The 4 R's of Gut Healing For Irritable Bowel Syndrome
What is irritable bowel syndrome (IBS)?
It is estimated that 5 million Canadians suffer from irritable bowel syndrome, with approximately 120,000 Canadians being diagnosed each year. IBS is a chronic gastrointestinal disorder that affects the small and large intestines. It commonly presents as abdominal cramping and pain, bloating and gas, mucus in the stool, and diarrhea and/or constipation. Unlike ulcerative colitis and Crohn’s disease, which are both inflammatory bowel diseases, IBS does not cause permanent damage to the bowel tissue, and does not increase your risk for colorectal disease.
How is IBS diagnosed?
Diagnosis of IBS is often a process of ruling out other conditions. A colonoscopy or blood work may be ordered to rule out inflammatory bowel disease, a stool test might be taken to rule out parasitic infections, and finally breath tests may be ordered to rule out H. pylori and lactose intolerance. To help this process researchers have developed a set of criteria for diagnosing IBS based on symptoms, after other conditions have been ruled out. This diagnostic criteria is called the ‘Rome Criteria.’ Based on this criteria, diagnosis can be made if the person has abdominal pain at least one day per week in the last 3 months, which is associated with 2 or more of the following criteria: the pain is related to stooling (either an improvement or worsening of pain), altered frequency of stool, or altered form of stool.
How can I get my irritable bowel under control?
The naturopathic approach for managing irritable bowel syndrome includes a process of removing aggravating factors, regenerating the health of the gastrointestinal mucosa, reinoculating the intestines with good microflora, and replacing crucial digestive factors. This process is called the 4 R GI Restoration Program, which is outlined below.
1) Remove
The first step to healing the gut involves removing aggravating foods from the diet, and misplaced or pathogenic bacteria from the intestines. Depending on the individual's symptoms and medical history, a variety of tests may be recommended to rule out lactose intolerance, food sensitivities, celiac disease, small intestinal bacterial overgrowth (SIBO), and/or dysbiosis of the large intestine. Elimination and challenge diets with high FODMAP foods may also be recommended.
2) Repair
Chronic exposure to aggravating foods or pathogenic microbes can cause damage to the epithelial lining of the intestines. Supplementing with an amino acid called L-glutamine, and omega 3 fatty acids can help repair the intestinal lining and restore healthy digestive function.
3) Re-inoculate
Re-inoculating the gut with health promoting ‘friendly’ bacteria (ie. ‘probiotics’) helps to promote a healthy balance of gastrointestinal microflora. This balance is important for gastrointestinal tissue health, immune function, and intestinal barrier function, and digestion.
4) Replace
Supplementing with digestive enzymes, and stomach acids may be beneficial in certain circumstances. Stomach acidity, and digestive enzymes facilitate the breakdown of food. A deficiency of these compounds is common, especially as we age, which compromises digestion, absorption of nutrients, and elimination of waste.
Along with the 4 R program, it is important to recognize that chronic stress, anxiety, and depression can also contribute or worsen IBS symptoms. Addressing these mental-emotional concerns through counselling, relaxation techniques, and other methods are strongly emphasized in a comprehensive naturopathic treatment plan.
In health and happiness,
Dr. Meghan van Drimmelen | Naturopath Victoria BC
References:
The Potential Role of Hypochlorhydria in the Development of Duodenal Dysbiosis: A Preliminary Report
