by Cassie Irwin, ND

Tummy troubles can suddenly divert your best-laid plans and impair your quality of life. Whether you’re dealing with gas, bloating, diarrhea, or constipation, your digestive system is signalling that something’s not quite working right. Finding out what’s causing it is key for carefree eating and smooth sailing in the restroom.

IS IT IBS?

Irritable bowel syndrome can present with gas, bloating, diarrhea, constipation and abdominal pain. But this syndrome is not fully understood, and is usually only given as a diagnosis if you’ve tested negative for other digestive conditions, like Crohn’s disease, ulcerative colitis and celiac disease. Testing for these conditions may involve a colonoscopy, allergy testing and blood work.

Sometimes, your symptoms themselves can suggest a diagnosis of IBS, and are assessed using the criteria below:

The Rome IV Diagnostic Criteria for IBS

Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following:

1. Related to defecation
2. Associated with a change in frequency of stool
3. Associated with a change in form (appearance) of stool

Not everyone meets these criteria, leaving many people scratching their heads about what’s causing their tummy troubles. That’s when I find it can be helpful to test for food sensitivities, do a comprehensive stool analysis, and hone in on the connection between digestion and stress.

Diagnostic Testing options:

Fecal calprotectin – blood test to measure intestinal inflammation

Stool analysis – stool test to quantify bacteria, viruses, and yeast, as well as markers for intestinal inflammation, pancreatic output, and gut-immune axis.

IgG Food Sensitivities – blood test to identify problem foods that can cause subacute and chronic symptoms

SIBO breath test – Breath test to identify presence of small intestinal bacterial overgrowth

Tissue Transglutaminase IgA – Blood test for an antibody which may suggest celiac disease

Colonoscopy – Visual inspection of colon via scope

1. Chill

We know that irritable bowel syndrome, as well as digestive symptoms like diarrhea and constipation, can be triggered by stress.

Managing your workload, asking for help, and implementing stress-relieving practices often benefit stress-related digestive issues.

Stress causes the nervous system to stay in sympathetic overdrive, which impairs the parasympathetic function of the nervous system responsible for digestion. When we’re anxious and rushing, we tend to take cursory chomps on our food without really chewing. But chewing performs the very important role of mechanical food breakdown, while coating the food in enzyme-rich saliva. When we’re stressed, the body also has a hard time producing digestive fluids like saliva and stomach acid, which are responsible for chemical food breakdown. You can see the problem here!

Set a goal to chew each bite of food 20 times before swallowing. Chewing has also been shown to improve the stress response in the neurological and hormonal system called the HPA Axis. So the more you focus on chewing well, the lower your stress will be, and the better your digestion will be for it!

Make sure you aren’t eating on the run or while working. Take three deep breaths before starting your meal to engage the calming parasympathetic nervous system and trigger digestive fluid production.

2. replenish

Research shows that the gut microbiome can play a role in the development of irritable bowel syndrome, and that treatment with probiotics can be beneficial.

A multi-strain, high dose probiotic supplement can help replenish depleted probiotics. Stress, sugar, antibiotics, environmental toxins, and a narrow intake of vegetables contribute to insufficient probiotics in the gut.

One of the best ways to encourage endogenous probiotic growth is to eat a wide diversity of plant-based foods on a regular basis, to provide fibre (or “prebiotics”) to support the growth of probiotics. Food sources of probiotics can be found in unsweetened yoghurt, kimchi, sauerkraut and pickles.

3. when probiotics and fibre make it worse…

If your digestive symptoms get worse from probiotics, this could speak to other issues underlying your concerns. If you have small intestinal bacterial overgrowth, or small intestinal fungal overgrowth, taking probiotic supplementation can worsen gas, bloating and overall well-being.

Taking supplemental fibre can also aggravate people who struggle with digesting foods rich in FODMAPS, making self-treatment and diet change tricky to figure out on your own.

In both of these cases, I recommend consulting with a Naturopathic Doctor to discuss testing options and to start an individualized treatment plan.

SUPPLEMENTS FOR DIGESTION:

Determining the underlying cause of your digestive woes is the first step in treatment. Consult a natural health practitioner for an assessment and recommendations on which supplements are appropriate for you.

• Full spectrum digestive enzyme
• Digestive bitters tincture
• Peppermint oil
• Apple cider vinegar
• Multistrain probiotic
• Prebiotics
• Oregano oil
• Chamomile tea
• Aloe vera gel

WORKS CITED:

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Distrutti E, Monaldi L, Ricci P, Fiorucci S. Gut microbiota role in irritable bowel syndrome: New therapeutic strategies. World J Gastroenterol. 2016;22(7):2219-2241. doi:10.3748/wjg.v22.i7.2219

Lacy BE, Patel NK. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017;6(11):99. Published 2017 Oct 26. doi:10.3390/jcm6110099

Mansueto P, Seidita A, D’Alcamo A, Carroccio A. Non-celiac gluten sensitivity: literature review. J Am Coll Nutr. 2014;33(1):39-54. doi: 10.1080/07315724.2014.869996. PMID: 24533607. https://core.ac.uk/reader/53288670?utm_source=linkout accessed 27Sep21

Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126-14131. doi:10.3748/wjg.v20.i39.14126