Leaky Gut Syndrome | Gutfulness Nutrition
October 23, 2024
Clarissa Lenherr is a gut health BANT Registered Nutritionist on a mission to help people optimise their digestive health and feel their best.
Irritable Bowel Syndrome (IBS) is a common yet complex gastrointestinal disorder that affects millions worldwide. Characterised by a combination of symptoms that vary in severity and duration, IBS can significantly impact quality of life. However, understanding the condition, its causes, and the natural management strategies available can empower individuals to regain control over their gut health.
In this article, we’ll explore the symptoms and potential causes of IBS and discuss evidence-based natural strategies to manage the condition.
IBS is a functional gastrointestinal disorder, meaning there are no structural abnormalities detected during diagnostic tests. Instead, it’s defined by chronic or recurrent symptoms, including abdominal pain, bloating, and altered bowel habits—whether diarrhoea (IBS-D), constipation (IBS-C), or a mix of both (IBS-M).
IBS is not life-threatening, but its symptoms can be debilitating, leading to social, psychological, and physical challenges. According to research, IBS affects approximately 11% of the global population (1), with women more commonly diagnosed than men. The exact cause remains elusive, but a combination of genetic, environmental, and psychological factors is believed to play a role.
The symptoms of IBS can vary significantly from one individual to another. The most commonly reported include:
Symptoms often fluctuate and may come and go, sometimes making it harder for people to spot patterns or triggers.
Although the exact cause of IBS is unknown, multiple factors are thought to contribute to its development.
The gut and brain communicate through the gut-brain axis, a complex network of neural, hormonal, and immune pathways. In IBS, this communication may be disrupted, leading to heightened sensitivity to normal digestive processes and changes in gut motility.
Research has suggested that people with IBS often have an imbalanced gut microbiome – aka dysbiosis. Beneficial bacteria may be reduced, while potentially harmful strains may flourish. This imbalance can lead to increased gas production, inflammation, and heightened gut sensitivity. Potential causes of an altered gut microbiome include poor diet, frequent antibiotic use, chronic stress, and infections.
A diet high in ultra-processed foods and low in fibre can starve beneficial bacteria and encourage the growth of less favourable strains. Similarly, excessive antibiotic use—while often necessary—can disrupt microbial diversity, creating opportunities for harmful bacteria to thrive.
Changes in gut motility—how quickly or slowly food moves through the digestive system—are a common feature of IBS. In IBS-D, rapid transit time can lead to diarrhoea, while in IBS-C, slower transit time can result in constipation. Dysregulated motility often contributes to abdominal pain and irregular bowel habits.
Individuals with IBS frequently experience heightened sensitivity to pain and discomfort within the gastrointestinal tract, even when no clear cause is present.
Stress and anxiety are significant contributors to IBS symptoms. The gut’s response to stress involves hormonal changes that can alter digestion and gut motility.
For some, IBS begins after a bout of gastroenteritis. The infection may damage the gut lining or disrupt the microbiome, triggering long-term symptoms.
Genetic predisposition may play a role in the development of IBS. Studies have found that individuals with a family history of IBS are more likely to develop the condition. (2)
Diagnosing IBS typically involves a thorough medical history, symptom evaluation, and ruling out other conditions, such as inflammatory bowel disease (IBD), coeliac disease, or small intestinal bacterial overgrowth (SIBO). The Rome IV Criteria, a standardised diagnostic tool, is often used to identify IBS based on symptoms.
The Rome IV Criteria focus on the following:
While these criteria provide a useful framework, IBS is a diagnosis of exclusion, meaning other potential causes must be ruled out through blood tests, stool analysis, or imaging studies.
While there is no cure for IBS, numerous strategies can help manage symptoms effectively. These include dietary changes, stress management, and targeted supplementation, with the guidance of a gut health nutritionist to identify underlying causes and create a tailored plan.
One of the most effective dietary strategies for IBS is the low-FODMAP diet. FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are types of carbohydrates that ferment in the gut, producing gas and drawing water into the intestines. Studies have shown that up to 70% of individuals with IBS experience symptom relief on a low-FODMAP diet! (3)
High-FODMAP foods include wheat, garlic, onion, cauliflower, certain fruits, and pulses. Managing a low-FODMAP diet typically involves a phased approach: an initial strict elimination of high-FODMAP foods for 4-6 weeks, followed by a careful and gradual reintroduction to identify individual triggers. Due to its complexity and the potential risk of nutrient deficiencies, this diet should always be implemented under the guidance of a nutritionist to ensure it is followed correctly.
Keeping a food and symptom diary can help identify specific triggers. Common culprits include dairy, caffeine, alcohol, spicy foods and high-fat foods.
My tips to start:
Adjusting fibre intake is a key strategy for managing IBS symptoms, as the type and amount of fibre can have a significant impact. For those suffering from IBS-C (constipation-predominant IBS), increasing the intake of soluble fibre, such as psyllium husk, oats, and flaxseeds, can help soften stools and promote regularity. These types of fibre attract water into the stool, making it easier to pass.
On the other hand, people with IBS-D (diarrhoea-predominant IBS) may benefit from reducing insoluble fibre, such as that found in bran, raw vegetables, and whole grains, which can irritate the gut and worsen diarrhoea.
Given the strong connection between stress and IBS, incorporating stress-reduction techniques can play a key role. Here are some of my recommendations[1] :
Mindfulness Meditation: Studies show mindfulness reduces IBS severity by calming the gut-brain axis (4)
Cognitive Behavioural Therapy (CBT): CBT has been shown to help reduce IBS symptoms by addressing thought patterns that exacerbate stress (5).
Yoga and Breathwork: Regular practice can improve digestion and reduce bloating.
Fibre supplements can play an important role in managing IBS symptoms, particularly for those who struggle to meet their fibre needs through diet alone. Soluble fibre supplements, such as psyllium husk, is often recommended because of its ability to regulate bowel movements without causing excessive gas or bloating.
One particularly beneficial fibre supplement is Partially Hydrolysed Guar Gum (PHGG). PHGG is a water-soluble dietary fibre that is gentle on the digestive system and well-tolerated by most individuals with IBS.
Top Tip – With fibre supplements, the key thing is to start low and slow and build up tolerance to avoid unwanted symptoms!
For those who struggle to digest certain food groups, digestive enzymes can support the breakdown of difficult-to-digest components, potentially helping to reduce symptoms.
Peppermint oil is a well-researched natural remedy for IBS. Its antispasmodic properties can relax intestinal muscles, helping to reduce pain and cramping.
ION* Gut + Microbiome is a unique, soil-derived supplement that addresses gut health from a foundational perspective. Unlike traditional probiotics, ION* focuses on strengthening the gut lining to support a diverse and thriving microbiome. By reinforcing the tight junctions in the intestinal wall, it creates an environment where beneficial bacteria can flourish.
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Exercise can help regulate bowel motility, reduce stress, and improve overall gut health. Aerobic activities, such as walking, swimming, or cycling, have been shown to benefit people with IBS by enhancing digestion and reducing bloating.
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Quality sleep is essential for managing IBS, as poor sleep can worsen symptoms like abdominal pain and irregular bowel movements and impact your mood the next day! Establishing good sleep hygiene can help regulate the gut-brain axis and support overall digestive health.
Tips:
Adequate hydration is crucial for maintaining healthy digestion, especially for those with IBS-C. Drinking enough water supports stool consistency and prevents constipation.
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While IBS can often be managed with dietary and lifestyle changes, certain symptoms warrant further investigation to rule out serious conditions, such as:
Consult a healthcare professional for personalised advice and additional testing if these symptoms occur.
Living with IBS can feel overwhelming, but there are many ways to take control and reduce the impact it has on your daily life. By understanding your unique triggers, exploring dietary strategies like the low-FODMAP diet, and incorporating stress-management techniques, you can find what works best for you.
It’s important to remember that managing IBS is a journey. Be patient with yourself, and don’t hesitate to seek support from healthcare professionals or a nutritionist to help guide you. Small, consistent changes can make a big difference, allowing you to feel more in control and improve your overall quality of life.
This advice is not to replace your medical care, and please always check in with your doctor or work with a nutritionist before taking new supplements.
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