The Real Cause of Irritable Bowel Syndrome (IBS)
April 16, 2021
Rhya Pachin, RDN, LDN, CLT

Got the “I-look-6-months-pregnant-IBS-blues?” I hear you. The severe bloating that can sometimes accompany IBS is no joke. It’s uncomfortable, embarrassing, and sort of terrifying! It feels like you ate a pretty normal meal, but yet your distended abdomen tells a different story—a scary, sci-fi movie kind of story.


And it seems the responses to this symptoms are 1 of 3 from doctors and friends/family:

  1. You’re just stressed
  2. Maybe it’s something you ate (well duh!)
  3. Try this…. (antacid, antibiotic, laxative, fill in the blank…) It’s fine! (Do I need to say it’s not “fine” to need a laxative or anti-diarrheal—that means something is WRONG.)


Why is bloating such a mystery?!

Well, honestly it’s not, with the right testing and tools.


How to Demystify IBS

A common cause of bloating and IBS symptoms is SIBO (small intestinal bacterial overgrowth) for which some GI docs can/will order testing. It is usually a breath test, and should ideally measure both methane and hydrogen gas levels produced as a result of drinking a glucose formula and breathing into a bag. Note, if you are offered an antibiotic without testing, it may help to temporarily relieve IBS symptoms, but without proper follow-up, recurrence levels are very high.


There’s a reason SIBO snuck in in the first place, so it’s important to see the whole picture and finish the process to prevent the dreaded bloat from returning.


A comprehensive stool test can also save years of struggling by identifying the source(s) of IBS symptoms.

There are many companies, and most tests will measure:

  • infection markers (more common than you think!),
  • probiotic/prebiotic levels (how the badness started),
  • inflammation markers (from food, infection,
  • or other irritants),
  • and several digestive markers (also how badness gets in and makes symptoms worse).


Note this is not typically a test that a traditional insurance-based physician can/will order. Only a functional practitioner is trained to order and interpret it. (P.S. that’s what we are - functional practitioners!)


Typical Plan for IBS from Carolina Functional Nutrition


Since it’s based on the results of an individual test, the plan to address IBS can be a little different for everyone, but my typical plan consists of:

  • digestive support (depending on protein, fat, carbohydrate digestion markers)
  • liver support (liver congestions/sluggishness inhibits detoxification and elimination)
  • low FODMAP and/or other elimination diet (this is temporary people—not a long-term solution-- but it is very helpful to initially get symptoms under control).
  • sometimes a probiotic (yes, not all the time as probiotics can sometimes aggravate certain IBS triggers)
  • sometimes a plant/herbal extract to address infection/dysbiosis


Remember, when living with IBS,


IBS is not always easy, but it is simple in terms of first steps. Decide enough is enough and connect with a functional practitioner who works with IBS frequently and can order stool and/or SIBO breath testing. The tests literally provide a roadmap of how to address the issue(s) contributing to IBS symptoms. The order in which the products are used makes a difference, so again, make it a priority to work with a qualified functional dietitian or physician who can help. Remember, it takes time to see long-term changes, but significant relief from IBS can be just around the corner!


You can gain further support from Carolina Functional Nutrition by booking a jumpstart call, here.


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About the Author

Rhya Pachin is a licensed dietitian nutritionist who employs an "integrative" approach to support overall health rather than addressing just one symptom. As a certified LEAP therapist, she designs and supervises custom elimination diets. Her focus areas include gastrointestinal conditions like IBS and IBD, autoimmune diseases such as rheumatoid arthritis and Hashimoto's, persistent weight issues, food sensitivities, and chronic inflammatory conditions in both adults and children.

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