I often encounter patients who have read online that SIBO (small intestinal bacterial overgrowth) is a chronic condition that never fully goes away. In my clinical experience, this is not true. However, it can feel like a chronic issue when it’s either misdiagnosed or not treated thoroughly.

Why Accurate SIBO Diagnosis Matters

Let’s start with diagnosis. The most accurate, readily available, way to diagnose SIBO, is with a breath test. Sometimes patients tell me they were diagnosed using a specialty stool test. While certain stool markers might suggest the possibility of SIBO, they are not definitive or diagnostic. 

I typically order at-home breath tests, which I have found to be very reliable. These tests are often easier for patients to complete than in-office ones, especially since I usually order the 3-hour tests, to make sure to catch cases in people who have slower digestive motility. These breath tests measure hydrogen and methane gas levels in the breath. (When methane is elevated, it is technically considered Intestinal Methanogen Overgrowth, or IMO.)

Why does this matter? Because an accurate diagnosis is the first step to an effective, complete treatment plan. Which gases are present, and how elevated the levels become, are key to guiding treatment strategies. 

SIBO Treatment Plans Based on Breath Test Results

Knowing your gas levels helps tailor the treatment approach. As a naturopathic doctor, I offer an integrative treatment plan. This may include:

• Prescription antibiotics
• Herbal antimicrobials
• Or a combination of both 

I generally don’t recommend antibiotics without a confirmed diagnosis. But with a positive test, the treatment recommendations change depending on the type and amount of gases present. 

Some patients choose to go the herbal route only, which is totally fine. While it may take longer to fully eradicate with herbals alone, it is definitely possible. 

Preventing Chronic SIBO with Complete Treatment

So, how do we prevent SIBO from becoming chronic? We treat it until it has fully resolved. One of the most common mistakes I see is under-treatment. The only reliable way to confirm eradication is by repeating the breath test. 

What to Do When SIBO Symptoms Don’t Improve

Sometimes, gas patterns change in ways that give clues about how to shift treatment strategies, and this is where repeat testing can be helpful. Adjustments made based on the results can make your treatment plan more precise and more effective.

The key is working with a provider who has the clinical insight and experience to guide you through the process until the SIBO is truly resolved. 

Personalized SIBO Support in Seattle

If you’re tired of feeling adrift, and looking for this kind of specialized support, I’d love to help. 

You may call to schedule an appointment at 206-643-2239, or book online at www.pnwintegrativemed.com 

The post Is SIBO Chronic? Not Necessarily. first appeared on Pacific Northwest Integrative Medicine.

HYDRATION AND ELECTROLYTE REPLACEMENT

Admittedly, I was thinking about this blog topic after our late May heat wave, when I thought we might escape “Juneuary” here in Seattle, but alas, our weather can be very unpredictable. That said, it’s definitely bound to heat up after July 4th (at least we can count on that!) With that in mind, it’s time to talk about hydration and electrolyte replacement. I don’t often write about general health in my blogs, as a naturopathic doctor specializing in gastroenterology, however, this topic can be very relevant to one of my favorite topics – bowel function. Whether you’re dealing with chronic constipation or recovering from a bout of diarrhea, understanding how to stay hydrated in the right way can make a world of difference for your overall well-being.

As a rule of thumb, drink at least ½ ounce of water per pound of body weight each day. If you exercise frequently, increase the amount to 1 ounce per pound. If that seems like a challenging amount of liquid to ingest, start where you are and increase your intake by 12-16 ounces a week until you reach the targeted amount of hydration. It is important to take small incremental steps towards your goal so it may become a sustainable part of your daily liquid intake.

Choosing the right type of hydration for different situations is also crucial. If you’re experiencing chronic constipation, for example, opt for water-based hydration sources. This includes plain water, coconut water, and herbal teas (think hibiscus, mint or Green). However, it’s important to be mindful of your choices. Avoid fruit juices unless they’re heavily diluted with water. Coffee and black tea, while they do provide hydration, can also act as a diuretic which may increase urine output and counteract the goal of water absorption.

Now, let’s talk about electrolyte replacement. Many people know that it is important to replace electrolytes after activities in the sun and heat, but it is also important to replace electrolytes and fluid if you are having diarrhea. It can be hard to tell which products on the shelf might be best for supporting electrolytes, as creative marketing can be employed, and is often misleading. For instance, if an “electrolyte water” says it has electrolytes added for flavor, there may not be enough electrolyte present in sufficient amounts for replacement. Instead, choose products that truly replenish your electrolytes by looking for options that list the amounts of essential electrolytes such as potassium, magnesium, sodium, and chloride. These electrolytes play a vital role in maintaining your body’s balance and should be included as ingredients in a rehydration drink. While some sports drinks may contain carbohydrates in the form of sugar, they might not necessarily provide sufficient electrolyte replacement. A small amount of sugar can increase absorption of water however, high fructose corn syrup and artificial sweeteners should be avoided. Be sure to read the labels and choose wisely.

If you’re looking to add a little zest to your hydration routine, infused water is a fantastic option. Simply add fruits and veggies to your water and allow them to infuse it with delicious flavors. Some delightful combinations include lemon, cucumber, and mint for a refreshing twist. And if you prefer a less sugary option than fruit juice or sports drinks, infusing water with fruits adds a subtle essence without excessive sweetness. Ginger-infused water is also a wonderful choice, known for its refreshing and soothing properties.

Maintaining proper hydration and replenishing electrolytes is crucial for your overall health, especially as the temperatures rise. Remember to choose the right type and amount of hydration for your specific needs, avoid excessive sugar and artificial additives, and be mindful of electrolyte replacement options. Cheers to a hydrated and healthy you!

Natural medicine can work very well to improve GI health. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

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Therapeutic diets have been used for decades to manage various health conditions, especially gastrointestinal (GI) disorders. Although therapeutic diets can be beneficial for many patients, they must be used judiciously to avoid the risk of disordered eating, particularly in children. As a naturopathic doctor specializing in gastroenterology, I recognize the importance of using therapeutic diets for short periods of time to reduce symptoms and then gradually expanding the diet as symptoms improve. One important exception is celiac disease, which is an auto-immune disorder requiring lifelong complete avoidance of gluten.

One such GI disorder that can benefit from a therapeutic diet is inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease. According to a study published by Dr. Samir Kakodkar, the Specific Carbohydrate Diet (SCD) has been successful in reducing symptoms in patients with IBD by avoiding specific carbohydrates that promote the growth of harmful bacteria in the gut microbiome. Instead, SCD promotes the growth of healthy, anti-inflammatory bacteria in the gut microbiome, thereby reducing inflammation in the GI tract.

Additionally, researchers at the University of Massachusetts Medical School are conducting nutrition research on IBD and have developed the IBD-Anti-Inflammatory Diet (IBD-AID). This diet focuses on adding pre and probiotic foods while limiting inflammatory carbohydrates to induce anti-inflammatory bacteria into the gut, leading to longer-lasting remissions.

The UMass website has a wealth of information on IBD-AID, which includes a comprehensive breakdown of the diet, recipes, and scientific studies that support its use in managing IBD symptoms. 

It’s important to note that everyone’s body is unique, and therapeutic diets should be individualized to ensure the best outcomes. Frequent follow-up with a healthcare provider is recommended to monitor symptoms and adjust the diet as needed.

Natural medicine can work very well to improve GI health. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

SOURCES

Kakodkar, Samir, and Ece A Mutlu. “Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease.” Gastroenterology clinics of North America vol. 46,4 (2017): 745-767. doi:10.1016/j.gtc.2017.08.016

“Inflammatory Bowel Disease – Center for Applied Nutrition at UMass Chan Medical School.” UMass Chan Medical School, 22 June 2022, https://www.umassmed.edu/nutrition/ibd/. 

The post WHEN A THERAPEUTIC DIET MIGHT BE NECESSARY first appeared on Pacific Northwest Integrative Medicine.

Inflammatory bowel disease (IBD) is a chronic condition that affects the gastrointestinal (GI) tract.

Here are five important things you should know about IBD:

1. IBD affects millions of people worldwide: IBD is a global health issue, with an estimated 3 million people affected in the United States alone. The condition is found in people of all ages, although it is most commonly diagnosed in young adults between the ages of 15 and 35. (SOURCE)
2. There are two types of IBD: Crohn’s disease and ulcerative colitis, and both can cause severe symptoms that significantly impact a person’s quality of life. Both are considered to be auto-immune diseases, which occur with an overactive immune system. Crohn’s disease can affect any part of the GI tract, from the mouth to the anus, but most commonly affects the small intestine and the beginning of the large intestine. It can cause inflammation that penetrates the full thickness of the intestinal wall and can result in a variety of symptoms such as abdominal pain, diarrhea, fatigue, weight loss, and malnutrition. Ulcerative colitis, on the other hand, affects the large intestine and the rectum. It causes inflammation that disrupts the inner lining of the intestinal wall and can lead to symptoms such as abdominal pain, bloody diarrhea, and urgency to have a bowel movement.
3. In order to rule out IBD, you must be able to rule out both Crohn’s Disease and ulcerative colitis. When IBD is suspected, diagnostic work up should include both a colonoscopy and an upper endoscopy.
4. While there is currently no cure for IBD, advances in medical treatment options have significantly improved the outlook for people with the condition. Medications such as steroids, other prescription anti-inflammatories, and biologics can help reduce inflammation and suppress immune system flare-ups. (SOURCE)
5. In addition, lifestyle changes can help manage symptoms of IBD, such as certain dietary approaches, including the SCD, IBD-AID, or elemental diets, avoiding trigger foods, staying hydrated, and managing stress can help improve symptoms and quality of life for people with IBD. Complementary and alternative therapies such as probiotics, omega 3 fatty acids from fish oil, acupuncture, and herbal supplements – such as Curcumin, and Boswellia – may also be helpful for some people. (SOURCE)

It’s important to remember that with IBD, treatment is not all or nothing. Often patients come to me hoping to avoid taking prescription medications. Natural therapies work better for some patients than others. For instance, those with mild to moderate IBD have a better chance of disease control with nutritional interventions and supplementation. Those with moderate to severe IBD might require medication, in addition, to achieve successful remission. It’s important for people with IBD to work closely with their healthcare team to develop a personalized treatment plan that addresses their unique needs and goals.

As a naturopathic doctor specializing in gastroenterology, I use laboratory measures and clinical presentation to monitor and determine response to treatment. This can be helpful to determine whether we need to modify protocols to reach the most beneficial outcome for each individual.

Natural medicine can work very well to improve outcomes in IBD. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

The post FIVE THINGS TO KNOW ABOUT IBD first appeared on Pacific Northwest Integrative Medicine.

The diagnostic criteria for Irritable Bowel Syndrome is defined by intermittent or constant abdominal pain (mild or severe) for at least three months, chronic constipation or diarrhea or both, and bowel changes. You might be faced with the following type of IBS:

• IBS C – IBS with constipation
• IBS D – IBS with diarrhea
• IBS M – IBS with mixed constipation and diarrhea

When IBS is suspected, a conventional approach would be to treat constipation or diarrhea with medication. For instance, a Gastroenterologist might offer Miralax as a solution for IBS C.

As a naturopathic doctor specializing in gastroenterology, I don’t want to just leave it at “the diagnostics”. I want to look at underlying causes. With IBS, there is often an underlying condition like SIBO or Fructose Malabsorption that is causing IBS discomfort. 

We can do better than treating IBS as a chronic condition. Often by the time patients come to see me, they haven’t had stool tests or other testing for dietary and food sensitivities. Here’s how I approach these cases:

1. Search and test for underlying cause
2. Improve mucosal integrity
3. Improve function

I prepare patients for and IBS diagnosis by studying their stool and monitoring lab work to find if there are any food allergies. I look at how digestion and absorption are working. Then I assess for leaky gut and SIBO if it looks likely. Labs can tell what the cause of IBS is and help us get to the root of the individual’s IBS symptoms. 

Whether it’s mucosal lining, SIBO, or other functional issues like abdominal adhesions, or decreased motility, there are alternatives to managing symptoms with medication (even though medications are fine to use while we are figuring things out). Until we determine the underlying causes of an IBS diagnosis, there are a couple of things to consider:

First, is a dietary approach to alleviating discomfort. Try a regular meal pattern. It helps with the mechanisms in the GI tract that improve motility. Avoid large meals. Reduce fats and insoluble fiber, caffeine and gas producing foods like beans, brassicas, and, onions. Stay away from foods that contain lactose and gluten. I often suggest a Low FODMAP diet as a first step in ruling out SIBO or Fructose Malabsorption. 

Second, is the increase in movement. Exercise helps in situations with constipation. If there is a lot of pain associated with your IBS, exercise can help mitigate pain as a result of the endorphins produced. Exercise is both functional and practical medicine in the case of IBS.

IBS is a diagnosis with symptoms that mirror other illnesses, so it can be hard to understand what exactly you are dealing with. As a naturopathic doctor with expertise in gastroenterology, I can help make sense of your symptoms and help you alleviate them.

Natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

The post UNDERSTANDING IBS first appeared on Pacific Northwest Integrative Medicine.

I’m not one for New Year’s resolutions, they are hard to stick to. Instead, setting life goals and intentions that can actually be obtained are more helpful. Especially after the health scape of the last few years, it’s important to take care of the issues that we’ve put on the back burner.

In the new year, consider getting in touch with your body and revisiting the health needs you have been ignoring. For instance, I have patients who have had diarrhea for years. Years. We have spent so much time in survival mode, it’s time to thrive.

If you are someone who has been experiencing chronic GI issues it is long past time to get it checked out. Ask yourself the following questions:

• Have I had intermittent GI pain?
• Alternating diarrhea/ constipation?
• Acid reflux?
• Bloating or gas?
• Unexplained, ongoing nausea?

Rather than pushing past the pain and guessing why you continue to have these symptoms, take the time to look into it deeper. I can help decipher what’s going on with your body through testing and by offering dietary modifications that will alleviate discomfort.

The big goal should be restoring normal function to your GI tract, your body and your everyday life. Don’t set a resolution this year; instead follow through on your intention to take care of yourself and to be well.

Natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

The post STARTING THE NEW YEAR WITH INTENTION first appeared on Pacific Northwest Integrative Medicine.

Often times rather than narrowing down information to achieve diagnosis, independent investigation adds a level of complexity to the issues at hand. It can be hard deciphering the nuances of the symptoms on your own.

Commonly, people who have diarrhea, gas, or bloating start by googling their symptoms and begin to modify nutrition based on perceived food sensitivities. They might suffer through discomfort, pain, or worse – long term damage – by merely managing symptoms. Not understanding the root of the problem, the symptoms of IBS and IBD may appear similar but in reality, the treatments are very different.

IBS is a functional issue; chronic symptoms that develop into a syndrome affecting the body’s systems. As the symptoms of IBS are alleviated, the function of the body can be restored and maintained.

IBD, on the other hand, is a pathological issue causing inflammation of tissues in the GI tract. It is a disease rather than a syndrome, often manifesting as Chron’s Disease or Ulcerative Colitis. As such, there’s more of an algorithm to the treatment of IBD than IBS.

If you have IBD and treat the symptoms, they might alleviate to some degree but won’t go away. There are three red flags that we look at when differentiating IBD from IBS:

• Blood in the stool (usually diarrhea)
• Weight Loss
• Fatigue

It’s important to get a definitive diagnosis if you suspect IBD and better to rule out the other (IBS). Rather than gathering and deciphering the information on your own, it’s useful to have someone help you narrow down what you’re dealing with.

As a naturopathic doctor with a specialty in gastroenterology, I will recommend specific labs that make the distinction between an IBS or IBD diagnosis definitive. For instance, I can perform basic blood work and stool studies, but if IBD is suspected I will refer you to a GI doctor for endoscopy and/ or colonoscopy to rule it out. The definitive diagnosis is achieved through tissue biopsy. I will partner with you by offering a more educated distinction between IBS and IBD than you would be able to correlate independently.

Natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

The post THE DISTINCTION BETWEEN IBS AND IBD first appeared on Pacific Northwest Integrative Medicine.

And the last time you had a bowel movement did you check it out? I mean really check it out?

People rarely take time out of their day to think about poop. But they should. It’s an important part of daily life. A lot of people are constipated and don’t even know it. Constipation occurs when there is lack of ease or discomfort in eliminating the bowels, ideally on a daily basis.

There is somewhat of a stigma involved in talking about the body’s waste. Ultimately the lack of awareness related to this important bodily function is detrimental to overall health. I would like to open up the conversation and give you a place to start if you are wondering what exactly is constipation and if you are experiencing it at this time. Then, I will give you some naturopathic solutions that are found to address underlying causes and help alleviate constipation symptoms.

Take a look at the Bristol Scale (pictured below). It is a good visual and indicator of what your poop might look like on a spectrum from constipated to having diarrhea. Conventional medical guidelines say constipation occurs if stool is harder than type 3-4 (normal bowel movements) on the Bristol Scale. If your bowel movements are occurring less than three times per week and they resemble Type 1 or 2 on the Bristol Scale – lumpy, dry, hard to pass – you might be experiencing constipation (SOURCE)

Constipation can occur in both adults and children. There can be a number of underlying issues creating constipation, here are a few (SOURCE):

• Dehydration
• Poor nutrition – especially lack of fiber
• Lack of physical activity
• Stress
• Certain medications (including antihistamines, antidepressants, antispasmodics, antacids containing aluminum, blood pressure meds, opiates, iron supplements)

If you suspect constipation, you might be wondering how to repair your bowel function and get things moving.

Conventional primary care physicians generally recommend Miralax or a stimulant laxative like Senokot.

The naturopathic approach to constipation is a little different, and there are many natural agents you can try to alleviate the root causes of constipation prior to the use of laxatives. We start with the foundations: fiber, water, movement.

1. Hydrate. Start by adding water to your nutritional intake.
2. You might add fiber bulking drinks as a next step, but naturopathic doctors most often suggest dietary fiber in the form of fresh fruit, veggies and whole grains. 
3. Try to increase the amount of time you move your body (exercise) in a day.
4. I might prescribe magnesium or high doses of vitamin C as stool softeners.
5. Depending on the situation, I might suggest motility support.
6. I also often recommend the use of a stool, such as a Squatty Potty, to rest the feet on to make bowel function easier.
7. Self-abdominal massage has been shown to help with constipation as well.

Constipation is common, and natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state 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.

The post GETTING YOUR POOP TOGETHER first appeared on Pacific Northwest Integrative Medicine.

Eosinophilic esophagitis (EOE) is one of those specific types of diagnoses. 

A naturopathic approach to patient care looks for the root cause of an illness in order to relieve symptoms. The treatment of EOE requires a multifaceted approach, so my goal is to work in cooperation and conjunction with a patient’s Gastroenterologist.

Are you struggling with an EOE diagnosis and you’re not sure where to turn?

Following are some frequently asked questions patients have about EOE and its diagnosis and treatment.

What is EOE?

Eosinophilic esophagitis (EOE) is an inflammation that occurs when white blood cells infiltrate the mucosal lining of the esophagus. It is found in both adults and children.

What are the symptoms of EOE?

The main symptom of EOE is an increased difficulty in swallowing. For instance, if a patient were to say that swallowing certain foods had become problematic, like bread or meat, and they needed a lot of water to get those foods down, I would suspect EOE.

What causes EOE?

As with a lot of specialty cases, it is not yet well understood how someone might develop EOE. Here are a few things that can help us pinpoint EOE as the culprit in the inflammation process:

• ALLERGENS – The most common cause for EOE are allergens. We look at basic known triggers for all people: milk, eggs, soy, wheat (avoid these) and triggers specific to an individual. 

Fish, nuts, and tree nuts are not commonly associated with EOE but are more commonly associated with the symptoms of anaphylaxis

• GER – Gastroesophageal reflux (GER) occurs when stomach contents regurgitate into the esophagus causing irritation/ inflammation to the epithelial lining. This in and of itself makes it difficult to swallow. But the damage caused to the esophagus causes the lining to be more hypersensitive to allergens and then induces EOE.

How is EOE treated?

Generally, the initial diagnosis and treatment begins with a conventional approach by a gastroenterologist. However, there are many things a naturopathic doctor can do to support diagnosis and treatment of EOE.

Conventional Approach (gastroenterologist)

• eliminate dietary triggers
• endoscopy (biopsy and analysis)
• steroid therapy
• a balloon dilation if the esophagus narrows excessively (stenosis) 

Naturopathic Approach

• allergen panel
• elemental diet – no digesting, bowel rest, nutrients in w/out processing and observation for a change without dietary triggers
• supplements that will reduce hypersensitivity
• identify other potential causes for the excessive immune response

This integration of approaches is my specialty and what many who suffer from EOE prefer. I am able to decrease inflammation and fibrosis to support the therapies offered by a GI doctor – especially mucosal lining repair as a precursor for surgery or endoscopy.

One of the pillars of naturopathic medicine is 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 any gastrointestinal issues you may have. If you live in Washington state 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.

The post FREQUENTLY ASKED QUESTIONS ABOUT EOE first appeared on Pacific Northwest Integrative Medicine.

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.

Resources:

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

The post What To Consider: Is It IBS or Something Else? first appeared on Pacific Northwest Integrative Medicine.