Gastrointestinal issues are one of the main reasons why patients come into a doctor’s office. Certainly, irritable bowel syndrome (IBS) is the primary gastrointestinal diagnosis. Despite being a common disease, IBS’s etiology is still unknown due to the heterogeneity of its symptoms. The new hypothesis points to the fact that underlying infectious illness may cause IBS, and the bacteria overgrowth in the small intestine (SIBO) could explain the apparition of symptoms.

Observation concludes that the incidence of new-onset IBS symptoms is commonly reported after acute infectious gastroenteritis. In addition, breath tests have been able to determine the presence of SIBO in patients with IBS. Furthermore, after treatment, a reduction of SIBO resulted in an improvement of IBS’s symptomatology. 

IBS symptomatology:

• Abdominal pain.
• Bloating.
• Altered bowel movements.
• Constipation in women.
• Diarrhea in men.

Furthermore, these symptoms are usually paired with secondary complications due to the connection between the gut and the body’s systems.

Neural signaling and IBS

The presence of IBS can cause detrimental symptomatology in the nervous system. Issues like autonomic dysfunction, sensitization of primary afferents, central pain amplification, and visceral hypersensitivity are complications attributed to IBS.

Immune dysregulation

Patients with IBS have elevated proinflammatory cytokine levels, intestinal permeability, and mast cells in the mucosa. However, the main reason is not yet elucidated since a previous infection can cause these mechanisms.

SIBO

Small intestinal bacterial overgrowth (IBS) is commonly found in patients with IBS. Indeed, the bloating symptoms of IBS are associated with the increase of fermentation and gas production by intestinal bacteria. In addition, the risk of developing IBS rises after suffering from infectious gastroenteritis due to a disruption of colonizing bacteria.

How to treat SIBO and IBS? 5R’s Framework

Orthomolecular medicine seeks to treat upstream and deal with the root cause of disease. Restoring gastrointestinal health and treating the gut are the main focal points to treat SIBO and IBS. Therefore, what seems fair is to develop a treatment plan that focuses on removing the nocive gastrointestinal environment and replacing all the gastric secretions. Furthermore, the reinoculation of beneficial bacteria with probiotics and prebiotics is vital to repair and rebalance well-being.

5R’s Framework

1. Remove: Eliminating stressors that might affect the GI environment may include the use of an elimination diet or taking medication to remove pathogenic bacteria.
2. Replace digestive secretions: bringing back proper digestive function may lead to the use of digestive enzymes, promote adequate hydrochloric acid production and bile acid secretion.
3. Reinoculate: Replenishing the beneficial bacteria may need the supplementation of probiotics and prebiotics.
4. Repair: detecting and treating the gut lining is crucial for the absorption of essential nutrients. Therefore, the proper nourishment of this tissue might benefit from L-glutamine supplementation to maintain the rapid enterocyte turnover.
5. Rebalance: having good lifestyle choices that promote stress relief and balance can promote a sense of well-being. Reducing stress is a crucial part of gut health.

Disease progression is something that we can modulate by resetting our gut health. Resetting is the first step. However, to promote better gut health, we need to provide our beneficial bacteria with the proper prebiotics to flourish. Our nutritional decisions influence our microbiome variety and balance. – Ana Paola Rodríguez Arciniega, MS

References:

Thompson, John Richard. “Is irritable bowel syndrome an infectious disease?.” World journal of gastroenterology vol. 22,4 (2016): 1331-4. doi:10.3748/wjg.v22.i4.1331

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Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*

email: coach@elpasofunctionalmedicine.com

phone: 915-850-0900

Licensed in Texas & New Mexico