So you’ve been diagnosed with irritable bowel syndrome (IBS). Now what?? As someone who has IBS, I’ve experienced first hand how debilitating it can be, and how confusing the diagnostic process is. I want to share with you some things that I wish I would have known back when I got my diagnosis, that would have saved me years of excruciating pain and suffering. I have now seen thousands of patients who also have this diagnosis live a legendary life.
Why is Irritable Bowel Syndrome a Functional Bowel Movement Disorder?
Irritable bowel syndrome is classified as a chronic functional bowel movement disorder because it is diagnosed by the symptoms that you are experiencing. These are typically abdominal pain, gas, bloating, and changes in bowel movements, often diarrhea or constipation1. Other digestive diseases that can be seen by colonoscopy or confirmed by lab tests are often excluded before IBS is diagnosed.
Why Can’t Labs Tell Me That I Have Irritable Bowel Syndrome?
The labs that most conventional doctors use at this moment in time don’t give a definitive diagnosis of irritable bowel syndrome. This is because it is a complex interplay of all the processes in our body. It is most often a reaction to stress in the body, whether emotional or physical, that creates an imbalance in the immune, nervous and hormonal systems. This compounds and affects the natural digestive processes of the gut, causing inflammation, irritation, dysbiosis and lack of digestive factors that all contribute to and aggravate our symptoms2.
The big point here is that it is NOT just one thing causing IBS, and to treat it you need to have a MULTIFACTORIAL approach or it just won’t work.
Functional Disorders Involve the ENTIRE Environment of the Body
As a Naturopathic Doctor, we look at the body as a complete environment, an ecosystem. I have expertise in digestive disorders, specifically irritable bowel syndrome. I am also extremely well versed in hormonal problems such as hypothyroid, estrogen dominance, nervous system conditions like anxiety and depression, and immune system problems like Hashimoto’s thyroiditis, celiac disease, cancer, Crohn’s, ulcerative colitis and I have treated all successfully.
If I only knew about the gut and digestive system, I wouldn’t be able to treat a FUNCTIONAL digestive system disorder because functional means that the whole entire body is involved. The ecosystem needs rebalancing.
Are There Functional Tests for Irritable Bowel Syndrome?
Yes, there are things that can be tested, but again, it is a whole body approach. So as a Naturopathic Doctor I can see that there are imbalances in the whole body.
What Is the Point of Testing in Irritable Bowel Syndrome?
First off, it’s important to do tests to rule out other conditions. When the diagnosis is clear, I test irritable bowel patients in order to track improvements and direct and guide treatment.
For my health as well, I have noticed that it is vital to have this tracking system over time in order to gain a good understanding of what is going on inside your system, year to year.
Since irritable bowel is a chronic, long term disease, being proactive in this way helps to stay on top of things and avoid the frustration and suffering of living with uncomfortable symptoms.
Stress Hormone Testing Cortisol and ACTH
Research demonstrates that people with irritable bowel syndrome, mainly women, with onset at a younger age3, will have it for the greater part of their lives. They typically also have an imbalance in their nervous system and stress response.
Stress markers of cortisol in the blood can be tested and show a difference between men and women as well as between healthy and unhealthy subjects4. However, this is a costly test and is not common protocol for irritable bowel syndrome.
Salivary or urine cortisol markers can also be used to measure this, and they are my markers of choice. Research demonstrates that there is a significant difference in cortisol (stress hormone) markers in the morning and evening, and in general there was a higher spike in the a.m. and lower in the evening. The pattern of circadian rhythm night and day curve was still maintained5.
These tests can be purchased on YourLabWork.com.
Sleep is often something that is a complaint for women with IBS and there seems to be a difference between the type, whether it be IBS-D (diarrhea predominant) or IBS-C (constipation predominant)6. Sleep is something that normally balances our regulatory systems as it helps to reset the immune, nervous and hormonal systems.
I recommend wearing an eye mask to bed at night to help support natural melatonin production, without having to take a supplement. I’ve created a Beauty Sleep Kit that uses castor oil applied around the eyes, eyelashes and eyebrows, covered by a sleep mask. This has a relaxing effect on the system and improves natural melatonin levels, helping you to get a good night’s sleep. You will note over time, visible differences in sleep quality with using a mask7.
Inflammation Testing in IBS
Inflammation is a key component in IBS. Inflammation may be sourced from food sensitivities, allergies and intolerances, or choices of food, such as fermented foods that have high levels of histamine and act as an irritant to the gut. Inflammation is a root cause of all diseases and when there is imbalance in any system there is always inflammation.
Ferritin, the storage molecule for iron can also be a key indicator of acute inflammation. It is important to test in combination with a complete blood count (CBC) as well as an iron panel to make sure you rule out any other reasons for an elevated level of Ferritin.
In my practice there are certain key markers that I have noted are indicative inflammation. Firstly, high sensitivity C reactive protein (HS-CRP). This marker is not often tested, however, levels have been noted to be higher in those with irritable bowel syndrome as compared to the healthy population8.
Cholesterol has also been one of the markers of inflammation that I use to track progress in patients. It is linked to inflammatory processes in the body and I have seen clear indications post therapeutic cleansing interventions with my patients, where even if cholesterol is only moderately higher, it always decreases from the pre-testing phase9. I always test these levels in my IBS patients because I want to see how they are adapting to their protocols and where they are at the present state in time.
A complete blood count (CBC) is always important to do as well, because it demonstrates a variety of markers. With regards to inflammation, eosinophils are a marker of allergy and when they are elevated it’s an indicator that there is elevated histamines in the body10. It’s most commonly correlated to parasite infection, which is something to be considered in irritable bowel syndrome, since the onset of IBS can be due to a gastrointestinal infection11.
In my opinion, food sensitivity testing is in a class of its own. It can demonstrate inflammatory processes in the gut as well as immune reactivity. When aiming to fix an irritable bowel, it’s important to understand that there are so many things that can be irritating it.
Food is the biggest irritator and since we eat food every day, it’s very important to address this to reduce inflammation.
This website has more information on food sensitivity testing in the US.
Can You Test for Dysbiosis and The Microbiome?
You absolutely can, and uric acid (a key indicator of gout) is an excellent marker to use for dysbiosis or an unhealthy microbiome12. Uric acid is a good indicator of microbiome health because it shows improper metabolism of protein, typically due to unhealthy gut bugs.
Another my tests is the Organic Acids Test (OAT), which tracks overgrowth of yeasts as well as possible clostridium infections which aids in the support of patients with IBS.
There are also recent novel tests that will actually classify the types of healthy v.s. pathogenic microbes in your microbiome. This research is in its infancy.
What Should You Test? My Dream List
Here is my dream list, which is basically a full workup of a patient to rule out other sources of pain in the intestine:
- Serum Electrolytes
- Liver Enzymes, ALT, AST, ALP GGT
- Urobilinogen, direct and indirect
- Blood Lipids/Cholesterol
- eGFR and Creatinine
- Uric acid and urea
- Iron panel including Ferritin
- TSH, Free T3, Free T4, Antibodies for Thyroid
- Dutch Hormone Test
- Food Sensitivity Testing
- OAT Test
What to Do While You’re Waiting to Get Your Tests Done?
Start working on a solution!
My two first protocols for all patients is to start a castor oil pack, which immediately begins to work on the stress component of their condition. It will reduce inflammation, help the body to cleanse, get the bowels moving and significantly reduce pain in the gut (I’ve used it more times than I can count for acute pain in my situation and it hasn’t failed). It will also help you get a great night’s sleep. The Queen of the Thrones™ Castor Oil Pack Bundle™ is available here
In addition, I encourage patients to wear an eye mask to bed. As mentioned before, this will help to increase the body’s natural melatonin production, improving quality of sleep. The Queen of the Thrones™ Beauty Sleep Eye Kit™ is available here
This is the basic start for all of my patients from the get go, because if we can start to reduce the stress, address the inflammation, cleanse, poop and sleep (these are common problems that every single person who walks into my practice shares) I can actually start getting a clearer picture of what is going on.
Peek After You Poo
The other pièce de résistance is that I ask my patients to start peeking at their poo. I want a detailed account moving forward. Because let’s face it, lab tests start to get quite expensive. For the full panel above you could be looking at anywhere between $1500-$2500 per shot, so why not learn what your poo is saying about you? It is an easy daily at-home test, totally free!
Use Eau De Throne™ the ‘After You Poo Parfum™’ to get into the habit of peeking after you poo and allow the blend of organic essential oils to ensure that you will never be embarrassed again for the smell you leave behind!
Every visit, with every single patient, we have this discussion and you would be shocked at how much it guides treatment. So much so, that I’ve compiled my personal experience, clinical experience and research so that you have access to the same tools as my patients. For a better understanding of what your poo says about you, download my free e-book ’50 Shades of Poo’ here
Start today! Don’t wait for tomorrow to do what you can do today. This is your health, your life, your body and it’s time for you to know and understand what is going on.
1 Bandar Mohammed Bardisi,1 Abdulaziz Kamal H. Halawani,1 Hassan Kamal H. Halawani,1 Aseel Hassan Alharbi,1 Nesma Saleh Turkostany,1 Taraji Saeed Alrehaili,1 Aisha Ahmad Radin,1 and Nasser Moqbil Alkhuzea1 Efficiency of diet change in irritable bowel syndrome. J Family Med Prim Care. 2018 Sep-Oct; 7(5): 946–951.PMID: 30598938
2 Emanuele Sinagra, Gaetano Cristian Morreale, Ghazaleh Mohammadian, Giorgio Fusco, Valentina Guarnotta, Giovanni Tomasello, Francesco Cappello, Francesca Rossi, Georgios Amvrosiadis, and Dario Raimondo New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond. World J Gastroenterol. 2017 Sep 28; 23(36): 6593–6627.PMID: 29085207
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4 Elizabeth J. Videlock,a Wendy Shih,b Mopelola Adeyemo,a Swapna Mahurkar-Joshi,a Angela P. Presson,c Christos Polytarchou,a Melissa Alberto,a Dimitrios Iliopoulos,a Emeran A. Mayer,a and Lin Changa,* The effect of sex and irritable bowel syndrome on HPA axis response and peripheral glucocorticoid receptor expression.Psychoneuroendocrinology. 2016 Jul; 69: 67–76.PMID: 27038676
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6 Robert L. Burr, MSEE, PhD, Research Professor,a Monica E. Jarrett, PhD, Professor,a Kevin C. Cain, PhD, Research Scientist,b Sang-Eun Jun, MS, Doctoral Candidate,a and Margaret M. Heitkemper, PhD, Professora. Catecholamine and Cortisol Levels during Sleep in Women with Irritable Bowel Syndrome.Neurogastroenterol Motil. 2009 Nov; 21(11): 1148–1e97.PMID: 19573081
7 Rong-fang Hu,1 Xiao-ying Jiang,1 Yi-ming Zeng,2 Xiao-yang Chen,2 and You-hua Zhang3 Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment. Crit Care. 2010; 14(2): R66.PMID: 20398302
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12 Zhuang Guo,1,* Jiachao Zhang,1,* Zhanli Wang,3,* Kay Ying Ang,2,* Shi Huang,4 Qiangchuan Hou,1 Xiaoquan Su,4 Jianmin Qiao,1 Yi Zheng,1 Lifeng Wang,1 Eileen Koh,2 Ho Danliang,2 Jian Xu,4 Yuan Kun Lee,a,2 and Heping Zhangb,1 Intestinal Microbiota Distinguish Gout Patients from Healthy Humans Sci Rep. 2016; 6: 20602.PMID: 26852926 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4757479/
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