In Part 5 of her Leaky Gut series, Dr. Doni completes her exploration of the causes of Irritable Bowel Syndrome and their relationship to Leaky Gut.
Part 5 of Dr. Doni’s Series on Leaky Gut
In the first three parts of this series we have taken a broad look at Leaky Gut: what it is, how to test for it and how to treat it. Last week, we started down the path of exploring common underlying causes of Irritable Bowel Syndrome (known as IBS), a condition with many possible interrelated causes. We discussed the first 5 causes (lactose intolerance, fructose malabsorption, SIBO, dysbiosis, and yeast overgrowth), how they relate to Leaky Gut, how to test for them and possible treatment options. Click below to catch up:
Now it’s time to look in detail at the next 5 possible causes:
- Part 5: 5 More Causes of IBS and How They Relate to Leaky Gut (this post)
What makes IBS so unique to each person is that it’s possible to have more than one of the causes of IBS happening at the same time. It’s even possible to have all 10 causes. As you read, I want to encourage you to think about what may be the contributing factors in your case, and how each of these factors can lead to the next. As you will read in the treatment sections below, it is when we can grasp the inter-relatedness of these causes, and address them both individually and collectively, that we see the most progress toward recovery from IBS.
Five More Causes of Irritable Bowel Syndrome (IBS)—Causes 6 to 10
Here’s where you can find Causes 1 to 5 of Irritable Bowel Syndrome (IBS), if you want to catch up.
Kinetic issues such as constipation
One of the important functions of our digestive tract that is often overlooked is the fact that everything needs to keep moving at a regular pace in order for the whole digestive system to be healthy. You need for your food to be digested at an effective rate, for the nutrients to be absorbed, for the bacteria to have a chance to do their job, and for the stool to be eliminated. If this process does not occur on schedule, issues occur and may be labeled as IBS.
The Link to Leaky Gut
Kinetic issues make dysbiosis more likely. A slow and sluggish digestive system means the food you eat stays in your digestive tract for too long, causing it to ferment and encouraging the growth of bad bacteria. As we discussed last week, dysbiosis is when there are either too many bad bacteria or too few good ones, or both. Dysbiosis leads to Leaky Gut.
You’ll know if you need help in this area if you tend toward constipation or if you often feel over-full or bloated after eating. A gastroenterologist can determine whether you have a kinetic issue by doing a gastric emptying test where you swallow a radioactive meal that is tracked as it passes through your digestive tract using a kind of x-ray camera.
Many of the medications developed for IBS are in fact designed to address kinetic issues; these include Metamucil, Amitiza, Bentyl, Librax and laxatives.
Keep things moving properly—not too fast and not too slow—without medications by sitting quietly when eating and chewing well, drinking adequate water, and eating plenty of fiber (such as from fruits, veggies, nuts, and seeds).
Taking magnesium citrate or oxide at gradually increasing doses until your bowels move. I like this option because magnesium supports healthy muscle function (and it is your muscles that make your bowels move). It’s also my favored option because, unlike laxatives, your body will not become dependent on it.
All food sensitivities have the potential to be implicated in IBS however, one of the most often missed causes is delayed food sensitivities, caused by IgG and IgA antibodies. There are two reasons for this. Firstly, they are not tested for by an allergist (who only tests for IgE antibodies) nor by a gastroenterologist and secondly, the reaction is delayed for days or even weeks after you eat the food. So you might be eating the food every day and yet have no idea that it is causing digestive upset.
The Link to Leaky Gut
Leaky Gut leads to food sensitivities. When Leaky Gut is present it allows undigested food to leaky through your intestinal lining triggering your immune system to produce IgG and IgA antibodies to basically protect you from your food. Your body then identifies these foods as ‘dangerous’ and the antibodies end up causing more damage to your intestinal lining. So, the more you eat those foods, the ‘leakier’ your gut lining becomes and the more food sensitivities you develop.
Many different labs offer IgG and IgA testing for food sensitivities, but the one that I find provides the clearest answers is actually a test that you can do yourself at home with a finger prick. Find out more here.
Avoid the foods you are sensitive to: The most common of these are gluten, casein, whey, egg whites, and soy protein. By doing so, you’ll be both decreasing your symptoms and healing Leaky Gut.
We often think of histamine in relation to asthma or hay fever, but it can also cause trouble in your digestion. Histamine is released by cells when they are triggered by an allergen, a food or certain bacteria. It can cause reflux, stomach pain, bloating, diarrhea, headaches, anxiety, and skin rashes.
The Link to Leaky Gut
Histamine reactions are much more likely when Leaky Gut is present because when the immune system is activated and the intestinal lining is vulnerable, it makes histamine responses more likely. When we address Leaky Gut we see less and less histamine sensitivity.
There are several ways to find out if you are experiencing histamine intolerance:
- Your doctor can do a blood test for histamine levels and tryptase levels (a marker for the cells that release histamine).
- The best way to tell is often to avoid foods that are high in histamine or that trigger the release of histamine and see if you feel better (see the list below in The Treatment)
- Genetics – a genetic report can tell you if you have a DAO and/or HNMT mutation that may mean you are less able to process histamine out of your body. See my series on genetic mutations for more information.
Avoid the following foods that result in high histamine levels:
- wine and beer
- citrus fruits
- fermented foods such as sauerkraut, kombucha, and yogurt
- canned or smoked fish and meats such as salami, sardines, and sausage
- white potatoes, soy, gluten, and legumes
By decreasing or eliminating these foods, you can manage the intolerance. Healing Leaky Gut will lead to less reactivity in the long run.
Note that Lactobacillus (in probiotics) can also trigger histamine (the one exception to this Lactobacillus plantarum which is safe to take if you have a histamine intolerance).
This refers to not having the right quantity of stomach acid or enzymes to digest food properly. While we most often hear about having too much stomach acid, it is also quite common to have low stomach acid. In either situation, food will not be digested correctly and digestive issues may result.
The Link to Leaky Gut
Stress is known to increase stomach acid, making ulcers more likely, and at the same time it is associated with lower pancreatic enzyme production and increased Leaky Gut. So considering the amount of stress most people are exposed to daily, both maldigestion and Leaky Gut are extremely common.
Testing for maldigestion is not very often completed by a gastroenterologist, although they might test for the inability to digest lactose and fructose (lactose and fructose intolerance) with a breath test. So if you suspect maldigestion, your next step would be to work with a naturopathic doctor who could order a GI Effects stool panel which can indicate pancreatic enzyme function, protein digestion and fat digestion.
- The first step is to address your stress (this is cause 10 and we’ll address it next).
- In addition you can take plant-based digestive enzymes with meals (and hydrochloric acid if you have low stomach acid) as well as herbs that help to stimulate your digestion (such as gentian).
- Remember to chew your food, put your fork down between bites, and to eat smaller half-sized meals that your digestion can handle.
- Eating something bitter, like arugula, also tells your body that you are eating and need digestion to kick into gear.
Here we are, back to stress. Stress truly is one of the most common causes of IBS and we also know it is a cause of Leaky Gut. And it is no wonder when we think about how our bodies “turn off” our digestion when dealing with the stress at hand. So if the stress never ends, when will your body have the chance to digest your food? And if the food is not well digested (as discussed above) then it is more likely to be fermented by bacteria, making it more likely your healthy bacteria will be thrown out of balance, and the vicious cycle of IBS, begins. This connection is referred to as the “Brain-Gut Axis.”
The Link to Leaky Gut
Both IBS and Leaky Gut are caused by stress. In addition to this, the stress created by IBS further exacerbates the situation.
If you are wondering about how stress may be affecting your body, you can do my quick online stress quiz by clicking here. Alternatively, you can pick up a copy of my book The Stress Remedy and turn to chapter 3 where I guide you through a thorough stress evaluation.
You can also meet with a naturopathic doctor who can do a stress assessment—a test of your saliva and urine—to find out the state of your cortisol and adrenaline production (the stress hormones).
Now the treatment for stress, I think you all know, is to minimize your stress as much as you can, get good sleep, and make time for plenty of Stress Remedies. Check out my 99 cent e-book Stress Remedies for some ideas.
When we have the results of a cortisol and adrenaline panel, we can get more specific and use nutrients and herbs, in very individualized dosing, to help your body recover from stress. Pretty cool I think!
IBS is such a widespread issue, and yet few patients understand what it is and how to ask their doctor for help. With the information we’ve covered in this article and the last one, I think you’ll be much clearer about the next steps you need to take towards understanding what IBS means for you, and what you can do to feel better.
To help you out with the process, I have designed a 6-month program specifically for healing Leaky Gut (click here to learn more). It allows me to help you discover exactly what to eat and what not to eat, and which herbs and supplements you need to take to help improve your digestion.
As encouragement, I’d like to share this note from a patient:
“When I initially came to see Dr. Doni, I was barely able to make it through a day due to debilitating pain, fatigue, and severe digestive problems. In my opinion, Dr. Doni epitomizes what a doctor should be. She reminded me to listen to my body. She showed me that there are natural remedies that can work along with my body, instead of conventional drugs that have only worked AGAINST my body, and most importantly, her knowledge and expertise has given me the ability to live my life again— without the pain and fatigue! I am happy to say I no longer feel like my body is waging a war against me!!”
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I look forward to your comments and questions below. What causes and connections have you noticed with your IBS and what has helped you?
16th July 2015
*Please keep in mind that any and all supplements—nutrients, herbs, enzymes, or other—should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.