The functional nutrition approach to healing Irritable Bowel Syndrome (IBS) focuses on identifying and addressing the root causes of symptoms through diet and lifestyle changes. This whole body, root cause approach is individualized based on a comprehensive functional nutrition assessment, individual symptoms, health history, and labs aiming to restore balance to the digestive system.

What is Irritable Bowel Syndrome or IBS?

IBS also known as Irritable Bowel Syndrome is a chronic bowel disorder resulting in a group of symptoms including recurrent abdominal pain and is associated with a change in bowel habits. (diarrhea and/or constipation) It is not considered a disease rather it is a syndrome as the exact cause of it is still unknown and results from multiple factors. IBS is currently the most commonly diagnosed GI disorder affecting twice as many women than men and primarily affects the large intestine. There are four different sub-types of IBS: IBS with predominant diarrhea (IBS-D), IBS with predominant constipation (IBS-C), IBS-Mixed (IBS-M), and IBS Unclassified (IBS-U).

What are the four different sub-types of Irritable Bowel Syndrome?

1. IBS with predominant constipation (IBS-C): (often due to methanogen overgrowth) hard or lump stools ≥25% and loose of water stool <25% of bowel movements.
2. IBS with predominant diarrhea (IBS-D): loose or watery stools ≥25% and hard or lumpy stools <25% of bowel movements.
3. IBS-Mixed (IBS-M): hard or lumpy stools ≥25% and loose or watery stools ≥25% of bowel movements.
4. IBS Unclassified (IBS-U): meets diagnostic criteria for IBS but their bowel movement habits can’t be categorized into one of the 3 subtypes.

The IBS subtype is determined based on stool patterns.

The whole body, root cause approach to Healing Irritable Bowel Syndrome from a functional nutrition perspective:

Overall from a whole body, root cause approach, to heal IBS we would look at using a therapeutical diet to first manage GI symptoms, targeted supplements aimed for healing your gut depending on the IBS subtype, and then work to rebalance the gut using the 5R Treatment Protocol linked here. Any potential root causes are identified using the STAIN method specifically looking at stress, toxins (mold, plastics, heavy metals), adverse food reactions, infections, and nutritional imbalances.

During the initial comprehensive functional nutrition assessment, we will look at:

• Past Medical History: initial comprehensive patient questionnaire, symptom questionnaire, root causes: STAIN (stress, toxins, adverse food reactions, infections, nutritional imbalances), history of N/V/D/C (nausea, vomiting, diarrhea, constipation), family history (GI disorders, celiac disease), current medications/OTC’s and supplements, lifestyle factors such as sleep, stress, exercise, etc.
• Anthropometrics: changes in body weight, weight loss, weight gain.
• Nutrition Focused Physical Exam: dark circles under eyes, abdominal distention/bloating, hair loss/hair thinning, red, swollen, or coated tongue, skin rashes, mouth sores.
• Dietary and Food Habits: nutrient density in meals, caloric intake, meal pattern and timing, macronutrient balance, fiber types and sources, processed food and refined sugar intake, alcohol intake, adverse food reactions (food allergies or intolerances), FODMAPs, lactose, fructose, or sucrose intolerance, gluten sensitivity, histamine intolerance, prebiotic sources, probiotic sources, fermented foods, gut microbiome diversity.
• Conventional Labs: Comprehensive metabolic profile (CMP), CBC with differential, complete iron profile including serum ferritin, folate/B12 status, serum Vitamin A, serum 25-OH Vitamin D, serum zinc.
• Functional Labs: GI-MAP by diagnostic solutions, OAT test by mosaic diagnostics, or Breath test for small intestinal bacterial overgrowth (SIBO).
• Wearables Data: apple watch for exercise/HRV (heart rate variability), whoop for exercise/HRV, oura ring for sleep tracking.

A personalized functional nutrition care plan will be created for you based on the data from the initial comprehensive functional nutrition assessment that includes personalized diet therapy that is condition specific, personalized targeted supplements depending on the IBS subtype, as well as lifestyle changes in stress level, sleep quality, and exercise which are important for gut health.

By addressing these underlying causes — through personalized approaches like nutrition, simple lifestyle changes, and targeted supplements — functional nutrition aims to bring the body back into balance and resolve IBS at its root.

What are common symptoms associated with Irritable Bowel Syndrome?

Symptoms are a sign that something is off internally within one of these systems: Inflammation, Gut Dysbiosis or Gut Imbalance, Impaired Detoxification, Hormonal Imbalance, Mitochondrial Dysfunction, Circadian Rhythm Disturbances, Oxidative Stress, Neuro-disruption, or Immune dysregulation. Symptoms are essentially your body crying out for help in the only way that they know how to communicate. IBS typical symptoms are abdominal pain and/or discomfort, irregular stool appearance and bowel movements or bloating. Patients with SIBO experience abdominal pain or discomfort, bloating and flatulence as well.¹ Symptoms associated with IBS include:

• Constipation
• Diarrhea
• A mix of constipation and diarrhea
• Gas
• Abdominal bloating or distention: bloating is a sign of gut dysbiosis/gut imbalance.
• Abdominal pain
• Cramping
• Fatigue

Chronic symptoms that last for 6 months or longer: Symptoms should occur at least 6 months prior to the diagnosis of IBS and symptoms should be present during the last 3 months.

An IBS diagnosis is challenging due to the fact that symptoms often fluctuate and can mimic many other conditions. IBS can overlap with so many other conditions mainly small intestinal bacterial overgrowth (SIBO), small intestinal fungal overgrowth (SIFO), intestinal methanogen overgrowth (IMO), systemic nickel allergy syndrome (SNAS), histamine intolerance, gluten related disorders, pelvic floor dysfunction, or sucrase isomaltase deficiency. There is no gold standard test to identify IBS so ruling out other conditions is important such as celiac disease, gluten sensitivity, or SIBO.

What are root causes of Irritable Bowel Syndrome?

• Immune dysfunction
• Gut microbiome disturbances/Gut dysbiosis/Gut barrier disruption: IBS is associated with higher levels of methanogenic bacteria in the gut (IBS-C).
• Altered gut motility resulting in changes in transit time (rapid gastrointestinal transit versus normal or slow transit)
• Gut-Brain interactions: the gut and brain are linked through the nervous system via the vagus nerve. Disturbances in the gut-brain axis can contribute to IBS-related symptoms. It is well-established in studies that anxiety and depression are both common co-existing conditions alongside IBS as a result of the connection via the gut-brain axis. Essentially whatever happens in the gut will affect the brain and vice versa.
• Poor digestive function
• Intestinal and systemic inflammation
• Food intolerances: lactose, fructose, sucrose, gluten, etc
• Bacterial (SIBO) and fungal overgrowth (SIFO)
• Altered intestinal permeability also called Leaky Gut Syndrome is common in individuals with IBS specifically the IBS-D subtype. Inflammation that is triggered by leaky gut may be a potential root cause of IBS.

The underlying root causes of IBS are not very clear and vary from person to person. Oftentimes, IBS could be a result of a gluten, dairy, sucrose, or fructose intolerance so it’s crucial to first look at potential food sensitivities.

The connection between stress and Irritable Bowel Syndrome: (The Mind-Body-Gut Connection)

The Gut-Brain axis: the gut and the brain are connected through the nervous system via the vagus nerve. The gut, essentially the live micro organisms in your microbiome, and the brain are in constant communication with each other. They work alongside each other to produce various hormones and neurotransmitters, the same hormones that are responsible for your mood, energy, and appetite. What affects the gut will affect the brain and vice versa. Chronic stress affects the gut microbiome negatively. Think about it. Where do you feel stress? Where do you feel anxiety that results in chronic stress? Most often it’s that tight feeling in your gut area. The thoughts in your brain about a particularly situation (resulting in stress or anxiety as a result of the stress and vice versa) travel down the vagus nerve and communicate what is going on to the gut. This affects production of various important hormones and neurotransmitters that affect our day to day life as well as the gut micro organisms that help synthesize important vitamins and minerals for us.

Tip: Stress quickly depletes magnesium levels in the body. Magnesium directly impacts your mood so a magnesium deficiency can result in stress as well as stress burning through your magnesium stores. Consume various sources of foods high in magnesium or take a high-quality third-party tested magnesium supplement! (There are different forms of magnesium and each is used for different purposes.)

Take magnesium alongside Vitamin D3 + K2 — without magnesium your body will not be able to use Vitamin D and if you are only taking Vitamin D with a magnesium deficiency it will cause an imbalance in nutrient status resulting in various symptoms within the body. (with our soil-depleted agriculture supplementing certain nutrients are necessary)

Conditions that can commonly co-exist alongside Irritable Bowel Syndrome:

• Anxiety
• Bipolar Disorder
• Celiac Disease
• Polycystic Ovary Syndrome (PCOS)
• Small Intestinal Bacterial Overgrowth (SIBO)
• Chronic Fatigue Syndrome (CFS)
• Depression
• Fibromyalgia
• Chronic Pelvic Pain
• Gastroesophageal Reflux Disease (GERD)
• Non-celiac Gluten Sensitivity (NCGS)

How can I help heal Irritable Bowel Syndrome using functional lab testing?

There is some evidence that elimination diets based of food-specific IgG antibodies can reduce symptoms in IBS patients. Elimination diets involved the removal of certain foods that are considered potential triggers from the diet until GI symptoms subside and then gradually re-introducing “trigger foods” to determine which food, if any, are triggering GI symptoms. However, studies show that IgG testing may not be considered a reliable marker for diagnosing adverse food reactions. You may benefit from ordering a GI-MAP stool test to further assess gut health.

My storefront is linked here to order functional labs, which is signed off by a nationally-licensed physician, to assess for gut health issues, hormonal imbalances, or vitamin/mineral deficiencies. If you need help creating a personalized functional nutrition care plan based on the interpretation of any of the above functional labs, you can work with us here.

Functional lab testing would be a good idea if you really wanted to hone in on the specifics of gut microbiome imbalances, hormonal imbalances, vitamin/mineral deficiencies.

Are there any therapeutic diets used in healing Irritable Bowel Syndrome from a root cause approach?

Therapeutic diets for IBS typically include either a low FODMAP diet, a therapeutic elimination diet, a gluten, dairy, lactose, or fructose free diet, or removal of specific food triggers. Elimination diets involve the removal of certain foods that are considered potential triggers from the diet until GI symptoms subside and then gradually re-introducing “trigger foods” to determine which food, if any, are triggering GI symptoms.

The therapeutic diet chosen for IBS aims to first manage GI symptoms, reduce inflammation, reduce microbial fuel based on their food reactions, and reduce immune system burden. These are short-term therapeutic diets that are not meant for you to stay on the rest of your life. We are aiming to first heal and repair the gut, slowly re-introduce new foods, identify any trigger foods, and then work to rebalance the gut using the 5R Treatment Protocol linked here.

Looking at it from the STAIN framework — Stress, Toxins, Adverse Food Reactions, Infections, and Nutritional Imbalances — we aim to identify the root causes and design a personalized nutrition care plan based on your unique biochemical individuality. Biochemical individuality is the concept that each of us has a different nutrition blueprint to achieve optimal wellness. We each have our own, unique genetic expression and that is shown in a personalized nutrition care plan made just for you.

Tip: Keep a food journal so that pre and post meals you can become more in tune with your body and see how certain meals make you feel. Continuously check in with yourself to see how you are feeling, this is the type of subjective information that only you can know for yourself and make sure to share this information with the dietitian that you are working with!

Ask yourself: How do I feel after eating this specific meal? *insert symptom here* It’s helpful to have a dietitian that is able to look at your food journals so that they can decipher what specific ingredient or a combination of ingredients that may be causing these symptoms. Having a food journal is also helpful to look for any potential food reactions that may be related to IBS.

Caution: Restrictive eating due to GI symptoms associated with IBS may lead to an eating disorder. It is important to not be constantly under eating, resulting in less food and nutrients in the body, just because it results in less GI symptoms! It is still possible to eat high quality and nutrient dense meals with your favorite ingredients.

Are there any supplements, Probiotic strains, botanicals, or herbs that are helpful in healing Irritable Bowel Syndrome?

Targeted supplements, alongside a therapeutic diet using a food as medicine approach, are often used for gut microbiome support and healing. Different targeted supplements are helpful in treatment depending on the type of IBS that you have. Remember supplements are there to “supplement” or to help the main treatment which is using a food as medicine approach to healing.

Some general helpful supplements for IBS are:

• MotilPro by Pure Encapsulations (IBS-C)
• L-Glutamine to help repair the gut lining
• Iberogast

Make sure to order from a high quality and third party tested brand instead of purchasing from Amazon where practically anyone can sell anything without any rigorous testing. To make it easier for you, you may order from my supplement dispensary below through Fullscript’s catalog where each brand and product meets strict top quality standards. You can learn more about third party testing here.

My supplement dispensary is linked here (with a 30% off discount!) and you do not need to be a client to place an order.

What are some diet and lifestyle tips that can help me during the process of healing Irritable Bowel Syndrome?

Look at sleep, diet, exercise, and stress management.

Here are some helpful tips for you to begin the process of healing IBS:

• Chew your food mindfully and thoroughly
• Limit intake of ultra-processed foods and foods with refined sugars
• A few foods to avoid: fatty + spicy foods, coffee, alcohol, sodas, chewing gums, and sweeteners that end with -ol.
• Have a stress management routine! (traditional yoga, yoga nidra, breathwork)
• For bloating, you can use herbal teas such as teas with fennel, licorice, chamomile, and peppermint.
• Avoid alcohol: studies show that it is associated with increased GI symptoms in individuals with IBS.
• Having a routine that includes any form of daily movement: walking for 30 minutes daily has been shown to improve GI symptoms and lower inflammation.
• Yoga helps to reduce anxiety and stress resulting in improved GI symptoms.
• Using a bidet

Gentle reminder: Don’t stress yourself with an all or nothing mentality where you feel like you have to implement everything on this list all at once. Sometimes in order to reach the end goal, you need to take baby steps at first and build these habits bit by bit.

How can I heal Irritable Bowel Syndrome with the help of a functional nutrition dietitian?

Each person is unique and this is recognized in a personalized functional nutrition assessment and intervention plan that engages and empowers the patient in this process to restore optimal function, manage symptoms and promote overall health and well-being.

Functional nutrition addresses the whole person, not just an isolated set of symptoms. We look at it from a root-cause perspective and create a focus on prevention through nutrition, therapeutic diets, targeted supplementation, exercise, interpretation of conventional and/or functional lab testing, botanicals, detoxification protocols, and stress management tools.

Overall from a whole body, root cause approach, to treat IBS using nutrition therapy we would look at using a therapeutical diet to manage GI symptoms, targeted supplements aimed for healing your gut depending on the IBS subtype, and then work to rebalance the gut using the 5R Treatment Protocol linked here.

By addressing these underlying causes — through personalized approaches like evidence-based nutrition, simple lifestyle changes, and targeted supplements — functional nutrition aims to bring the body back into balance and resolve IBS at its root.

References:

1. Losurdo G, Salvatore D’Abramo F, Indellicati G, Lillo C, Ierardi E, Di Leo A. The Influence of Small Intestinal Bacterial Overgrowth in Digestive and Extra-Intestinal Disorders. Int J Mol Sci. 2020 May 16;21(10):3531. doi: 10.3390/ijms21103531. PMID: 32429454; PMCID: PMC7279035. ↩︎