House Call: How to Cure Irritable Bowel Syndrome in a Few Days

So many times I get asked questions in my newsletters, on Facebook, on Twitter, with patients when I go give lectures, and I thought I'd do something new, which is have Q&A with Dr. Hyman once a week. So I invite you to send your questions, to share your thoughts, to ask me whatever you want about your health issues and concerns, and I'll try to answer them. And I'll do it from the perspective of functional medicine, which is a whole new framework of thinking. Welcome to my weekly house call, your chance to ask me your questions. So this week's question is, I have irritable bowel syndrome. What do I do about it? What causes it? And do I have to take drugs? Well, irritable bowel syndrome is a huge problem. It affects 60, 70 million people. It's one of the most common reasons for visits to the doctor. And yet, most doctors have no clue how to treat it or what's really causing it. That's where functional medicine comes in. Functional medicine is not a new treatment or test or modality. It's a whole new way of thinking about solving the puzzle of chronic symptoms and diseases. And the irritable bowel is a fantastic model for how functional medicine works. Now, what is it anyway? Well, irritable bowel is when you have symptoms of bloating, or gas, distension, constipation, diarrhea, where your bowel is just irritable. And when you look in there with like a scope, you don't really see anything. So they call it functional bowel disease, but it really causes a lot of misery for a lot of people. And the causes, even though the symptoms may be the same, causes can be different. So in functional medicine, we talk about the root causes, getting to the root cause. We have allergens, microbes, imbalance in the bugs in your system, toxins, poor diet, stress, all of which can trigger symptoms. And in any two or three or four or five people with irritable bowel, each one of them may have different causes for the exact same symptoms. So let's go through what they could be and then what we can do to find out what your symptoms are caused by, and then what you can do to fix this thing once and for all. Because it's fixable. It really is. And it's extraordinary how simple it is once you know the right thing to do. There's a funny joke I always tell about this patient who had his appendix out, and the doctor sends him a bill for $1,000, and the patient goes, Wow, that's such a lot of money for such a simple operation. And the doctor's like, you,'re right. so he sends him another bill, $1 for taking out your appendix, $999 for knowing what needs to be taken out. So functional medicine is sort of like that. We know exactly what to do and how to take things out. So the first thing that can happen is that foods can irritate your colon and irritate your bowel. They're called food sensitivities. It's not a true allergy like a peanut allergy or shellfish allergy, but it's a sensitivity and they're very common. The most common cause is gluten. That's the protein found in wheat, barley, rye, oats, spelt. Very common reaction, even if you don't have celiac disease, which is full-blown reaction to gluten. Dairy, another big problem. And that can be caused by the lactose, which causes bloating and gas, but it may just be the casein and other proteins in the dairy that are causing irritation and inflammation in your gut. And there are many, many other foods like soy, corn, eggs, other foods that can also be irritants. And I talk a lot about this in my book, the Ultra Simple Diet, where I give people a comprehensive elimination diet so you can connect the dots whether what you're eating is causing your symptoms. Most people don't connect those dots very well. So first thing is allergens or sensitivities. There's some tests that you can do also, food sensitivity testing, gluten testing that may be useful. And I talk a lot about that In many of my books, you can go online and find my How To Work With youh Doctor To Get what yout Need guide. It's free and you can actually download it and figure out what tests you need. The second thing is the ecosystem in your gut. You have an enormous ecosystem of bugs in there. 500 species of bugs. There's 100 trillion bacterial cells in there. That's 10 times as many as your own cells. In fact, there's 100 times as much bacterial DNA in you as your own DNA. so you're only really 10% human. And these bugs have to be in balance. If you have bad bugs or an overgrowth of yeast, if you have parasites, if you have worms, which we see sometimes, you can get symptoms. And they're common. And also, if you have bugs in the wrong spot, you can have a problem. Most of the bacteria are in your large intestine, but sometimes they kind of move up and they go into the small intestine. That's not very good because that should be sterile. And when you eat food that's starchy, bread, cereal, pasta, rice, or sugary, the bacteria in there ferment it. Like beer, you know, when like an apple cider blows up and the plastic container gets almost to explosion size, that's what happens in your gut. The bacteria ferment the sugars in the food you're eating and you blow up. That's why you get this bloating right after meals. We call that postprandial bloating, or bloating after you eat. And that's a very common sign of, or symptom of, bacterial overgrowth. We call that SIBO, S-I-B-O, small intestinal bacterial overgrowth. Very common and a very easy thing to treat if you use the right modality. The other thing that can happen is you get yeast overgrowth, which is common in your gut, but it's sort of like a garden when the weeds overtake it. Well, that's what happens. If you have too much yeast because you've taken lots of antibiotics, you've been on steroids, you've been on the birth control pill, you've taken acid blocking drugs, you eat a lot of sugar, you're diabetic, all these things tend to cause overgrowth of yeast, and that can be treated with antifungals. It can be antifungal herbs or antifungal medication. Now, I'm not a big fan of medication, but sometimes for irritable bowel, a good non-absorbed antibiotic called Xifaxan will clear out the SIBO so you don't have a bloat, and an antifungal like Nystatin or Diflucan will will clear out the yeast and you can kind of reboot. It's almost like hitting the reset button on your computer. You reboot your gut and then you start over. And then we focus on also looking at other things if that doesn't work. Parasites or worms that may require some stool testing and we do extensive tools testing in functional medicine to look at the ecosystem in there, not just whether you have an infection or not, but are things in balance? Do you have enough of the good bacteria? Whether you have worms or parasites or yeast or other bad bugs. We can tell all that and that can be very helpful, but it's not always necessary because sometimes just treating it, you'll get better. And then we use other things to help reset the system because you can get rid of the bad stuff, but then you have to put in the good stuff. And so what is the good stuff? Well, enzymes, digestive enzymes can be very helpful and those help break down the food while you're gut's healing. You may need those for two or three months. We reinoculate with healthy bacteria, probiotics, bifidobacterium, lactobacillus, other strains of bacteria, and they help to repopulate the healthy gut flora and allow your digestion to work. You can also use flora-rich foods like kimchi or sauerkraut, sometimes yogurt if you're not dairy allergic, miso, these are all foods that have natural bacteria in them that can help your gut flora stay healthy. And then we use things to repair the gut. so we remove the bad stuff, we replace the things that are missing like enzymes, we re-inoculate with healthy bacteria, and we repair the gut with the right nutrients, vitamin A and zinc and fish oil and glutamine and evening primrose oil and all these wonderful nutrients that help repair the gut. We use herbs like quercetin and turmeric, things that just help reduce inflammation and heal a leaky gut. And a leaky gut just means that your gut lining is sort of interrupted, it's sort of broken. Normally the cells are stuck together like this, but they kind of come apart like Legos, and then food proteins and bacteria leak in, they start pissing off your immune system, you get inflammation, and not only do you have irritable bowel, but it can cause joint pain, fatigue, cognitive problems, depression, allergies, congestion, you name it, pretty much you can get rashes, eczema, all of which can be caused by this gut issue. So in functional medicine, the gut is one of the most important things to focus on and to get working well because that's the seat of your health. Now, if you want to learn more about this, I've written many blogs on the Gut. I encourage you to link to them below. They're linked here in this blog. I encourage you to sign up for our weekly house call. I encourage you to join me on Facebook and Twitter and stay connected, share your comments, share your questions, submit your questions and maybe next week I'll make a house call to you.