IBS: a common yet enigmatic condition!
IBS stands for Irritable Bowel Syndrome, which means that, if you have this condition, your gut has strange, annoying, and exaggerated responses to many triggering situations, which can be foods, alcohol, emotions, or even infections of any kind.
But how can your gut be "irritable" and what does this have to do with your gut microbiome?
Until not long ago, people with IBS were labelled as "difficult" patients who had nothing physically wrong but kept complaining about unexplained symptoms. Despite doctors' best efforts, this mysterious bunch of symptoms, including stomach pain, diarrhea, constipation, gas, and even fatigue and brain fog, has puzzled them.
A few doctors or other health providers try and suggest probiotics, fiber, antidepressants or herbs of all sorts but finding the correct treatment seems to be a guessing game with a slim chance of success!
More recently, however, IBS has been officially renamed a "gut-brain axis disorder", which finally acknowledges that this problem isn't just in people's heads but is rather the result of complex interactions between some dysfunctional brain and digestive system signaling, abnormal immune responses, and what's called "gut dysbiosis". Unfortunately, this newly acquired recognition hasn’t necessarily improved the outcomes for most patients, who still tend to be quite confused and frankly bewildered by their oversensitive gut.
For instance, IBS sufferers might wonder "What is dysbiosis, and how can I tell if and how it's affecting me?". And if you’re trying to figure out the why behind your symptoms, this is a fundamental question!
Gut dysbiosis and IBS.
Dysbiosis has become a buzzword in articles, podcasts, and even TV shows. While it's a popular definition among experts and non-experts in gut health, many people are confused about what it really means.
In a nutshell, gut dysbiosis refers to any kind of imbalance in the microorganisms living in your intestine (and the rest of your digestive system too!). Most of these microorganisms are bacteria, and any time they grow out of control and start occupying too much space and resources, they can cause a whole range of problems in the gut or other organs.
Dysbiosis is not a diagnosis or an exact term for a specific group of "bad bugs" that can cause any illness! For example, the dysbiosis we see in people with colorectal cancer is completely different from that in people with IBS, IBD (Inflammable Bowel Disease), or neurodegenerative disorders. In other words, any disease tends to manifest with a specific assembly of gut bacteria. Also, these bacteria don't have to be scary or dangerous! Although it's wreaked havoc in your gut and nearby, often, just "normal" bacteria, if out of balance in terms of quantity and distribution, can cause symptoms and issues.
IBS isn't a simple disorder and manifests in many ways, so everyone's "dysbiotic" state can be different. However, we do see that an imbalance in gut bacteria fermenting sugars and fibers, metabolizing bile acids, or producing and interfering with neurotransmitters can trigger IBS. But here's where identifying ALL bacteria in your gut is so crucial! You won't get any insight into your unique microbiome profile if you take a generic microbiome test that just looks at some well-known bacteria but can't identify all of them.
There are some intestinal bacteria that produce chemical molecules (metabolites) that can reach the brain or interfere with nervous and immune system signalling, causing some confusing and exaggerated reactions. Those metabolites may make your brain think there's something wrong, so it interprets them as a threat. These chemicals may mess up your neurotransmitters and cause abnormal bowel movements (too many or too few!), pain perception or even make you moody!
Also, some of these bacteria can cause a lot of fermentation (gas) in your gut, which is usually not a big deal or an illness, but it may cause severe pain and discomfort.
IBS: diet and the microbiome.
It's no secret that the kind and number of bacteria in your gut are heavily influenced by what you eat. It's true that drugs and supplements can have a big impact on your microbiome, but your typical diet is mainly responsible for what happens there.
GutID research has found that an individual's microbiome tends to remain relatively stable over time, unless something dramatic occurs (like a course of antibiotics). Most people eat the same type of food or follow the same diet, so these daily habits are what matter. Thus, having a glass of wine or a salad every couple of weeks won't change your microbiome, but what you eat most of the time does!
Many people are surprised or even upset to find that it can take a few months of good changes to their diet to see improvements in their microbiome and fix their bacterial imbalances. Sometimes, supplements like fiber help speed things up. However, what keeps a microbiome in check is usually a healthy, varied, balanced diet that is maintained most of the time.
Getting rid of IBS isn't as simple as avoiding junk food though! It seems that even healthy stuff triggers symptoms sometimes, so why? Clearly, IBS is not just one disorder but rather a cluster of symptoms that may respond differently to specific foods. For some people, improving IBS symptoms is as easy as discovering they're lactose intolerant or they can't handle coffee. Nevertheless, most IBS sufferers react to the same foods differently at different times. For instance, potato chips can be okay one day, and a boiled potato can cause terrible pain the next!
Microbiome composition might not always be the problem, as worrying, not sleeping or having surgery, for example, may worsen your IBS without changing the bacteria in your gut significantly. Your gut bacteria are very often the main culprit, though and the more you know about them, the easier it is to control your symptoms and change your diet accordingly.
For example, both GutID CGI and CMA tests can show if there are too many bacteria fermenting FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides And Polyols). In this case, your health provider or nutritionist can help you make the right changes to adopt the appropriate diet.
But a low FODMAP diet won't cure IBS, it'll just manage it temporarily. If you stick with this diet too long, especially without knowing if it's necessary, your microbiome could get even worse. Most FODMAP-rich foods are healthy and contain fiber that makes some of your "good" bacteria thrive, like Bifidobacterium species. In other words, if you eliminate these foods for too long, it might hurt you.
In some cases, FODMAPs aren't even a trigger, but instead, it's the lack of probiotics or bacteria producing Short Chain Fatty Acids (SCFAs), which can reduce local inflammation and help relieve IBS symptoms.
Therefore, it's only a comprehensive and precise microbiome analysis that can tell you if you need to change your diet to balance your gut bacteria, and for how long.
IBS: one diagnosis, many microbiome-based solutions!
The term IBS is more of an umbrella definition than a specific diagnosis. Therefore, it doesn't make sense to treat everyone the same way without knowing what areas of gut function need attention.
Microbiome testing is on the rise, but not all tests are created equal! There are a lot of tests out there that can't identify all bacteria in a sample, so they can't really tell you why and how your microbiome affects your form of IBS.
So what's the deal with GutID tests, and how can they help you? Here's what you can learn from a GutID test:
- Your microbiome profile is unique so your treatment should be too: as explained above, although IBS patients tend to have similar gut bacterial imbalances (we often refer to them as “microbiome signatures”), their journey in terms of diet, live events, drugs and supplements are individual. So, instead of thinking of and treating all patients the same, it is necessary to look at what the microbiome profile is showing us. As a result, we can do a more personalized intervention instead of just trying everything! However, the analysis needs to be thorough.
- Same IBS symptoms may have different root causes: abnormally high or low bacteria in your gut can cause different symptoms in different individuals. Therefore, it's more useful to detect these out-of-range bacterial compositions than just focusing on a few well-known "good" and "bad" bacteria, like many tests on the market do! Once again, a full analysis of all bacteria present in a stool sample is necessary.
- There are potentially millions of bacterial species and strains that can colonize your gut: even though a few specific bacteria are more likely to cause most symptoms of IBS, you may have problems with some very unusual ones. You'd never know if you didn't have a test to identify all bacteria!
To sum up, IBS can be an extremely bothering chronic condition but with the right amount of information regarding your microbiome, you and your clinician of choice will have far more clues to solve the enigma. And it may be easier than you thought! Reach out to us at ask@gutid.com with any questions on how GutID can help you and your microbiome!
