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.

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.