. The key to resolving IBS is to understand all the key factors involved and then developing a personalised plan to resolve. Sounds simple, right!
If you would like to learn more about all the factors that contribute to IBS and how to start to improve your symptoms, join us for a free webinar on this topic on 21 January 2022. The webinar is a collaboration with Food Pharmacy and we are privileged to have Lina Nertby Aurell hosting the webinar. To read more about the webinar and to sign up, click here.
This article was originally published as a guest editor post at foodpharmacy.se
By: Graeme Jones, clinical physiologist and CEO at Nordic Clinic Stockholm.
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