Dr. Mark Hyman explains what causes IBS: bacterial overgrowth and food sensitivities. He walks through treatment approaches including diet changes, antibiotics, and supplements to manage the condition without drugs.
Hi, this is Dr. Mark Hyman. Imagine having a condition with symptoms so severe that you can't leave the house. Yet your doctor calls it a functional or psychosomatic disease, meaning it's all in your head. Imagine that's frustrating. But it's a very real problem for the 60 million people. That's 20% of Americans who have irritable bowel syndrome. They're plagued by uncomfortable and often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain. I have many patients with irritable bowel syndrome, some of whom have suffered for decades without relief. Their previous doctors couldn't find the cause of their illness, so they were told just to take more fiber or take Metamucil or were prescribed sedatives like Valium or antispasm drugs or antidepressants. That's not the answer and I can tell you about a different way to solve the problem of irritable bowel syndrome by dealing with the cause. Let me tell you about my patient Alexis. At 45 she suffered from irritable bowel for 33 years almost her whole life. Her sudden and major symptoms were painful cramping diarrhea that would come out of the blue. She was doing the best she could to prevent it. She didn't consume dairy. She didn't drink or smoke, she took Citrus-HL every day, and yet nothing helped. She would go to the bathroom four or five times even before she left the house in the morning. And she couldn't go out of the house without knowing where all the closest bathrooms would be in case she had what she called S attacks. Now, these weren't Alexis's only problem. She also felt full and bloated after every meal, which starchy foods made worse. An upper endoscopy had shown that she had gastritis or inflammation of her stomach, and she'd taken many antibiotics over the years. She also had severe PMS or premenstrual syndrome and had irregular periods, breast tenderness, sugar cravings, headaches, agitation. She also had very unusual symptoms like rectal itching which is often a clue for yeast infections or food allergies and she was tired all the time. Now, she tried to eat healthy but her diet was less than ideal. She had a bran muffin and coffee in the morning and a salad for lunch but her drug of choice was sugar. form of cakes and ice cream and jello and diet sodas and other junk food. Not surprisingly, she was about 20 pounds overweight. So how did I help Alexis? Well, all I really did was to treat the underlying causes of her digestive problems. And how did I do that? Well, first you have to understand a little bit about how the gut works to know how to fix it if it's broken. Now imagine a tennis court. That's the surface area of your small intestine where all your food is absorbed. Your small intestine is also the site of about 60% of your immune system. The bad news, the small intestine is also just one cell layer away from a toxic sewer. All of the bacteria in your gut and the toxins from food, if that lining breaks down from stress or too many antibiotics or anti-inflammatory drugs or intestinal infections or a low fiber, high sugar diet or alcohol and more, look out. Your immune system will suffer and you can develop all sorts of digestive problems and other systemic problems. Let's talk a little bit more about those bacteria in your gut. You've got about three pounds of it, 500 species in your gut. In fact, there's more bacterial DNA in your body than there is human DNA. Of all the gut bacteria, there are the good guys and the bad guys, and then there's the very bad guys. If the bad guys take over or if they move on to the areas where they shouldn't be, which is the small intestine, it's normally sterile in there, then the body can start fermenting the food you digest, particularly sugar and starchy foods. that's called small bowel bacterial overgrowth or small intestinal bacterial overgrowth. It's a major cause of irritable bowel syndrome. The major symptom it causes is bloating or feeling of fullness after meals. Now what causes the bloating? It's the overproduction of gas by bacteria as they have lunch on your lunch. This can be diagnosed by a breath test which measures gas production by the bacteria or a urine test that measures the byproducts of the bacteria after they are absorbed up in your system. Bacterial overgrowth is a real problem and it was recently described in a review paper published in the Journal of the American Medical Association and it can be treated. In fact, just recently a major paper was published in the Annals of Internal Medicine that showed that using a non-absorbed antibiotic called rifaximin for 10 days resulted in dramatic improvement in bloating and overall symptoms of irritable bowel by clearing out the small bowel bacterial overgrowth. That's very good news for irritable bowel patients. But unfortunately not all patients with the same diagnosis are created equal. There's more than one factor that leads to irritable bowel syndrome. Another major cause of IBS is food sensitivities. Another landmark paper was published in the prestigious British medical journal Gut and it found that eliminating foods identified through delayed food allergy testing called IGG antibodies resulted in dramatic improvements in irritable bowel symptoms. Another article in an editorial in the American Journal of Gastroenterology stated that clearly we must respect and recognize the role of food allergies and inflammation in irritable bowel syndrome. These are the two main causes of irritable bowel, food allergies and overgrowth of bacteria in the small intestine. But there may be others including lack of digestive enzymes, parasites, worms, zinc or magnesium deficiency and more. And this is precisely why it is so critically important to personalize the treatment based on the unique circumstances that exist for each person who suffers from IBS. The solution is most certainly not a one size fits all. Now, this is exactly how all of functional medicine is practiced, which is individualizing and personalizing treatment. Now let's get back to Alexis. I prescribed her a non-absorbed antibiotic, I gave her an antifungal drug for her yeast problem, and I had her eliminate the foods she was allergic to. Then I gave her supplements of healthy bacteria to normalize her gut and zinc to help with her digestive enzymes. See, because chronic diarrhea can cause a zinc deficiency. I also gave her extra fiber to feed the healthy bacteria, fish oil to reduce gut inflammation, and a multivitamin and herbs to help balance her hormones which are greatly affected by abnormal gut bacteria. So what happened next? Well, Alexis came back two months later a different person. Not only did she lose 20 pounds, she had not had one of her attacks at all and was having normal bowel movements for the first time in 33 years. And as a side effect, she also had more energy, no more PMS, she looked and felt 10 years younger and was free of the suffering she endured for over three years. and she lost 20 pounds. Are you like Alexis? It doesn't have to be that way. We have the understanding and tools to deal with this chronic problem and the suffering it causes in one in five people. There is no need to wait for any more studies. I have been treating irritable bowel in my practice for over 15 years with dramatic success. In fact, just today one of my patients told me that for the first time in his life he didn't have any more stomach pains or digestive problems. He had been so bad that he had to have phone installed in his bathroom. So what do you need to do to take advantage of these discoveries today? If you have irritable bowel, follow these steps. One, take the test for IgG food allergies and eliminate the foods that are positively testing for 12 weeks. Or you can do it on your own. If you can't afford the test, just eliminate the most common food allergies for 12 weeks. That's dairy, gluten, yeast, corn, eggs, soy and peanuts. And then reintroduce them to see if they cause symptoms. I've written about this in the Ultra Simple Diet It's a complete program that you can follow at home. Next, get rid of the unwanted visitors in your small bowel. Ask your doctor to prescribe rifaximin. Next, you can repopulate your gut with healthy bacteria. So there is a way out of irritable bowel syndrome and it's not through your head.
