Underlying Causes of Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome, or IBS, is a common diagnosis in primary care and gastroenterology settings. IBS can present with constipation (IBS-C), diarrhea (IBS-D), or mixed. IBS is a diagnosis of exclusion and cannot be tested for via labs or imaging. Hence, the problem with a diagnosis of IBS is that it often stops the investigation to determine root cause of the patient’s symptoms. Treatment is then usually focused on symptom management alone. There are several conditions that can mimic IBS that can often be revealed through additional work-up.
We recommend considering the following when evaluating for causes of IBS:
Stool testing: comprehensive stool testing can assess many aspects of gut health through conventional lab tests. This can reveal levels of beneficial bacteria, pathogens, opportunistic microbes, markers of digestive health, and inflammation markers.
SIBO Test: Small Intestine Bacterial Overgrowth, or SIBO, is an overgrowth of bacteria in the small intestine. SIBO is an underlying cause of >50% of IBS cases. SIBO symptoms include acid reflux, gas, bloating, constipation, abdominal discomfort, and diarrhea.
Candida: Candida is a yeast that can overgrow in the digestive tract, along with many other surfaces of the body. Candida overgrowth can contribute to many of the same symptoms of IBS and SIBO. Symptoms may flare especially when patients consume foods rich in sugar or yeast.
Food sensitivity test: Food sensitivity testing can be helpful to determine if any particular foods may be contrbuting to digestive symptoms. This is usually done via blood testing for IgG or IgA antibodies to a panel of foods.
Other conditions to be ruled out: inflammatory bowel disease, celiac disease, food allergies, and H Pylori infection.
In summary, there are many underlying causes of IBS that often go undetected in many healthcare settings. If you are struggling with IBS, be sure to establish care with a qualified healthcare practitioner and request additional testing be performed. We encourage you not to accept a diagnosis of IBS until all other possibilities have been ruled out.
