4 Steps for Finally Healing IBS: A Gut Doctor Explains

April was IBS Awareness Month, but my experience as a functional gut expert has shown me that IBS is a year-round problem for many. Irritable bowel syndrome (IBS) is the most common gastrointestinal disease in the world, with a prevalence of about 15 percent. That means one out of seven people will be diagnosed with IBS at some point in their lives. For this reason, I can never stop talking about the 4 steps I use to finally heal IBS and other chronic gut-related health issues. In this blog, I’m highlighting the blueprint that I have used to help thousands put an end to their IBS.

 

Including me! Yep, I was one of them! Plagued by digestive issues for the greater part of my teenage years, as well as my 20’s and 30’s, I sought to find the answer to something that Western medicine did not believe to be curable. After twenty plus rounds of antibiotics as a teenager, my gut was a mess, and it took me the greater part of two decades to finally heal it. Unfortunately, there are still too many people suffering from IBS.

I mean, one out of seven people is about 1.7 billion people worldwide…that’s a lot!!! And it’s really grown in the last two decades. What explains this worldwide rise in digestive disease?

What We’re Getting Wrong About IBS

The answer lies in changes in our food supply, processed food, genetically modified crops, chronic stress, gastrointestinal infections, and the overprescribing of antibiotics. All these factors together have sabotaged our gut health and contributed to the huge increase of very real digestive problems like chronic constipation, diarrhea, excessive bloating, stomach pain, heartburn, and of course, IBS.

 

And here’s where the problem gets even deeper: The medical community uses “IBS” as an umbrella diagnosis, which means a person is diagnosed with it when they experience chronic gastrointestinal symptoms without a clear structural or functional reason. Conventional medicine diagnoses IBS using the Rome Criteria, which provide a limited definition of what IBS truly is:

“Recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following criteria:

 

• related to bowel movements
• associated with a change in the frequency of stools
• associated with a change in form (appearance) of stool

And these criteria must be fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.”

If you think this sounds pretty broad, that’s because it is. If you have digestive issues but your doctor can’t immediately figure out why, or diagnose you with a known issue like Crohn’s, then they label you as having “IBS.” You’ll notice that the definition above has everything to do with the symptoms you experience and how frequently you experience them — it has nothing to do with the actual underlying cause of the issue or even the specific symptoms themselves. And because we don’t understand the underlying cause, there is currently no diagnostic test for IBS. After all, what would you test for if you don’t know what to look for? The only tests they run are to rule out other conditions.

 

If you’re like me, you’ll read the section above and ask yourself: There must be a better way, right? Actually, there is. Keep reading to learn about the HAPPY GUT ^® ‘blueprint’ — my approach to healing irritable bowel syndrome, slimming the waistline, and reversing chronic disease.

The HAPPY GUT ^® Approach to IBS

The Western model for IBS is simply wrong. For one, it clumps the millions of people walking around with completely different gut health symptoms — some with chronic diarrhea, constipation, others with cramping, and some with GERD or reflux — into the same diagnosis. The standard medical approach to IBS also neglects to uncover what the underlying cause of IBS really is; instead, your doctor will focus on relieving symptoms with drugs like laxatives, antidiarrheal medications, antacids, or even antidepressants. And while relief from painful and uncomfortable symptoms is always welcome, it doesn’t help get to the root of the problem, which means you’ll inevitably have more problems down the line and need more meds or be offered experimental new drugs. Oftentimes, the very meds used to treat IBS have other, unwelcome side-effects or consequences.

Instead, why not take the time to look at IBS from a systems biology approach? This means that instead of focusing on the smaller pieces of IBS — like the symptoms and medications — we try to put all the pieces together to understand the big picture of digestive health.

This is exactly what I did in my book Happy Gut and it’s what I’m going to teach you to do today. If you want to tame IBS, you need to zoom out and look at the gut as a whole, then zoom back in and look at that secret world inside you — your gut microbiome.

The 3 Components of a Healthy Gut

If you have IBS, it’s tempting to focus on the symptoms you’re experiencing — which are very real and difficult to cope with — and find the quick fix solution for them. But I actually challenge my patients to focus on what makes a gut healthy first; that way, we can identify what’s going wrong and how we can fix it, not just for a day or a few months, but for life.

 

For a healthy, happy gut, we look at these three key components:

1. The Gut Microbiome

The gut microbiome is the community of at least 100 trillion bacteria living mainly in your large intestine. The vast majority of these bacteria are good; in fact, humans have evolved alongside these microbes to the point where we’ve developed a very symbiotic relationship with them. For example, the good bacteria in our gut feed off the foods we eat and in turn, they help us by making vitamins, short-chain fatty acids, and neurotransmitters like serotonin — a chemical that makes us feel happy. They also help us absorb and break down nutrients and regulate our immune system. And they do this while crowding out bad bugs from overgrowing in the gut.

Pretty great, right?

Unfortunately, a combination of a low-fiber, high-sugar diet, stress, medications, antibiotics, lack of exercise, and environmental factors can sabotage the delicate balance of bacteria in our guts and by doing so, it creates damaging ripple effects throughout the entire body, affecting our health.

If you have IBS, you almost definitely have an imbalance in gut bacteria. In fact, studies have shown that 73% of IBS patients have dysbiosis (an imbalance between good and bad bugs, tipped in the favor of the bad) . A large chunk of people also develop IBS after an infection of pathogenic bacteria like E. Coli, Salmonella, or Campylobacter jejuni, which disrupt the balance. According to new research, these pathogenic bacteria can produce toxins called cytolethal distending toxins (CDTs for short), which seem to play a major role in IBS that we haven’t been aware of until now. In fact, CDT’s can trigger an immune response in the gut, including antibodies to the very proteins that hold gut cells together, possibly triggering an autoimmune attack. This new information suggests that for some people, chronic IBS may actually be an autoimmune condition.

2. The Gut Lining

Your gut lining is another important element of healthy digestion. This one-cell-layer-thick lining is responsible for absorbing nutrients and keeping other harmful things — like large, partially-digested food particles, toxins, and pathogenic microbes — out of the bloodstream where they can wreak havoc by triggering an immune response that leads to inflammation. Unfortunately, an imbalance in the gut microbiome can lead to a breakdown in tight junction proteins — which are like the security guards who decide what passes through and what stays out. This can lead to a leaky gut, which allows food particles, microbes, and microbial toxins (like endotoxin) to slip through the gut lining and causes inflammation, food allergies and sensitivities, and all types of digestive symptoms.

 

New research on CDTs (I mentioned above) has shown that these toxins can also cause increased permeability of the gut lining. But here’s the interesting part: CDTs can cause leaky gut without actually harming the tight junction proteins, which means they cause a new, sneaky type of leaky gut. There’s even a new line of research exploring whether these CDTs can bind to the body’s proteins and cause the immune system to attack itself. This means that in the near future, IBS might be described as an autoimmune issue. This is a totally new way to look at what actually causes the disease. The new things we’re learning about CDTs mean that we’re also one big step closer to developing a simple test for this subset of IBS.

3. The Gut as a System

As you’re probably already sensing from reading the first two components of a healthy and happy gut, the gut is an amazingly complex part of the body. It’s no wonder so much can go wrong with it! Understanding IBS requires us to zoom out and look at the full picture of the gut and all its many mechanisms. In order for you to digest properly, your gut has to move at a pace that allows you to have regular bowel movements, which require plenty of water and fiber in your diet. You also have to produce bile salts to emulsify and absorb fats, as well as adequate amounts of digestive enzymes, which are produced by both your pancreas and the cells that line the gut lining, and adequate stomach acid to break down the foods you eat. This is something that can easily get interrupted by a stressful day (stress has been linked to decreased HCL production). If you’ve ever had stomach ache after a stressful meal, you’ve experienced this connection first hand!

 

The other thing that’s consistently underestimated are the wide-ranging effects of IBS, which can impact so many other areas of your life — like your concentration, mood, and energy levels. The gut is the cornerstone of your health; it impacts your immune system, the production of your brain’s “happy chemicals” and can either help or hurt your metabolism, causing weight gain and low energy levels.

As we already know, treating IBS isn’t just about covering up constipation, diarrhea, or digestive symptoms. It’s also about investing in the three components of a healthy gut as well as getting other symptoms like brain fog and fatigue under control. I figured it out for myself after over two decades of suffering unpredictable abdominal pain, mental fog, fatigue, weight problems and skin rashes. In addition, I’ve worked with hundreds of patients, helping them navigate their own gut-healing journeys.

 

So how do I do it? I follow…

4 Steps to Healing IBS with the HAPPY GUT® ‘Blueprint’

We all need a roadmap for healing, and when it comes to the gut, what I have realized over the last two decades of being a medical doctor focused on gut health is that “slow and steady wins the race.” That’s what led me to create these four steps for anyone looking to revamp their gut health and wreak the benefits thereof, including weight loss without counting calories, improved energy, sharper focus, and a clearer mind. When you start with the right ‘blueprint’ for healing IBS, so much more improves that, perhaps, you had learned to “live with.”