What Your Doctor Didn’t Tell You About Your IBS Diagnosis

GI Track with Large yellow question mark on itBeing sick is the worst.

Having gastrointestinal symptoms daily is not only embarrassing, but it’s also inconvenient.

You just want to know what’s wrong so you can figure out how to fix it. And, honestly, that’s not too much to ask.

So you go to the doctor and embarrassedly state the problems you’ve been experiencing: bloating, gas, diarrhea and/or constipation, and abdominal cramping/pains.

These are common symptoms of many different conditions. 

Your doctor decides to send you for several different tests. Most of them are to rule out terrible diseases like cancer and autoimmune disorders — only adding to your mounting anxiety caused by your health issues.

Once you get all of the results back that you don’t have any of these problems, you’re told that your group of symptoms is irritable bowel syndrome (IBS). 

You’re sent on your way with dietary restrictions, sometimes an antidepressant, or over the counter drugs to manage symptoms.

Covering up the symptoms won’t help stop your misery. And that isn’t fair to you.

The Problem with Being Diagnosed with IBS

The problem with being diagnosed with IBS is that it’s a syndrome. 

Syndrome means that they basically grouped together your symptoms and slapped a label on them because they didn’t have enough evidence to call it any other disease or condition.

This also means that they don’t know exactly what you have or what caused it. Since they don’t know the cause they can’t treat you properly and just offer you solutions that sometimes worked for some people.

IBS is basically an umbrella term for your symptoms so they can tell you that you have something — to give your misery a name. 

Giving it a name doesn’t help you fix it. 

Giving it a name doesn’t help you understand why you are suffering.

Giving it a name for it doesn’t allow you to find a set course of treatment.

You suffer enough. You deserve to understand what the problem is and finally find a solution to end your pain.

Getting to the Source of Your IBS Symptoms

Since they’ve slapped a name on your symptoms we will continue using it, because for now, that’s all we have. Fortunately, scientists haven’t stopped working to understand this debilitating condition.

Obviously something is going on in your body, but what you might not know is that it’s likely not in the spot you thought it’d be. 

We often talk about the gut microbiome. The complex world of bacteria that live inside of your gut that help to maintain the balance of your gut and body functions.

What they’re finding to be a major cause of a lot of IBS diagnosis is actually a different problem — bacterial overgrowth in your small intestines. 

Small intestinal bacterial overgrowth (SIBO) is a complication that works alongside a lot of different diseases. Unfortunately, SIBO is another one of the “what came first: the chicken or the egg” ordeals.

Scientists are able to see a link between SIBO and a plethora of conditions, but determining if it started the condition or was a result is a whole different story. 

Some of the conditions that coexist with SIBO (outside of IBS) include:

  • Irritable bowel diseases (IBD) like Crohn’s disease and ulcerative colitis

  • Diabetes mellitus

  • Chronic pancreatitis

  • Celiac’s disease

  • Immunodeficiency disorders (IgA deficiency, AIDs, etc.)

  • Non-alcoholic steatohepatitis (NASH)

  • Liver cirrhosis

Doctors should be testing for SIBO before giving a diagnosis of IBS. 

 

What is SIBO?

As the name states SIBO is an overgrowth (105 CFU/mL or more) of bacteria in your small intestines. 

This is a problem because your small intestines should remain fairly sterile. The bacteria that live inside your microbiome should stay in your colon. 

Different circumstances can cause the bacteria to hang out in the small intestines. Even though these bacteria are beneficial to your health, if they go to the wrong area, they can be dangerous and the source of your problems. 

When the bacteria are in your small intestines they still try to break your foods down the way they would in your colon. The breakdown process puts off gases that normally are fine to have in your colon. However, your small intestines weren’t created to withstand this extra gas which causes your bloating and other unfavorable symptoms.

You can be tested for SIBO with jejunal aspirate culture or one of two hydrogen breath tests

Testing with jejunal aspirate culture is more accurate, but it is also much more invasive. 

The glucose hydrogen breath test (GHBT) and the lactulose hydrogen breath test (LHBT) aren’t quite as accurate but they’re much less invasive.

Most doctors will opt for breath tests because they’re less invasive. The inaccuracies are based on timing issues. The GHBT seems to be the better option since the timing helps the test to be more accurate. 

The inaccuracies with the testing cause a lot of problems with people going misdiagnosed as having SIBO when they actually don’t and people go undiagnosed when they do have SIBO.

How to Manage IBS/SIBO

When it comes to IBS, there are different categories (IBS-C, IBS-D, and IBS-M). This provides you with a simpler path on how to go about trying to get rid of your symptoms. 

During testing for a study on IBS/SIBO, it was found that those with IBS-D had higher hydrogen production in their breath tests. IBS-C patients produced higher quantities of methane during breath tests. 

Some doctors have found that giving their IBS patients an antibiotic (typically Rifaximin) that their symptoms will improve. This in and of itself is proving the link or misdiagnosis of IBS as actually being SIBO. 

Taking antibiotics is generally not a great idea unless you absolutely need them. Antibiotic use can kill good bacteria in addition to the bad. Antibiotic resistance is becoming an increasing issue as well so the less you take the better.

However, there are now great natural options to treat bacterial overgrowth in the small intestine.

Have you found any great options to treat IBS/SIBO naturally?   

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890937/pdf/WJG-16-2978.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949258/pdf/WJG-20-2482.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155069/pdf/jnm-17-312.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2838757/pdf/1471-230X-10-23.pdf

https://www.ncbi.nlm.nih.gov/pubmed/19243285

What Your Doctor Didn\'t Tell You About Your IBS Diagnosis