Irritable bowel syndrome: approaches to stabilizing the bowel

Understanding and treating irritable bowel syndrome holistically

 

A contribution by Dr. Joris Budweg, ORIGIN HEALTH – Center for Functional Medicine and Longevity, Basel

Many of our patients come to us because they have been suffering from recurring abdominal pain, flatulence, diarrhea or constipation for years – often accompanied by exhaustion, sleep disorders or concentration problems. The diagnosis with which they appear is usually irritable bowel syndrome. But despite countless examinations and attempts at therapy, the condition remains unchanged.

If you recognize yourself in this description, we would like to encourage you to take the next step. At ORIGIN HEALTH – the practice for Functional Medicine & Longevity in Basel – we don’t look at your symptoms in isolation, but as an expression of deeper imbalances in the body. We combine state-of-the-art diagnostics with an individualized treatment approach that goes far beyond the mere treatment of symptoms. Because real progress begins with a different perspective – and an open ear for what your body is trying to tell you.

OVERVIEW

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a widespread gastrointestinal disorder that primarily affects the large intestine. Patients often report abdominal pain, cramps and changing bowel habits. In some cases, diarrhea dominates (IBS-D), in others constipation (IBS-C). Accompanying symptoms such as a lack of energy, constant exhaustion and sleep disorders can significantly reduce quality of life. Many sufferers have to deal with painful symptoms on a daily basis, which have a major impact on their social and professional lives. The symptoms described have an intense impact on quality of life and often lead to chronic stress. Frequently observed symptoms include recurring abdominal pain, cramps and an urgency to have a bowel movement. For many sufferers, these symptoms raise questions about the cause and possible solutions.

Why irritable bowel syndrome is not a simple diagnosis

Irritable bowel syndrome is not a single disease, but a complex syndrome. Women are affected more often than men. It is estimated that around 10 to 20 percent of people suffer from irritable bowel syndrome – many of them without an official diagnosis.

Irritable bowel syndrome is a so-called functional bowel disorder – this means that the bowel is structurally intact, but its function is impaired. This disorder manifests itself through

  • Recurrent abdominal pain

  • Flatulence

  • Stool irregularities (diarrhea, constipation or both alternating)

  • Urgency when going to the toilet

  • Feeling of incomplete emptying
  • and often also extraintestinal symptoms such as fatigue, headaches, muscle pain or concentration problems.

The pathophysiology is complex – and this is precisely the challenge, but also the key to therapy. Functional medicine aims to decipher this complex interplay. And these are often hidden deep in the metabolism, in the intestinal flora – or in the nervous system.

The gut thinks – and suffers too

Research from the USA, for example from the Institute for Functional Medicine (IFM) or the Cleveland Clinic Center for Functional Medicine, shows: Irritable bowel syndrome is usually not a local intestinal problem, but an expression of a disturbed balance.

Vital substance infusions for chronic fatigue

The intestine – more than just a digestive organ

The gut is part of a highly complex system. It communicates with the brain (gut-brain axis), the immune system and the endocrine system via nerves, hormones and immune cells. Over 70 % of immune cells are located in the gut – as is 90 % of the body’s own serotonin. If something gets out of balance here, it can have far-reaching consequences.

These aspects are essential. They offer valuable treatment approaches

The intestinal microbiome – i.e. the community of all microorganisms living in the gut – influences our digestion, immune response, nutrient absorption and inflammation regulation. Dysbiosis, i.e. an imbalance of bacterial species, can lead to increased gas production, irritation of the intestinal mucosa and inflammatory processes. Patients with irritable bowel syndrome usually have an altered microbiome composition – with less diversity and a lack of anti-inflammatory bacteria.

Small Intestinal Bacterial Overgrowth (SIBO) refers to a bacterial overgrowth in the small intestine, where normally only a few bacteria should be present. These bacteria ferment carbohydrates and produce gases (methane, hydrogen), which lead to flatulence, cramps and diarrhea – typical IBS symptoms. Breath gas tests (lactulose or glucose test) enable a reliable diagnosis. Studies show that up to 70% of IBS sufferers are SIBO-positive. So is this a possible cause?

One study investigated these correlations and the small intestine microbiota in 126 patients with gastrointestinal symptoms, 52% of whom were classified as SIBO-positive by duodenal culture. Interestingly, the presence of SIBO did not correlate with the symptoms of those affected. Instead, symptomatic patients showed a significantly altered composition of the small intestinal microbiota with reduced diversity and functional capacity, regardless of SIBO status.

An intervention study with healthy individuals also showed that a short-term switch from a high-fiber to a low-fiber diet led to GI symptoms, reduced microbial diversity and increased small intestinal permeability.

So is SIBO related to irritable bowel syndrome?

In short: yes.

Yes, because SIBO is often found in patients with IBS.
No, because according to this study, SIBO does not correlate causally with the symptoms of IBS. Rather, it appears to be a marker for certain dietary habits or a consequence of other factors.
The microbiome composition of the small intestine, on the other hand, plays a more decisive role in the development of functional bowel complaints – and could be a better therapeutic target than the mere amount of bacteria.

Source: Saffouri, G.B., Shields-Cutler, R.R., Chen, J. et al. Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders. Nat Commun10, 2012 (2019). https://doi.org/10.1038/s41467-019-09964-7

Chronic irritation of the intestinal mucosa can loosen the tight junctions – the cell connections between the enterocytes. As a result, incompletely digested food components, toxins or bacterial components enter the bloodstream and activate the immune system. This leads to so-called “low-grade inflammation”, which can trigger systemic symptoms: Brain fog, joint pain, skin problems, hormonal dysregulation.

 

When we talk about irritable bowel syndrome, many people first think of digestive enzymes, the microbiome or intolerances. However, an often overlooked factor lies at the cellular level: the function of our mitochondria. These tiny “power plants” in our cells use aerobic respiration to produce the molecule ATP – the central energy source for all cell processes. Also in intestinal tissue.

It has been shown that many people with irritable bowel syndrome suffer from mitochondrial dysfunction. This is particularly relevant in the highly active intestinal mucosa, which is dependent on constant cell renewal, immune modulation and neuronal signal transmission

A disruption in mitochondrial function can also lead to increased production of reactive oxygen species (ROS), which cause oxidative stress and impair intestinal health.

What does “leaky gut” mean in connection with irritable bowel syndrome?

The term leaky gut refers to an increased permeability of the intestinal mucosa (intestinal permeability). Normally, a tight cell connection – so-called tight junctions – ensures that only desired nutrients and molecules from the intestinal lumen enter the body. This barrier protects us from pathogenic bacteria, toxins and indigestible food components.

In leaky gut syndrome, these tight junctions are loosened. This results in so-called “paracellular translocation” – substances that should remain in the intestine enter the bloodstream in an uncontrolled manner. The result: the immune system reacts in an alarmed manner – with silent inflammation, food reactions, autoimmune processes or neurological symptoms.

How does a leaky gut develop?

There are a large number of potential triggers:

  • Dysbiosis: An imbalance in the intestinal flora favors the production of irritating metabolic products (e.g. LPS – lipopolysaccharides).

  • Chronic stress: Activates signaling pathways via cortisol and adrenaline that weaken the tight junctions.

  • Gluten: In sensitive individuals, the protein gliadin can increase the release of zonulin – an endogenous protein that opens the intestinal barrier.

  • Alcohol consumption and medication: NSAIDs such as ibuprofen or diclofenac disrupt the integrity of the mucous membrane.

  • Histamine, environmental toxins, emulsifiers: Additives in food can also contribute to irritation.

  • Influence of diet and lifestyle: The consumption of highly processed foods significantly increases the risk of leaky gut and irritable bowel syndrome.

  • Extraintestinal symptoms such as fatigue, headaches, muscle pain or concentration problems.

These factors lead to a kind of “micro-inflammation” in the gut – often long before structural changes become visible. Leaky gut is therefore not a “fashionable term”, but a real, laboratory-measurable condition.

What does a “leaky gut” have to do with irritable bowel syndrome?

Irritable bowel symptoms are often not the cause, but rather the result of leaky gut syndrome. The increased permeability of the intestinal mucosa means that certain food components are no longer sufficiently filtered and the immune system overreacts – leading to pseudo-allergic reactions. At the same time, a disturbed microbial balance in the intestine favors the formation of gases, which can lead to flatulence and cramp-like pain. The nerve cells in the intestinal wall are also activated by these irritants, which contributes to increased sensitivity to pain and intestinal hypersensitivity. Last but not least, communication along the gut-brain axis changes: concentration problems, sleep disorders or emotional irritability (“brain fog”) are not uncommon. In functional medicine, we therefore understand irritable bowel syndrome not as an isolated digestive disorder, but as a systemic warning signal.

Darmbakterien reizdarmsyndrom

Irritable bowel syndrome – recognizing the causes

How we diagnose leaky gut

While conventional diagnostics often reach their limits, we at ORIGIN HEALTH use modern laboratory procedures and test, among other things:

  • Zonulin in stool or serum – a marker for tight junction dissolution
  • LPS (lipopolysaccharides) – bacterial endotoxin marker
  • Alpha-1-antitrypsin, secretory IgA – marker for mucosal inflammation
  • IgG4 food reactions – indication of immune activation due to leaky gut
  • Histamine in plasma – indication of impaired degradation due to DAO deficiency or mast cell activation

These tests provide a functional snapshot – the basis for your individual therapy program.

Treating leaky gut & irritable bowel syndrome

The 5R protocol of functional medicine

Removal of factors that damage the gut, such as certain foods, toxins or pathogenic microorganisms.

Replacing or supplying missing digestive enzymes and stomach acid to support digestion.

Recolonize: Building up the microbiome with individually selected probiotics and prebiotics.

Repair: Regeneration of the intestinal mucosa with L-glutamine, zinc-carnosine, omega-3, curcumin, aloe vera, etc.

Balancing: Promoting a balanced lifestyle with stress reduction, sleep optimization, mindful living.

Mitochondrial strengths

IHHT therapy for irritable bowel syndrome

Interval hypoxia-hyperoxia therapy (IHHT) is a modern, scientifically proven method for stimulating mitochondrial performance. The cyclical change between phases with reduced oxygen supply (hypoxia) and phases with increased oxygen supply (hyperoxia) acts on the mitochondria like a training stimulus. IHHT can help to stabilize the energetic foundation, especially in the case of chronic illnesses with low energy levels – such as irritable bowel syndrome, fatigue, long Covid or burnout.

IHHT Therapie

Irritable bowel syndrome – Our approach at ORIGIN HEALTH

We see the diagnosis of irritable bowel syndrome not as the end point, but as the starting point of an in-depth functional analysis. With the help of state-of-the-art functional medicine, we develop a customized treatment plan for each patient – including microbiome therapy, nutritional concept, targeted supplementation, infusion therapy and neurovegetative regulation.

 

FAQ ON irritable bowel syndrome

What exactly is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a functional disorder of the bowel in which no organic disease is detectable – however, the symptoms are real and often very distressing. Typical symptoms are abdominal pain, flatulence, diarrhea, constipation or an alternation of both. Fatigue, sleep disorders or concentration problems can also occur. IBS is not dangerous in the classic sense – but the quality of life can be massively impaired. In functional medicine, we see irritable bowel syndrome as an expression of an underlying imbalance in the body.

Irritable bowel syndrome is not a structural disease, but a functional dysregulation. This means that the symptoms are caused by disturbances in the interaction between the intestinal flora, mucous membrane, immune system and nerve signals – not by visible damage.

Common causes include a disturbed intestinal barrier (“leaky gut”), a dysbiosis of the microbiome, a weakness of the mitochondria, poor nutrition, chronic stress, food intolerances – or all of these together. These factors can only be identified with targeted special diagnostics, as used in functional medicine.

The most important first step is to listen to your own body: Which foods do I tolerate well and which not? A temporary low-FODMAP diet often helps to provide relief. Regular exercise, mindful eating, stress reduction and a healthy sleep-wake cycle also make a decisive contribution to stabilization. Dietary supplements such as L-glutamine, probiotics or inflammation-regulating plant substances can be helpful in an individually tailored form – but should be supervised by a doctor.

Irritable bowel syndrome is considered a chronic diagnosis. If we turn away from the pure diagnosis and focus on the causes, we can often bring about a significant improvement. We activate the body’s self-healing powers and treat what is preventing the body from regulating itself.

At ORIGIN HEALTH in Basel, we start with a detailed medical history and individual functional diagnostics. On this basis, we create an individual therapy program that includes nutrition, microbiome building, intestinal mucosa regeneration, stress modulation and, if necessary, mitochondrial therapy (e.g. IHHT). We accompany you step by step – with well-founded medicine, genuine care and an open eye for correlations.