Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS), as the name implies, is a grouping of symptoms that include gas and bloating, abdominal discomfort and constipation or diarrhea. IBS is a diagnosis of exclusion, meaning it is diagnosed after other conditions, such as irritable bowel disease (IBD), have been ruled out. Many natural treatments can help IBS. Meditating 30 minutes a day for just six weeks significantly decreased diarrhea, bloating, flatulence, and belching in one study. Not surprisingly, the study reported no side effects. Dietary allergies can contribute to IBS symptoms, and eliminating them can lead to dramatic improvement as well. A recent review of dietary allergies in IBS published in Neurogastroenterology and Motility concluded that excluding dietary allergens can lead to an improvement in up to seventy one percent of IBS sufferers. We can identify food allergens several ways. Blood tests for IgG4 antibodies and the allergy elimination-challenge tests are the most sensitive. In an elimination-challenge test, patients follow a hypoallergenic diet for a prescribed period of time and track their symptoms in a journal. Then they methodically, and with guidance from a clinician, reintroduce foods one at a time. If symptoms return with specific foods, the patient eliminates them from her diet altogether, perhaps not forever, but for a while.
A forty-nine year old woman complained of diarrhea multiple times a week, with a past diagnosis of diarrhea-predominant IBS. She would experience bouts of urgency several times a day during which she would be forced to stop anything she was doing to rush to the bathroom, where she would have diarrhea. She also was experiencing depression for which she was taking forty mg of Prozac for the depression. Her health goal was to test for the possible underlying causes of her IBS so that she could get rid of it once and for all. Her MetaCT 400 test results revealed severe allergies to dairy; functional hypothyroidism (low T3); deficient in all 10 essential amino acids and some non-essential amino acids; multiple essential mineral deficiencies (magnesium, zinc and manganese); elevated free radical damage to lipids and DNA, which are risk factors for heart disease and cancer; mercury toxicity, a risk factor for depression and irritability; vitamin D insufficiency, a risk factor for colorectal cancer, osteoporosis, and cervical cancer; decreased ability to burn fats and carbohydrates for energy production; borderline vitamin B12 deficiency, a risk factor for dementia; intestinal bacterial dysbiosis, a risk factor for malabsorption and nutritional deficiencies; and iron deficiency (low ferritin). These test results explained her IBS and depression (below).
| Food allergies, explaining her IBS symptoms |
  Note: Casein is a protein found in high concentrations in dairy and dairy products |
| Intestinal bacterial infection, explaining her IBS symptoms |
 |
| Amino acid deficiencies, explaining fatigue, depression, exercise intolerance |
 |
| Low minerals, explaining fatigue, increased free radical damage to DNA |
 |
| Mercury toxicity |
 |
| Elevated free radical damage to cell membranes (lipid peroxides) and to DNA (8-Hydroxy-2-deoxyguanosine) |
  |
| Vitamin D insufficiency |
 |
This woman was placed on a therapeutic elimination diet, her bacterial infection was treated, and her nutritional deficiencies addressed with dietary supplements and dietary modification. After six weeks of being on the program her diarrhea was decreased by eighty percent and she no longer had any urgency. After twelve weeks her IBS was decreased by ninety percent, she no longer experienced gas/bloating or diarrhea except when she would eat dairy. Her mood had also improved during this period, she reported feeling "calmer," and she spoke with her physician about coming off of her antidepressant medication.
Case: IBS in a Thirty-one-year-old Woman
As you will see, the underlying causes of IBS are not always the same, and therefore the treatments are customized based on the underlying causes. This next case is that of a thirty-one-year-old woman who suffered from severe bouts of diarrhea. They were so debilitating that she also suffered from extreme anxiety to the point where she refused to board a plane or even take a vacation with her husband. Not surprisingly, she also suffered from depression, abdominal pain, and social phobia. She had also been trying to get pregnant for ten months without conceiving.
She had originally gone to see Dr. Neustadt a year earlier and decided not to take his recommendations to get tested. However, her symptoms persisted and even got worse. It turned out that a close friend of hers had been evaluated by Dr. Neustadt and her life-long depression and insomnia were cured. The point here is that some people need reassurance from a friend that this functional and holistic approach may help them before they are willing to set aside their skepticism and fear and give it a try. Drs. Pieczenik and Neustadt find this phenomenon very interesting and common, since patients don’t question the legitimacy of the conventional medical approaches even though they don’t understand the science behind them either. But in terms of the functional medicine approach, they often need a reference point of credibility in order to allow them to get to the point that they’ll follow this approach.
Her testing revealed:
This woman was placed on customized treatment plan to treat the underlying causes of her symptoms and rebuild her health. She was told to stop trying to get pregnant until the completion of the three-month treatment plan until repeat toxic metals testing showed she no longer had dangerous levels of toxic metals. After just a few days of complete avoidance of dietary allergens, she reported a complete resolution of her IBS symptoms. She no longer had severe abdominal pain and diarrhea.
At her two-week follow-up appointment, she reported that she continued to improve and felt much better. One important aspect of this plan for her, as it is with many people who are diagnosed with food allergies, is that she began to advocate for herself when she would go out to eat and question the waiters to ensure that she was getting food that wouldn’t harm her. This empowerment for her was very important. It is quite common for many people, and women in particular. It is the first time in their lives that they actually act proactively about their health and place themselves first without feeling guilty.
