IBS testing—What you need to know!

Irritable Bowel Syndrome (IBS) impacts one in five Australians at some point in their lives and is generally more common in women than in men.

Clinically these have to be the most common conditions I see accompanying many other health concerns in my clinic connected to skin flare-ups, chronic inflammatory conditions like arthritis, depression, endometriosis, allergies, and the list go on. When we do a deep dive into patient history, it’s not uncommon to see a history of IBS, either past or present.

All systems of your body are intimately connected, and if your gut function is off, it makes sense you’ll see it elsewhere as well. Researches on the microbiome are now supporting the link between the gut and many chronic inflammatory conditions.

One of the most frustrating things about IBS is the lack of information about what’s causing the condition if you’ve struggled with elimination diets, FODMAPS, over-the-counter medications, and the ever confusing amount of information out there on the interweb. 

Natural IBS support

Suppose you’ve struggled with IBS for some time. I want you to know you’re not a failure when it comes to your health! This condition requires testing and a close look at your current microbiome to understand better what’s going on and how to navigate best the terrain that is your gut.

IBS is a complex condition that often requires a combination of treatment and management strategies to manage symptoms effectively.

No two cases of IBS will ever present the same, and the management involved will likely differ between patients as well. This includes diet and nutraceuticals as well as lifestyle modifications. First…

What is IBS and how is it diagnosed?

The diagnosis of IBS is often based on symptoms after doctors have excluded other possible gastrointestinal diseases. IBS can be categorised into four major subtypes depending on the predominant stool pattern:

• IBS with constipation (IBS-C)

• IBS with diarrhea (IBS-D)

• IBS with mixed bowel habits (IBS-M)

• Unclassified IBS (IBS-U).

Understanding that this classification is not telling of what caused the condition but rather simply a way of identifying the critical class of symptoms you’re struggling with. Regardless of which classification you fall under, you can improve your digestive health and reduce the severity of your symptoms with the proper support.

What are the main causes of IBS?

The cause of IBS is still unknown. However, it is thought that IBS involves many factors, including microbial dysbiosis, visceral hypersensitivity (sensitive gut), altered immune function in the gut lining, and even changes to the brain’s regulation of gut function.

Some research has suggested that around 9% of IBS is thought to be post-infective IBS triggered by a gut infection. Age, genetics, diet, and stress are also known to play a role in the onset of symptoms associated with IBS.

That’s why an in-depth case history is a key to understanding the underlying factors contributing to your IBS as well as the appropriate testing.

What are the known associations between the gut microbiome and IBS?

The gut microbiome is associated with many areas of health, including gastrointestinal health and related medical conditions.

There is mounting research looking to understand how the gut microbiome differs in people who have IBS compared with those who do not.

Some of the patterns that are evident in the microbiomes of individuals who have IBS include:

• Reduced microbial diversity— Less variety in the good bugs!
  Microbial dysbiosis in IBS is predominately characterized by a loss of diversity in your essential bugs. Some of the most common factors in my clients that lead to this are poor diet, stress, infection, antibiotic usage, immune activation, and low-grade inflammation.

• Reduced potential to produce butyrate and other essential gut nutrients
  Studies have shown that patients with IBS have a lower potential to make the essential Short Chain Fatty Acids (SCFAS) butyrate and propionate. These SCFAs play a role in maintaining gut barrier function, reducing inflammation, and regulating gut motility.

• Low levels of Akkermansia muciniphilia
  Studies have observed low levels of Akkermansia muciniphilia in the gut microbiome of patients with Irritable Bowel Syndrome. This species lives in the mucus layer of the intestine and plays an essential role in regulating the health of the mucus lining. To find out more about the link between this microbe and your weight check out this post.

• Higher levels of pro-inflammatory bacteria— more bad guys!
  Patients with IBS have also been found to have an increased number of the bad guys' bacteria like Eggerthella lenta and Rumminoccus gnavus, and both have been linked to IBS.

  While this article is focused on the testing available to you for information on different diets to help with the dysbiosis commonly seen in IBS head across to this article.

IBS testing- Microbiome testing

As I’ve mentioned, an imbalance in the gut microbes is seen in IBS sufferers.

However, the characteristics of dysbiosis are different from patient to patient. Nevertheless, using proper stool analysis, we can understand dysbiosis.

This is a vital part of my clinical practice when it comes to gut health and IBS. Once we know what’s happening with your microbiome, we can formulate a proper plan to balance the relevant bacteria SPECIFIC TO YOU.

I’ve never seen two microbiome reports present the same, even in people who are genetically related.

Currently, at the time of writing this post, I have several labs that I refer my patients to for stool testing concerning their IBS as well as other gut imbalances:

Microba— linked to the university of Queensland - The information these guys provide on your gut bacteria is impressive, with a catalog of hundreds of species that they can screen for. It’s also one of the most straightforward stool tests to conduct.

Microbiome mapping - This looks at several bacteria, both healthy and unhealthy. It also screens for a select number of parasites, viruses, yeasts, and inflammatory markers. 

How does Stool testing help with IBS?

Knowing what’s going on with your microbiome and other gut markers can significantly help with insights to the following questions:

What probiotics and bacterial strains should I be taking?

What dietary guidelines should I be following?

What nutraceuticals should I be taking? Glutamine? Turmeric?

What functional foods should I be eating to help promote a healthier gut function?

These are questions that most of my IBS clients come to me with and while it’s possible to support your gut through a process of trial and error this can also lead to lost time, money and continued frustrations while you’re figuring it all out. When applied properly testing can bring more of the pieces of the puzzle together.

But what about food sensitivity testing?

Which test is best?

There is a rabbit hole of testing that you can find yourself in which is time consuming but also costly, one of the key things to consider here is your symptom picture and what to prioritise. You can and should discuss this with your naturopath who will help you navigate testing.

For more on food sensitivity testing check out this blog post

These tests enable me as your health practitioner to get a concrete insight into your current gut health and monitor changes to your gut microbiome over time. Thus, ensuring we get you results and maintain them.

If you have any questions or need support with your IBS feel free to book in a complimentary 15 minute call with me below. Looking forward to chatting soon : )