DIET FOR IBS: Reversing IBS or IBD
Irritable bowel syndrome (IBS) is a disappointing diagnosis. Mostly because your gastroenterologist can't give you the answers you are looking for. Questions like:
How did this start?
What is causing my IBS symptoms?
Is it just stress and anxiety?
Is there treatment for IBS?
Am I going to have to live with bloat, constipation, diarrhea, abdominal pain, restricted diet, and anxiety and depression for the rest of my life?
As a functional medicine nutritional therapy practitioner, I've worked with hundreds of clients with IBS symptoms and oftentimes people don't even know they are suffering from this condition. Diagnosis of these common symptoms is typically made 6.6 years after symptoms start. Even though chronic constipation and diarrhea affect between 25 and 45 million people in the United States, where 2 in 3 IBS sufferers are female, most doctors don't know the exact cause of IBS.
However, it is well known in functional medicine that gut imbalances in the microbiome contribute to changes in bowel frequency and we know that dysbiosis is the root cause of IBS. Dysbiosis (the imbalance of gut bacteria) affects the intestines, brain, immune and nervous systems and will cause anxiety, depression, constipation, bloating, abdominal pain, and diarrhea, among other conditions.
Dysbiosis and IBS
A healthy microbiome consists of trillions of bacteria, protozoa, fungi, and even parasites. It is either a source of health or toxicity. In the microbiome's healthy state, it produces neurotransmitters, vitamins, hormones, and it protects us from toxins.
When the microbiome is exposed to antibiotics, medications, chemicals, stress, and processed foods an overgrowth of opportunistic bacteria emerge which deplete the balance of vitamin and neurotransmitter production and other metabolites necessary for a healthy brain, body, and bowel movement.
IBS symptoms like anxiety, chronic constipation, bloating, abdominal pain, and chronic diarrhea occur after dysbiosis sets in.
IBS and Anxiety
Neurotransmitter production in the gut is why IBS and anxiety are often experienced together. While there are also external stressors that might contribute to the feelings of anxiety or depression with IBS, there are also very physical reasons due to the microbiome.
It becomes clear that the only way to reverse the condition of IBS is to create a new balance of the microbiome. This is quite hopeful since what we eat shapes the bacteria present in our gut microbiome. We can change our microbiome through diet.
Treatment for IBS
Most conventional medical treatments are only to manage the symptoms. If you want to finally reverse the condition and expand your diet without abdominal discomfort, constipation, or diarrhea then diet change is necessary.
Many functional medicine providers will recommend a low FODMAP diet for IBS symptoms. While this can improve symptoms temporarily, this diet is not a long-term diet and is designed to be. I've seen many clients get stuck on FODMAPS without addressing nutrition to heal deficiencies and target the root of the problem. Once individuals start to reintroduce new foods, they get symptoms all over again.
IBS and IBD
It is important to mention Irritable Bowel Diseases (IBD) in this post to help connect the importance of the microbiome in overall health. These two acronyms are easily misunderstood.
Are IBS and IBD the same thing?
No. IBD is an umbrella term for inflammatory bowel diseases such as Ulcerative Colitis, microscopic colitis, and Crohn's. IBS is a disorder characterized by altered bowel habit ( can be chronic constipation and/or diarrhea) and abdominal distention or pain.
What is the difference between IBS and IBD?
Inflammatory diseases defined as IBD are often autoimmune. Doctors will screen for IBD before an IBS diagnosis to rule out any autoimmune or inflammatory pathways. Individuals with IBS usually don't show any inflammatory markers in their routine bloodwork whereas IBD patients do.
So, is IBS and IBD the same?
They are not the same but they have similar root issues, dysbiosis. The main difference is how the immune system and nervous systems interact in IBD vs IBS. Both IBS and IBD are caused by dysbiosis and can be resolved with a very similar diet by addressing nutritional deficiencies and microbiome health.
Diet for IBS and IBD
Address Nutritional Deficiencies
Nutritional deficiencies found in individuals with leaky gut and dysbiosis are numerous. The major deficiencies are fat-soluble vitamins which regulate the immune and nervous systems like vitamin D, A, K. Also minerals and vitamins that are used up frequently in a standard American diet are depleted, such as B vitamins, magnesium, zinc, iodine, and selenium.
A diet rich in nutrient-dense bio-available forms of these nutrients is essential because supplementation can aggravate the intestinal microbiome. Manufactured supplements with these vitamins are not utilized properly in the body and often contribute to microbiome imbalances.
Pasture-raised poultry and eggs
Fresh Wild-caught seafood & Fermented Cod Liver Oil
The richest source of B vitamins:
pork, liver, heart, kidneys, eggs, meat, raw milk, poultry, fish
The richest source of bioavailable Vitamin A (not synthetic vitamin A or beta-carotene):
liver, fish, egg yolks, and butter
The richest source of bioavailable Vitamin D:
fish liver oils, eggs, fish eggs or fish, and sunlight
The richest source of Vitamin K2 (menaquinone):
organ meats, full-fat cheese, raw butter, raw cream, animal fats (tallow), egg yolks, and natto
The richest source of Magnesium:
dark leafy greens, egg yolks, nuts, and seeds
The richest source of Zinc:
oysters, shellfish, egg yolks, lamb, liver
The richest source of selenium:
organ meats, seafood, egg yolks, pork, beef, poultry, and brazil nuts
The richest source of iodine:
seaweed, seafood, and Celtic sea salt
Rebalance the Microbiome
To reverse IBS and IBD, we first have to address the overgrowth of opportunistic bacteria in the intestines. Imagine that the bacterial overgrowth is taking over like in the board game Risk. To win, you have to make room for the good bacteria to conquer. We do this in the gut by choosing to only feed the good bacteria and starve out the overgrowth.
Overgrowth bacteria feed on sugar and starch and can live up to 2 years without being fed. So a starch-free, refined sugar-free diet must be followed for at least 2 years. Fruits and honey are allowed in later phases of the healing protocol within 2 years. Fructose doesn't feed opportunistic bacteria. Good bacteria feed on protein, fat, and non-starchy carbohydrates, and will outlive and regain control of the opportunistic bacteria.
Cooked foods by boiling them in meat broth are essential to increase nutrient absorption and allow the intestines to heal. These foods are soothing to the digestive tract and quickly resolve IBS and IBD symptoms. For some, even plants, like vegetables or fruit, contain too much fiber or plant toxins to digest during the beginning phases of the healing process, so these should be limited or removed depending on the severity of symptoms, especially in cases of a diet for ulcerative colitis or a diet for Crohn's.
GAPS intro protocol or an individualized modified GAPS protocol is the optimal approach for IBS and IBD. People don't feel deprived on a GAPS protocol and they can expand the diet throughout their healing journey. In under 2 years, IBS or IBD symptoms are resolved almost completely and the remaining steps are to ensure no relapses occur.
