Our approach to treating IBS
In my clinics I see many Patients with IBS, it is not uncommon to hear of individuals who have suffered for 20 years or more and who have continued to visit their GP but have not achieved any significant improvement in their symptoms. Patients are often told “you’ll just have to live with it” and are offered little explanation as to its cause, my approach is very different to this.
Firstly, patients are asked to fill in a health questionnaire which enables me to build a picture of their IBS symptoms and gives me an insight as to the probable cause.
Common causes of IBS include:
- Imbalanced gut flora
- Candida overgrowth
- Parasitic infection
- Overgrowth of other yeasts or bacteria
- Food intolerances
- Bacterial overgrowth of the small intestine
Secondly, I am a strong advocate of clinical tests and use the excellent Comprehensive Stool Analysis (CSA), Hydrogen breath test and the ELISA test for food intolerances in order to identify the cause of the IBS symptoms. On many occasions, patients have a combination of factors causing their IBS and clinical testing is invaluable in enabling me to put together a health programme to address the causes.
Finally, the test results and my recommendations are clearly and concisely explained to the patient giving plenty of opportunity to answer questions or concerns and we decide on a course of action.
Most importantly, I like to hear from my patients, and make sure that they know that they can call or email me to discuss their health programme or to let me know how they are doing, as its vital that they do not feel like they are on their own.
Want to learn more on IBS and our approach? Have a look at Healthy Aspirations TV, where Tracey Randell talks about IBS, Healthy Aspirations approach and what we can do to help.
Comprehensive stool analysis with parasitology
The stool test provides an unparalleled view of the workings of the gut and is used to identify other known factors in IBS namely imbalanced gut flora (dysbiosis) and unwelcome guests in the form of parasites (commonly Dientamoeba fragilis or Blastocystis hominis) or yeast overgrowth (i.e Candida) which appear to play a role in IBS. Despite a recent study (Stark et al. 2007) recommending the routine screening for parasites in diagnosing IBS, it seems that such testing has yet to be widely available in the UK.
The images below are taken from the stool test results of a young man who was suffering with both gut and mental IBS symptoms and had been feeling unwell for some time. The test results were quite a relief to him. He is still following an anti-candida programme but reports that his symptoms are much improved.
The images show dysbiosis (imbalanced gut flora, no growth of Lactobacillus a very important strain of beneficial bacteria as well as many B Hominis, he didn’t have Candida, although that was what we expected to see!
Food intolerance testing
Immune-mediated food sensitivity remains officially controversial, but I have found it to be invaluable in identifying the triggers of IBS in some individuals. Indeed there are now studies (Andersson et al. 2001; Atkinson et al. 2004) which support the elimination of foods found to raise IgG antibodies as a way of relieving the symptoms of IBS.
Understanding the NHS approach
GP’s make a diagnosis of IBS after ruling out other diseases such as inflammatory bowel disease, diverticulitis and colon cancer by undertaking testing as recommended by NICE (National Institute of Clinical Excellence). NICE guidelines (NICE 2008) recommend a full blood count, erythrocyte sedimentation rate (ESR) or plasma viscosity, C-reactive protein (CRP) and antibody testing for coeliac disease. Other tests for thyroid function, fecal parasites and a hydrogen breath test for lactose intolerance might also be used as well as a barium enema, colonoscopy or sigmoidoscopy if there is a family history of bowel cancer. Once these tests have been undertaken and found to be negative the patient will be diagnosed as having IBS. At this point the GP is unlikely to have any other solutions other than offering laxatives for constipation, Imodium for Diarrhea and Anti-spasmodics for the abdominal cramping sometimes experienced with IBS. This really isn’t all that can be done and there is no need to put up with the symptoms of IBS. The reason for your IBS just hasn’t been identified yet, contact me if you would like to discuss this more.