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Irritable Bowel: making sense of a meaningless diagnosis


Irritable Bowel Syndrome is a problem I see so often in clinic and it is problematic on many different levels. If you have been diagnosed with this condition, you may well have been suffering with it for years and, while a diagnosis can – at first– offer comfort in finally having a recognised problem, the satisfaction is short lived because often that’s where all support ends, and you’re left no further forward in actually fixing what the problem is.

The difficulty begins because IBS is essentially meaningless; it’s a catch-all term used to encompass a huge variety of digestive issues. If you’re serious about getting to the bottom of the problem (no pun intended), I’m happy to discuss your symptoms and help find a way forward. You can book a free IBS health check with me by clicking here

In my experience, it’s likely to be one of the following five conditions.

1 SIBO (small intestine bacterial overgrowth)

Around 60% of people with IBS will have SIBO. Though you might have heard about good (and bad) bacteria in the gut, really what experts are talking about is the balance of bacteria in the large intestine: the colon. The small intestine shouldn’t have any bacteria, and the each day the body should perform a flush to sweep bacteria from the small intestine and into the large intestine. This flush is called the ‘migrating motor complex’. For a huge variety of reasons (historic food poisoning being the most common, but also low levels of stomach acid or adhesions play a role, among others) the bacteria are not swept away. The trouble is that these bacteria can ferment the food in your small intestine, causing gas, belching, bloating, pain and a variety of other symptoms, including constipation and/or loose stools, and even anxiety.

2 Lactose intolerance

This is when your body is not able to tolerate lactose, a type of sugar found naturally in milk and other dairy products. Essentially, bacteria in your intestine feed on these milk sugars, leading to a host of IBS symptoms, like bloating and gas, nausea, constipation or diarrhoea. It can go hand in hand with other digestive complaints, such as coeliac disease or increased intestinal permeability (‘leaky gut’).

3 Fructose malabsorption

The symptoms are very similar to lactose intolerance. Fructose (which is found in fruit, honey and many processed foods) is a sugar, which, like lactose, is digested in the small intestine. Some people cannot absorb fructose, and what is not absorbed is fermented by intestinal bacteria, causing bloating, cramping, gas and distension of the stomach. You might also experience brain fog and headaches.

4 Dysbiosis

This is an imbalance in the levels of beneficial (good) and pathogenic (bad) bacteria in the large intestine or colon. This is now common due to overuse of antibiotics and alcohol, an increase in high sugar diets, and stress. Symptoms can vary from a sluggish bowel or diarrhoea, pain, bloating and flatulence, to chronic bad breath, joint pain, fatigue and food sensitivities. Dysbiosis is also implicated in a variety of health conditions like diabetes, heart disease and obesity. A stool test can help establish whether your gut bacteria are out of balance, along with a host of other markers that might be useful in getting to the root of your digestive problems.

5 Yeast overgrowth

Where the gut environment becomes out of balance (due to dysbiosis), yeast can thrive. Diets high in sugar feed the yeast – although if you think you might have a yeast overgrowth, it’s worth noting that long-term yeast problems can mean that the yeast cells are pathogenic or disease causing, and that the yeast has switched its metabolism to also be able to digest protein and fat. Symptoms of yeast overgrowth include recurring thrush, gas or bloating, fatigue, bad breath, cravings for sweet foods, joint pain and brain fog.

Some people struggle with digestive problems for years. If you are ready to make fixing your gut health a priority, I would love to work with you. Please click the link here to book your free IBS health check now.

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