Irritable bowel syndrome (IBS) is the most common gastrointestinal complaint, affecting up to 20% of all UK adults.
It's believed that 75% of people who have IBS never seek a doctor's help. Of the minority who do, it accounts for 10% of all doctor's visits and 50% of referrals to gastroenterologists.
In other words, IBS is a big problem.
Over the years, it's had a variety of names: spastic colon, spastic bowel, mucus colitis, colitis, and functional bowel disease. It's called 'functional' bowel disease because people who have IBS don't have any obvious changes in bowel structure or other serious complications, and they rarely require hospitalisation. Nevertheless, IBS can significantly restrict a person's lifestyle.
The most common pattern of IBS is diarrhoea alternating with constipation. Bowel movements (i.e. pooing) usually relieve the discomfort. Other common IBS symptoms include:
There are lots of potential causes of IBS. Some of these include:
In 20% of cases, IBS is originally triggered by infection. These people are more likely to have diarrhoea-dominant IBS. The infection causes inflammation in the mucosal tissues (the gut lining), which stimulates immune and muscle changes. When the inflammatory response continues over time, the bowels learn to be over or under-reactive to stimuli.
In others, there's usually no single cause for IBS. By using the functional medicine model, we aim to find the root of the problem in each person, working with him or her individually in response to their biochemical uniqueness.
Testing can be used to investigate the underlying causes of IBS. In our practice, we typically use four different tests:
This stool test provides us with intestinal health markers, giving us insight into your digestive capacity. It enables us to see whether inflammation is present.
The test also looks at infections and pathogens. These are bacteria, yeast/fungi or parasites that may be contributing to your health complaint.
One example of this is H.Pylori. This bacterium is frequently associated with IBS and digestive complaints, and new research is even investigating H.Pylori's role in the development of stomach cancer.
The Comprehensive Digestive Stool Analysis measures H.Pylori, along with several other pathogens.
There are countless food intolerance tests available on the market. While some of these tests can provide useful insights on occasion, we prefer to use elimination diets with patients—simply because they tend to yield better results.
When we feel a food intolerance test is warranted, we work with Cyrex Laboratories and Dunwoody Labs.
SIBO stands for Small Intestine Bacterial Overgrowth. Put simply, it means a person has too much bacteria in their small intestine.
SIBO is viewed as one of the most common causes of IBS, especially the constipation-dominant type. We test for SIBO using something called a hydrogen breath test. It may seem odd that a breath test can let you know what's going on in your intestines, but it makes sense when you know the science.
Bacteria in the large intestine produce hydrogen as they ferment carbohydrates. However, this can only occur if carbohydrates remain undigested in the small intestine, instead travelling along the digestive tract to the large intestine.
Although some of the gas produced by the bacteria is expelled as flatus (farts!), most of the gas is absorbed across the lining of the large intestine into the bloodstream. The gas is then transported into the lungs and breathed out.
So, by measuring your breath, we can work how what's going on with your gut bacteria.
After a 24-hour pre-test protocol—which includes a restricted diet for 12 hours followed by a 12 hour fast—you complete your hydrogen breath test. It lasts three hours and requires a breath sample every 20 minutes.
When the results are in, we get to see how much hydrogen and methane gas were produced over this time period. This allows us to see whether you test positive or not for SIBO.
Bacteria and fungi living in the intestines create breakdown products (known as metabolites) that are excreted in your urine.
If you have elevated values for certain metabolite markers, it may be an indication that you have yeast or bacterial dysbiosis.
There are many dietary approaches that can work well for irritable bowel syndrome. Some examples include:
We're all different, so any diet for IBS needs to be tailored to the individual. Based on your clinical history and tests, for example, it may become clear that you require a low FODMAP diet with no grains, while another person would do better on the specific carbohydrate diet.
There's no one-size-fits-all solution.
IBS requires an approach that addresses both diet and lifestyle. Here's where to start:
The functional medicine model uses a systems-biology approach to understand the underlying causes of IBS. Some these include:
In the functional medicine model, we also pay a lot of attention to the mental, spiritual and emotional aspects of people's health. Our bodies are a reflection of what's going on in our emotional life, so the importance of mindset cannot be underestimated.
Approaches such as cognitive behavioural therapy (CBT) address the way IBS patients experience, interpret, and respond to their symptoms. This can be helpful if you recognise yourself in any of the mindsets listed above.
New research indicates that the gut-brain axis plays a key role in digestive disorders, and the presence of psychological factors and central processing deficits contributes to symptom severity and disability.
So what does this mean in everyday life?
Find a stress-reducing practice that you enjoy. This could be tai chi, breath therapy, meditation, the Feldenkrais method, craniosacral therapy, grounding or yoga. You could also try CBT. Along with dietary changes, relaxation should be a key factor in reducing symptoms of IBS.
A visit to the London Clinic of Nutrition is more than an appointment—it's a complete wellness experience. We aim to get to the root cause if your IBS symptoms, addressing them via a jointly agreed nutritional and lifestyle protocol.
Step 1: Pre-consultation
Enjoy a complimentary 15-minute chat. You'll then receive a questionnaire and a food diary to fill in ahead of your session.
Step 2: Initial Consultation
Together we gather a detailed picture of your health, and further testing will be recommended if necessary. You'll come away with a bespoke nutritional and lifestyle protocol.
Step 3: Follow-up Consultations
We ensure your progress through regular meetings. These give you the opportunity to talk about your experiences, review test results and make adjustments where necessary.
"After numerous visits to specialists to address worsening gut issues, Yuwa provided clarity with diagnosis and a plan that immediately alleviated digestive symptoms that had been increasingly limiting my lifestyle. I can't recommend her highly enough."
"I have been working with Farzanah since February 2018 on a range of gastrointestinal, hormonal and skin problems that have been plaguing me for several years. Farzanah was able to diagnose my symptoms and suggest a treatment plan. On starting treatment I immediately noticed a significant improvement in all my symptoms. I have had several follow-up appointments since then and continue to see improvements."
"I have been working with Helen Williams for the past five months and cannot thank her enough! She is the only person who has helped with my stomach/gluten issues after seeing numerous medical consultants and five years of being very sick. I would encourage people to be more open minded and to pursue a more holistic route as you never know what you may discover!"
"After 20 years of digestion-related issues, I found The London Clinic of Nutrition last year during a rudimentary google search. Specialist Nishtha Patel has since provided me with invaluable support and expertise—guiding me through an initial consultancy, sample tests, diagnosis results, analysis, treatment etc. But, above all, provided me with clarity and honesty throughout the process of educating myself about the root of my issues with digestion, and working towards discovering a life beyond them. The results started literally overnight, and have continued since. I sincerely cannot recommend LCON enough."
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