8) Microbial Imbalance: Lack of Good Gut Bacteria, Excess Bad Bacteria
Individuals with IBS have been found to have decreased diversity and numbers of bacteroidetes microbiota.
Fecal microbiota transplant has a ‘cure’ rate of between 36 percent and 60 percent. (R)
The nonabsorbed antibiotic rifampin can provide sustained relief for some IBS patients. This could be because it prevents the overgrowth of small intestinal flora. (R)
In all mammals (our animal relatives) tested, they were found to have L reuteri in their guts.
With humans, L Reuteri is found in only 10-20% of people. It’s likely that we once had this in our guts, but with our shitty diets and lack of fermented veggie, most of us don’t now.
L reuteri switches consumption from sugar to tryptophan and produce the molecules for our gut protection (AhR ligands – 3-IAld).
L Reuteri increases gut motility and decreases pain perception. (R)
Clay has been found to be beneficial, likely because of its antimicrobial and laxative properties. (R)
9) Intestinal Permeability
If you’ve been reading the blogosphere, you’ll know by now that gut permeability has to do with every disease in existence – and even in diseases not in existence such as adrenal fatigue.
Well, the whole gut permeability spiel is overdone, but there’s some truth to it.
IBS and IBD are in part caused by gut permeability. (R)
Stress increases gut permeability. (R)
In animal models, both acute and chronic stress enhance the ability of bacteria to adhere, internalize and cross over your gut, which causes gut inflammation. (R)
Hypersensitivity from stress results from an alteration of colon permeability. (R)
Probiotics such as L Plantarum (R), L Rhamnosus, B infantis and S Boulardiicounteract these changes in gut permeability. (R)
10) Bad Diet: Excess Sugar
When bacteria in our gut consume sugar, they stop producing molecules (AhR ligands) that are necessary for our gut protection against pathogens such as candida. (R) These bad pathogens then overgrow.
When sugar is the energy source for our gut microbes, they stop consuming tryptophan and serotonin is reduced. Serotonin is necessary for proper gut function. (R)
So stay away from added sugars.
Also, added sugars, sugared drinks, and foods made from flour (bakery products and pasta) are the ones that are most easily fermented by bacteria to cause intestinal gas.
A lack of plants or natural antimicrobials contributes to the bacteria in your gut.
11) FODMAPs
FODMAPs are fibers that result in fermentation and associated gas production, which causes gut distension and bloating.
One the most evidenced-based treatments for IBS is to restrict FODMAPs. (R)
Studies show a good improvement when people go on a low FODMAP dietand it’s suggested that low FODMAP diets be used as a first-line approach in treating IBS. (R)
Leafy greens and cucumbers are low FODMAP veggies that I enjoy.
Bottom Line: FODMAPS+CRH=Gut pain.
12) TGR5 and Bile
It enhances energy expenditure, increases oxygen consumption, prevents obesity, and decreases insulin resistance in a mice model of obesity. In humans, it converts T4 into T3. (R)
Therefore, a deficiency of bile could lead to IBS-C and too much bile could lead to IBS-D. (See below for variations in the TGR5 receptor). (R)
Indeed, up to 30% of people with IBS-D have bile acid malabsorption (which is a different condition, but the results are similar: diarrhea). These people do well with bile acid sequestrants. (R)
If you have IBS-C then you should consider taking Ox Bile to activate TGR5.
13) Undiscovered Infection
Research supports IBS being caused by an as-yet undiscovered active infection.
The nonabsorbed antibiotic rifampin can provide sustained relief for some IBS patients. This could be because it kills an undiscovered microbe (or because it reduces overgrowth of intestinal flora). (R)
Other researchers have focused on a possible unrecognized protozoal infection such as blastocystosis as a cause of IBS, as certain protozoal infections occur more frequently in IBS patients. (R)
14) Antibiotic Usage
Antibiotics can contribute to intestinal overgrowth by killing your good bacteria.
Antibiotic usage increases the risk of developing IBS. (R)
However, some antibiotics like rifaxamin can be beneficial, probably because it’s selective against only certain bacteria.
15) Low Stomach Acidity
Stomach acidity prevents the growth of bacteria. Although neutralized when it goes to the small intestine, if your gut isn’t acidic, more bacteria will grow in your intestines.
a meta analyses found that proton pump inhibitors (decreases stomach acid release) caused an increase in small intestinal overgrowth (SIBO). (R)
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