IBS versus IBD – A Functional Medicine Approach

Several clients have asked me to outline the evaluation and treatment differences between irritable bowel syndrome and inflammatory bowel diseases, such as ulcerative colitis or Crohn’s disease. Although both IBS and IBD can wreck havoc on peoples lives, inflammatory bowel diseases are far more severe in nature, as the title suggests. Irritable bowel syndrome should not be overlooked, however, as it does produce a lot of irritating symptoms, including cramping, pain, bloating, gas and irregular bowel function. Add a lot of bleeding and mucous to this list of symptoms and essentially you have the outline for inflammatory bowel diseases, ulcerative colitis and Crohn’s.

When it comes to evaluation, these very different conditions should be assessed in a similar fashion. Both IBS and IBD assessment should start with thorough trackable blood testing, looking for signs of malabsorption, poor macronutrient digestion and any signs of inflammation and/or infections. Following the conventional blood testing, if signs of low grade infections from bacteria, parasites or viruses are seen, comprehensive stool analysis should be preformed. A proper test will evaluate for all organisms in the gut, including the elusive anaerobic bacterial species and fungus. If conventional blood testing indicates any signs of allergic reactions, IgE and IgG4 food allergy testing should be considered.

Once we identify the specific imbalances or concerns it’s just a matter of cleaning them up, one by one. Typically, with IBS or IBD, antibiotics and/or antiparasitic and/or anti-fungal drugs or herbs are recommended and based specifically on test results. There is very frequently a lot of damage to the gut lining that needs to be addressed, and dietary guidelines are essential for supporting the health of our gut wall.

A diet consisting mainly of lightly cooked fruits and veggies, lean proteins such as chicken, fish and turkey along with healthy fats such as coconut oil and olive oil will help to eliminate unwanted bacteria and yeast while providing nourishment to repair the intestinal lining. Using a variety of herbs including turmeric, garlic and sea salt to flavour your foods will also help to clear out unwanted guests from the gut. Green tea plays an important role in repairing a leaky gut lining and may be used to replace coffee during the first few weeks. These steps allow your guts to repair before restoring and replacing healthy bacteria.

Once you feel that you have sufficiently taken back control of your intestines, functional foods such as natto, kimchi, tempeh, kefir, sauerkraut and yogurt may be introduced into the diet in large amounts to increase the number of healthy bacteria. If you have done an elimination diet, you may also carefully reintroduce one food group every two days to determine if you have any food reactions. Reactions may come in the form of abnormal bowel movements but may also cause problems with concentration among many other symptoms. Be aware of any unwanted symptoms and immediately eliminate that food group again until that symptom subsides. Along with stress reduction and deep breathing practices to increase blood flow to the intestines, you can virtually take control of any health condition and get your life back!

Please refer to the following list of “very common” food allergies. People may consider eliminating all of these foods to avoid food allergy testing. This is referred to as an elimination diet.