If you’re searching for the causes of IBS symptoms, you’ve probably Googled a few hundred pages!
You might have found a range of answers from ‘the cause is unknown’ to ‘high FODMAP foods’ with a few suggestions of stress along the way.
Most of my clients are well researched in all the possibilities, but it’s hard to objectively filter information from so many sources, particularly if you are unsure whether to trust the internet ‘experts’.
What is IBS?
Irritable Bowel Syndrome is a collection of symptoms, and each person will have a different experience and triggers, partly down to different actual root causes.
This means it can be hard to define a treatment approach based on the diagnosis of IBS.
Post infectious IBS
Did your IBS start after food poisoning?
After a bout of gastroenteritis or any stomach infection you are up to six times more likely to get IBS. This risk may still persevere even after 2-3 years. Post infectious IBS is one of the common causes of IBS, thought to cause of 5-32% of IBS.
How does an infection cause IBS?
When we eat that dodgy kebab or dirty water we take pathogenic organisms such as Campylobacter, Shigella, Salmonella and Escherichia coli (E. coli), into our body. These organisms affects the whole digestion by:
- disrupting intestinal barrier function
- altering neuromuscular function
- triggering chronic inflammation
These can cause IBS symptoms, and drive ongoing issues after the infection is cleared.
When we have an infection our body draws water into the bowel to create diarrhoea, and we also produce an antibody called Cytolethal Distending Toxin (Cdt-B).
Our motility (the way food passes through the gut) can be affected by this toxin, and our immune response to the toxin. People with IBS-D have been shown to have higher levels of anti-cdt-B antibodies, showing a potential test for IBS in the future.
Motility issues can cause IBS
Slow movement of food through the digestive tract can cause an overgrowth of bacteria, which can increase constipation.
A sluggish digestion can be caused by
- not enough food (are you eating enough)
- insufficient fibre (fibre provides bulk which triggers an urge for a bowel movement)
- structural issues (e.g. strictures, growths, adhesions)
- smooth muscle or nerve impairment that weakens digestion.
Addressing the speed at which food travels through your digestion is really key to overall gut health. This may be done with diet change, supplements, or changing when and how you eat.
Small Intestinal Bacterial Overgrowth – common cause of IBS
We can get increased bacteria in the small intestine which causes symptoms of IBS. The bacteria can overgrow due to poor diet, blockages in the gut, slow transit time (see above), medication (e.g. antibiotics), or impaired digestion (e.g. lack of stomach acid or digestive enzymes).
The cross over of SIBO in people with IBS is thought to be between 16-70%, so this is worth considering as a cause of your symptoms.
Maldigestion of food causing IBS
If you struggle to eat fruit, artificial sweeteners, or bread for example you may have an issue absorbing certain carbohydrates. When these foods aren’t broken down properly in the small intestine they travel to the large intestine and can cause bloating, gas and cramps.
These foods may be an issue for you:
- Fructose – high in fruits, honey and high fructose corn syrup
- Lactose – dairy foods
- Galacto-oligosaccharides (including fructans) – wheat, onions, garlic, beans & pulses
A low FODMAP diet can improve symptoms for some people who react to these foods, or identifying triggers through diet tracking can also help. Eliminating certain foods for a set period can help you identify if these kinds of foods are causes of your IBS.
Gut – Brain connection
The way we think and how we feel can hugely impact on our digestion. There is a large connection between our brain, our mood and our ability to break down food. In fight or flight mode we do not prioritise digestion, leading to constipation, bloating, fermentation or gas.
You might consider whether these affect you:
- Stress (e.g. parenting, work stress, relationships) and the knock on impact on your sleep
- Adverse childhood experiences may also affect IBS. People who experienced trauma (e.g. abuse, accidents, domestic violence) were twice as likely to have IBS as those who didn’t.
Many of my clients find managing their stress levels makes a huge difference on symptoms.
The causes of IBS are very varied, and may overlap.
If you need help identifying your IBS triggers and what to eat please get in touch with me. You can see how I work and then make an appointment if it interests you.
Hi I'm Anna Mapson, registered Nutritionist (mBANT, CNHC). I help people with IBS, SIBO, reflux and other gut health issues.
I can help you to:
- understand your digestion better, so you recognise your triggers
- eat a well balanced diet, with tasty meals that are simple to prepare
- develop healthy, sustainable habits for life
“Anna is amazing! I feel totally transformed"
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