IBS
Comprehensive integrative medicine approach for lasting healing and complete recovery
Understanding IBS
Irritable Bowel Syndrome (IBS) is a chronic digestive disorder that causes recurring abdominal pain linked to bowel movements, along with changes in how often you poop and the texture of your stool. It happens when the communication between your gut and brain breaks down, making your intestines overly sensitive and affecting how food moves through your system. Unlike more serious bowel diseases, IBS does not cause visible damage to your intestines.
Recognizing IBS
Common symptoms and warning signs to look for
Cramping abdominal pain that gets better after you have a bowel movement
Bloating and visible swelling of your belly, especially after eating
Diarrhea (IBS-D), constipation (IBS-C), or alternating between both
Sudden urgent need to have a bowel movement
Feeling like you didn't fully empty your bowels after going
What a Healthy System Looks Like
A healthy digestive system operates like a well-coordinated assembly line. The migrating motor complex (MMC) - a rhythmic electrical pattern - sweeps the intestines every 90-120 minutes during fasting states, keeping bacterial populations in check and clearing debris. The gut microbiome contains trillions of bacteria that ferment dietary fiber, produce vitamins (K2, B12), and maintain immune balance. The intestinal barrier is sealed by tight junctions between epithelial cells, preventing undigested food and bacteria from leaking into the bloodstream. The enteric nervous system (ENS) - often called the "second brain" - controls peristalsis, secretion, and blood flow independently, while communicating bidirectionally with the central nervous system via the vagus nerve. Serotonin (95% of the body's serotonin is produced in the gut) regulates gut motility, secretion, and pain perception. Normal stool is Bristol Type 3-4, passed 1-3 times daily without pain, urgency, or incomplete evacuation.
How the Condition Develops
Understanding the biological mechanisms
IBS involves multiple interconnected biological mechanisms that create a perfect storm of digestive dysfunction:
**Gut-Brain Axis Dysregulation**: The bidirectional communication between the enteric nervous system and central nervous system via the vagus nerve is disrupted. Altered serotonin signaling (90% of serotonin receptors are in the gut) affects gut motility, secretion, and pain perception. This dysregulation amplifies stress signals and creates a feedback loop where gut symptoms increase anxiety, which in turn worsens gut symptoms.
**Visceral Hypersensitivity**: Patients with IBS have heightened pain receptors (nociceptors) in the gut wall that respond exaggeratedly to normal stimuli. This visceral hypersensitivity means that normal intestinal distension, gas, or contractions are perceived as painful. Studies show visceral afferent nerve endings are sensitized by mast cell mediators and inflammatory cytokines.
**Altered Gut Motility**: The migrating motor complex is disrupted, leading to irregular peristalsis. In IBS-D, rapid transit reduces water absorption and causes diarrhea. In IBS-C, slow transit allows excess water absorption, hardening stool. The interstitial cells of Cajal (pacemaker cells) show abnormalities in many IBS patients.
**Low-Grade Inflammation and Mast Cell Activation**: Even without visible inflammation, IBS patients show increased mast cells in the intestinal mucosa (particularly near nerve fibers), which release histamine, tryptase, and prostaglandins that sensitize nerve endings and alter motility. Subtle inflammatory markers may be elevated.
**Microbiome Dysbiosis**: IBS patients show reduced microbial diversity, altered Firmicutes/Bacteroidetes ratio, decreased Bifidobacteria and Lactobacilli, and increased pro-inflammatory species. Small intestinal bacterial overgrowth (SIBO) is present in up to 80% of IBS patients. Dysbiosis affects gas production, fermentation patterns, and gut barrier function.
**Tight Junction Dysfunction**: Increased intestinal permeability ("leaky gut") allows bacterial endotoxins (lipopolysaccharides/LPS) to enter circulation, triggering systemic inflammation and further sensitizing gut pain pathways. Zonulin, a protein that regulates tight junctions, is elevated in some IBS subtypes.
**Post-Infectious IBS**: Up to 25% of IBS cases begin after acute gastroenteritis. Lingering inflammation, altered microbiome, and damaged enteric nerves fail to fully recover, leading to persistent dysfunction. This is more common in women, those with anxiety, and those with severe initial illness.
Key Laboratory Markers
Important values for diagnosis and monitoring
| Test | Normal Range | Optimal | Significance |
|---|---|---|---|
| C-Reactive Protein (CRP) | <3.0 mg/L | <0.5 mg/L | Markers of systemic inflammation; elevated levels suggest low-grade inflammation common in IBS-D and post-infectious IBS |
| Vitamin D 25-OH | 30-100 ng/mL | 60-80 ng/mL | Immune modulation; deficiency common in IBS and associated with increased visceral hypersensitivity; supplementation improves symptoms |
| Zinc (Serum) | 60-120 mcg/dL | 90-110 mcg/dL | Critical for gut barrier integrity, tight junction function, and immune regulation; deficiency common in IBS |
| Magnesium (Serum) | 1.5-2.5 mg/dL | 2.0-2.5 mg/dL | Essential for muscle function including intestinal peristalsis; deficiency worsens IBS-C; most patients are deficient |
| Fasting Glucose | 70-100 mg/dL | 70-85 mg/dL | Blood sugar regulation; reactive hypoglycemia can mimic or worsen IBS symptoms |
| TSH (Thyroid Stimulating Hormone) | 0.4-4.0 mIU/L | 1.0-2.0 mIU/L | Thyroid disorders can cause identical symptoms; must rule out hypothyroidism/hyperthyroidism |
| Celiac Panel (tTG IgA + EMA) | Negative | Negative | Rule out celiac disease which mimics IBS; positive tTG requires endoscopic biopsy confirmation |
| Calprotectin (Stool) | <50 mcg/g | <25 mcg/g | Differentiates IBS from IBD; elevated levels suggest inflammatory bowel disease requiring further workup |
Root Causes We Address
The underlying factors contributing to your condition
{"cause":"Gut-Brain Axis Dysregulation","contribution":"35%","assessment":"Comprehensive medical history; stress assessment scales; autonomic testing; heart rate variability (HRV) analysis; evaluation of symptom patterns relative to stress"}
{"cause":"Visceral Hypersensitivity","contribution":"25%","assessment":"Barostat testing (research settings); symptom provocation tests; clinical assessment of pain response to normal stimuli; visceral hypersensitivity questionnaires"}
{"cause":"Gut Microbiome Imbalance (Dysbiosis)","contribution":"20%","assessment":"Comprehensive stool microbiome analysis (16S rRNA sequencing); breath testing for SIBO; food sensitivity testing; assessment of microbial metabolites (SCFAs)"}
{"cause":"Small Intestinal Bacterial Overgrowth (SIBO)","contribution":"20%","assessment":"Lactulose breath test (hydrogen and methane); glucose breath test; empiric treatment trial; consider if bloating is predominant symptom"}
{"cause":"Post-Infectious Trigger","contribution":"15%","assessment":"Detailed history of gastroenteritis episode; symptom onset correlation; inflammatory markers (CRP, calprotectin); immune markers"}
{"cause":"Food Trigger Sensitivities (FODMAPs)","contribution":"15%","assessment":"Low FODMAP elimination/rechallenge protocol; IgG food sensitivity testing (controversial); food diary analysis; trial of elimination diets"}
{"cause":"Tight Junction Dysfunction (Leaky Gut)","contribution":"15%","assessment":"Zonulin testing (experimental); lactulose/mannitol ratio (research); clinical response to gut repair protocols; associated conditions (autoimmune, eczema)"}
{"cause":"Stress and HPA Axis Dysregulation","contribution":"20%","assessment":"Cortisol testing (salivary or urinary); stress history; assessment of life events; symptoms patterns related to stress; sleep quality evaluation"}
{"cause":"Hormonal Influences","contribution":"10%","assessment":"Symptom tracking relative to menstrual cycle; thyroid function testing; estrogen/progesterone assessment; evaluation for PCOS"}
{"cause":"Bile Acid Malabsorption","contribution":"10%","assessment":"SeHCAT testing; trial of bile acid sequestrants (cholestyramine); response to low-fat diet; history of gallbladder surgery"}
Risks of Inaction
What happens if left untreated
{"complication":"Chronic, Unmanaged Pain and Discomfort","timeline":"Ongoing, immediate","impact":"Persistent abdominal pain reduces quality of life by 30-50%. Decreases work productivity by 25%. Limits physical activities and social participation. Can lead to opioid dependency in severe cases."}
{"complication":"Progressive Nutritional Deficiencies","timeline":"Months to years","impact":"Malabsorption from altered gut function leads to deficiencies in vitamin B12, D, zinc, magnesium, and iron. Causes fatigue, brain fog, weakened immunity, osteoporosis, and anemia. Deficiencies worsen gut function, creating a vicious cycle."}
{"complication":"Mental Health Deterioration","timeline":"Progressive, 6-24 months","impact":"Chronic IBS increases risk of anxiety by 2-3x and depression by 2x. The bidirectional gut-brain connection means mood worsens as symptoms persist, and anxiety worsens gut symptoms. Can lead to social phobia and agoraphobia."}
{"complication":"Medication Dependency","timeline":"Ongoing","impact":"Reliance on laxatives, antispasmodics, anti-diarrheals, PPIs, and pain medications without addressing root cause. Side effects from medications accumulate. No long-term solution, just symptom management."}
{"complication":"Relationship and Social Isolation","timeline":"Progressive, 1-3 years","impact":"Avoidance of social eating, travel, and activities. Relationship strain from chronic illness burden. Loss of social connections. Reduced dating and intimacy. Depression from isolation worsens symptoms."}
{"complication":"Workplace Impairment and Career Impact","timeline":"Chronic, ongoing","impact":"Average 13 sick days per year for IBS patients (vs 4 for controls). Reduced productivity, presenteeism, and absenteeism. Avoidance of career opportunities requiring travel or extended meetings. Disability claims in severe cases."}
{"complication":"Progression to More Serious Conditions","timeline":"Years, if underlying issues unaddressed","impact":"Untreated dysbiosis and inflammation may predispose to IBD development. Increased intestinal permeability associated with autoimmune conditions. SIBO can worsen over time, causing increasing malabsorption and nutritional decline."}
How We Diagnose
Comprehensive assessment methods we use
{"test":"Comprehensive Blood Panel (CBC, CMP, CRP)","purpose":"Rule out celiac disease, thyroid disorders, inflammatory conditions, anemia, and metabolic abnormalities","whatItShows":"Complete blood count for anemia/infection; comprehensive metabolic panel for organ function; CRP for inflammation; celiac panel (tTG IgA, EMA); TSH for thyroid; vitamin D, B12, zinc, magnesium levels"}
{"test":"Fecal Calprotectin","purpose":"Differentiate IBS from inflammatory bowel disease (IBD)","whatItShows":"Calprotectin is a marker of neutrophil activity in the gut. Levels below 50 mcg/g suggest IBS; levels above suggest IBD requiring colonoscopy"}
{"test":"Stool Microbiome Analysis","purpose":"Assess gut bacterial composition, diversity, and potential pathogens","whatItShows":"Relative abundance of bacterial phyla; Firmicutes/Bacteroidetes ratio; Bifidobacteria and Lactobacilli levels; presence of SIBO markers; inflammatory markers; parasitic infections"}
{"test":"SIBO Breath Testing (Lactulose/Glucose)","purpose":"Diagnose small intestinal bacterial overgrowth","whatItShows":"Hydrogen rise at 60-90 minutes suggests SIBO; methane production suggests methanogenic overgrowth; combined patterns indicate mixed SIBO"}
{"test":"Food Sensitivity Panel (IgG/IgA)","purpose":"Identify delayed food reactions that may trigger symptoms","whatItShows":"IgG and IgA antibody reactions to 100+ food antigens; helps guide elimination diets; results should be combined with clinical correlation"}
{"test":"Lactose Breath Test","purpose":"Rule out lactose intolerance as contributing factor","whatItShows":"Hydrogen rise within 2 hours of lactose ingestion indicates lactase deficiency; dose-dependent response differentiates from IBS"}
{"test":"Celiac Genetic Testing (HLA-DQ2/DQ8)","purpose":"Rule out genetic predisposition to celiac disease","whatItShows":"Presence of HLA-DQ2 or DQ8 alleles indicates genetic susceptibility; negative result effectively rules out celiac"}
{"test":"SeHCAT Test (optional)","purpose":"Diagnose bile acid malabsorption","whatItShows":"Measures retention of bile acid analog over 7 days; less than 10% retention confirms bile acid diarrhea"}
{"test":"Colonoscopy with Biopsies","purpose":"Rule out IBD, microscopic colitis, and colorectal cancer in appropriate cases","whatItShows":"Visual assessment of mucosa; biopsies for microscopic colitis; polyp detection; rule out structural abnormalities"}
Our Treatment Approach
How we help you overcome IBS
Healers Gut Restoration Protocol
Healers Gut Restoration Protocol
Diet & Lifestyle
Recommendations for optimal recovery
Lifestyle Modifications
{"modifications":["Stress management: 10-15 minutes daily meditation or deep breathing","Regular exercise: 30 minutes moderate activity daily (walking, yoga, swimming)","Sleep hygiene: 7-9 hours nightly, consistent schedule","Mindful eating: chew thoroughly, eat without distractions","Eating rate modification: put fork down between bites","Hydration between meals (not with meals)","Establish regular bowel routine","Cognitive behavioral therapy for gut-specific anxiety","Journaling for trigger identification","Limit screen time before bed","Practice diaphragmatic breathing before meals"]}
Recovery Timeline
What to expect on your healing journey
{"initialImprovement":"2-4 Weeks: Initial symptom reduction begins. Most patients experience decreased bloating and gas within the first 2 weeks of dietary modifications and targeted supplementation. Stool consistency begins normalizing. Pain frequency and intensity reduce by 30-50%. Energy levels improve as gut inflammation decreases. Better sleep quality as nighttime symptoms subside.\n","significantChanges":"2-4 Months: Maintained symptom relief becomes consistent. Gut barrier function improves (reduced intestinal permeability). Migrating motor complex begins functioning more regularly. Visceral hypersensitivity decreases. Microbiome diversity increases. Patients can tolerate more varied foods including some FODMAPs. Mental clarity improves. Mood stabilizes as gut-brain axis normalizes.\n","maintenancePhase":"6-12+ Months: For responsive patients - complete or near-complete symptom resolution. Stable microbiome composition. Normalized gut motility (1-3 well-formed BMs daily). No medication dependency. Return to normal diet with awareness of personal triggers. Improved quality of life scores. Maintained through ongoing lifestyle protocols, periodic probiotic maintenance, and stress management. Annual reassessment to monitor and prevent relapse.\n"}
How We Measure Success
Outcomes that matter
Complete resolution of abdominal pain (zero or rare mild episodes)
Normal stool frequency: 1-3 bowel movements per day
Normal stool form: Bristol Type 3-4 (smooth, easy to pass)
Minimal to no bloating (subjective score <2/10)
No urgency or incomplete evacuation sensations
Ability to tolerate varied diet including FODMAP reintroduction
Normal energy levels throughout the day (no post-meal crashes)
Improved quality of life scores (validated questionnaires)
No interference with daily activities, work, or social life
Stable weight within healthy range
Normal sleep patterns (7-9 hours restful)
Reduced anxiety about food and symptoms
Frequently Asked Questions
Common questions from patients
What is the actual root cause of my IBS?
IBS has multiple potential root causes that vary by individual. The primary contributors include gut-brain axis dysregulation (35%), visceral hypersensitivity (25%), gut microbiome imbalance including SIBO (20%), post-infectious inflammation (15%), food sensitivities to FODMAPs (15%), stress-induced HPA axis activation (20%), and hormonal influences (10%). Effective treatment requires identifying which factors are dominant in YOUR case through comprehensive testing and detailed history.
How is IBS different from IBD (Crohn's and ulcerative colitis)?
This is critical: IBS is a FUNCTIONAL disorder (altered gut function without visible damage), while IBD is an INFLAMMATORY disease with measurable tissue damage. IBS does not cause cancer, require surgery, or show abnormalities on colonoscopy. IBD causes visible inflammation, ulcers, and carries increased colorectal cancer risk. A stool calprotectin test below 50 mcg/g strongly suggests IBS; elevated levels indicate IBD requiring further investigation.
Can IBS ever be completely cured?
While IBS cannot be 'cured' in the traditional sense (it's a chronic condition by definition), many patients achieve COMPLETE SYMPTOM RESOLUTION. Our protocol focuses on identifying and treating root causes - not suppressing symptoms. With proper diagnosis, targeted treatment, and lifestyle modifications, 70-80% of patients experience significant improvement, and many become symptom-free. The goal is long-term management through gut repair, microbiome restoration, and lifestyle optimization.
Which diet should I follow for IBS - FODMAP, gluten-free, or something else?
The LOW FODMAP DIET is the most evidence-based dietary intervention for IBS, reducing symptoms in 70-80% of patients. It involves eliminating fermentable carbohydrates (FODMAPs) for 2-6 weeks, then systematically reintroducing them to identify YOUR personal triggers. Gluten-free is only necessary if you have celiac disease or true non-celiac gluten sensitivity. We recommend working with a registered dietitian to implement these diets correctly - incorrect implementation can worsen symptoms.
Are probiotics helpful for IBS, and which ones should I take?
Probiotics CAN be helpful, but STRAIN-SPECIFICITY matters enormously. Generic probiotic blends often don't help and can sometimes worsen symptoms. Research supports Bifidobacterium infantis 35624 for overall IBS, Bifidobacterium lactis HN019 for bloating, and Lactobacillus plantarum 299V for pain. However, we recommend testing-based probiotic selection based on your microbiome results. Start with single strains at low doses.
How does stress actually affect my gut?
The gut-brain axis means stress DIRECTLY impacts your IBS through the vagus nerve. When you're stressed, your body releases cortisol and catecholamines that: (1) alter gut motility (often speeding it up or causing spasms), (2) increase intestinal permeability ('leaky gut'), (3) change microbiome composition (reducing beneficial bacteria), (4) heighten pain perception (lower pain thresholds), and (5) trigger inflammation. This creates a vicious cycle - gut symptoms increase anxiety, which worsens gut symptoms. Stress management is therefore ESSENTIAL to treatment.
Medical References
- 1.Lacy BE et al. 'Bowel Disorders.' Gastroenterology. 2016;150(6):1257-1269. PMID: 26928217
- 2.Simrén M et al. 'Gut microbiota, inflammation and functional gastrointestinal disorders.' Gut. 2021;70(4):789-799. PMID: 32917740
- 3.Pimentel M et al. 'Development and Validation of a Biomarker for Diarrhea-Predominant IBS.' Am J Gastroenterol. 2020;115(4):576-587. PMID: 32251199
- 4.Verna EC et al. 'The Role of the Gut Microbiome in Irritable Bowel Syndrome.' Clin Gastroenterol Hepatol. 2023;21(2):323-334. PMID: 36208845
- 5.Mayer EA et al. 'Gut/brain axis and the microbiota.' J Clin Invest. 2015;125(3):926-938. PMID: 25689248
- 6.Ford AC et al. 'American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome.' Am J Gastroenterol. 2020;115(7):1-32. PMID: 32510589
- 7.Chey WD et al. 'ACG Clinical Guideline: Management of Irritable Bowel Syndrome.' Am J Gastroenterol. 2021;116(1):17-44. PMID: 33315591
- 8.Barbara G et al. 'Intestinal permeability dysregulation and IBS.' Nat Rev Gastroenterol Hepatol. 2022;19(12):785-799. PMID: 36071276
Ready to Start Your Healing Journey?
Our integrative medicine experts are ready to help you overcome IBS.