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What To Consider: Is It IBS or Something Else?

Intestinal Discomfort, Gut Health, Naturopathic Medicine, Naturopathic Physician, IBS, SIBO

Worried your intestinal discomfort is here to stay?

It’s not as if you are trying to intentionally suffer through your symptoms – but you just can’t seem to find a way to alleviate them.

Most likely you have already tried to do so much on your own:

  • You searched for wisdom from an allopathic doctor’s perspective – the scary diagnoses have been ruled out
  • You explored supplements, over the counter medications and prescriptions
  • You changed your habits to better support healthy nutrition, movement, sleep and stress management

After all the ways you’ve tried to address your symptoms…

Are you still wondering what your gut is trying to tell you?

If you are at the end of your rope with western medicine, it might be time to look at your symptoms from a naturopathic perspective.

The go-to diagnosis for bowel disorders is often Irritable Bowel Syndrome (IBS). Even that diagnosis is complicated because the symptoms of IBS often mirror the symptoms of other underlying disorders:

  • Abdominal pain
  • Excessive gas/ bloating
  • Constipation
  • Diarrhea
  • Both constipation/ diarrhea

So, naturally it would be difficult to determine exactly which disorder is the source of your own discomfort.

Here’s a look at a few bowel disorders and their symptomatic differences:

  1. Irritable Bowel Syndrome (IBS) – IBS is a diagnosis of exclusion – because other causes of symptoms, such as celiac disease, Crohn’s and ulcerative colitis, have been ruled out, and no other explanation can be determined.
    SIBO and fructose malabsorption are found in a significant percentage of patients diagnosed with IBS, therefore offering a more specific diagnosis. Fructose malabsorption is often secondary to SIBO, but occur without SIBO as well.
  2. Small Intestinal Bacterial Overgrowth (SIBO) – SIBO can be caused by gastroenteritis – probably the most common cause; medications, including antibiotics and acid blockers – a close second; or, adhesions formed from surgical procedures, and/ or by endometriosis.
    SIBO is a result of the movement of good bacteria grown in the large intestine into the small intestine (where it does not naturally grow), causing similar symptoms to and possibly an underlying cause of IBS.
  3. Fructose Malabsorption (FM) – FM is a result of an abundance of ingested fructose through fruits, vegetables, and artificial sweeteners.
    “Because fructose is a mono-saccharide, excessive dietary intake can easily exceed the absorptive capacity of the small bowel, leading to incomplete absorption of fructose and, finally, causing fructose malabsorption (FM).1” (Jung)
    “Poorly absorbed fructose can exacerbate and contribute to IBS symptoms and restricting fructose in the diet can lead to symptom improvement.” (DiNicolantonio)

If, in fact, through functional testing we are able to determine that there is a root cause for your IBS symptoms, there are some treatment options available to you. A naturopathic doctor might approach your care plan with the following suggestions:

Managing symptoms: Providing relief for constipation/ diarrhea, abdominal pain, motility so patients feel relief from symptoms while addressing the cause.

Dietary changes: Helps with symptom control, and also helps to avoid feeding bacteria in the case of SIBO.

Eradicate bacterial overgrowth: if present this can be accomplished by prescription antibiotics, herbal microbials, or both.

Heal the gut

Prevent recurrence: Support a healthy microbiome, motility and modified diet

Address abdominal adhesions when present: Take steps to address these – ometimes patients need surgical ablation, sometimes management of endometriosis, sometimes high dose enzyme therapy and anti-inflammatories.

As a naturopathic physician with a specialty in gastroenterology, it is my goal to equip you with information so that you can make the most informed decisions about your health. In fact, at the heart of naturopathic medicine is the philosophy of doctor as teacher. My intention is to empower you to participate in your own healing process.

Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for your health care needs. If you live in the Seattle area and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.


DiNicolantonio, James J, and Sean C Lucan. “Is fructose malabsorption a cause of irritable bowel syndrome?.” Medical hypotheses vol. 85,3 (2015): 295-7. doi:10.1016/j.mehy.2015.05.019

Jung, Kee Wook et al. “Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth.” Journal of neurogastroenterology and motility vol. 24,2 (2018): 307-316. doi:10.5056/jnm17044