In today's video, I'm going to discuss whether or not your doctor is getting
IBS right. So stay tuned. If you're returning viewer, welcome back. And if you're new here,
welcome. My name's Amanda Malachesky. I'm a certified functional nutrition,
health coach, and a digestive and allergy detective.
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Today, I want to talk about whether your doctor is getting IBS right. As an IBS and SIBO gut health
coach, I meet a lot of people who are struggling with IBS symptoms like bloating, constipation,
and diarrhea. Something I hear a lot is that they feel like their doctors haven't really
helped them very much or that they don't really have much of an idea about how to help them.
So for today's video, I want to discuss the standard IBS recommendations that
doctors often give out and offer a little bit of critique about some of those things,
and also discuss which things I feel are useful and helpful. And this is a quick reminder that if
you have severe digestive problems, this video is not a substitute for medical advice from
your doctor. So, if you're having a significant problem, please do go speak with your doctor.
All right. Let's get started. All right. Number one, let's talk about diagnosis first.
So, typically, IBS is a diagnosis of exclusion, meaning that if your doctor has ruled out all
of the kind of scary things that might be going on in your gut and they don't know what's causing it,
they're going to diagnose you with Irritable Bowel Syndrome or IBS.
And because IBS is a syndrome, this means that there's no clear underlying pathology or
underlying cause, but more on that in a minute. The standard medical model is to run a bunch
of tests to evaluate this. So, this might include things like blood tests,
stool tests, imaging tests like CT scans. And surprisingly to me, a lot of people report
being given endoscopies and colonoscopies, even when they're presenting with kind of basic
digestive symptoms. The benefit of this approach is that you can be relieved that you don't have
anything really significant or severe going on, but the downside is that it doesn't necessarily
give you a whole lot of information if you did all that testing and you kind of come up empty-handed.
And it can also feel a little discouraging to do all of that expensive and sometimes invasive
testing and not have any answers. So from my perspective, for those of you who are having IBS
symptoms, and this typically includes bloating, constipation, and diarrhea, and who aren't
suffering from an inability to eat severe weight loss, or bloody or mucusy stools. So if you don't
have any of those things, most of this is probably somewhat overkill and it's probably safe for you
to be working on lower-hanging fruit first to see if you can get some traction with your symptoms
before moving into the more [Cardillac 00:02:45] zone of medical evaluation and testing. So,
here, I'm thinking about things like simple diet changes, well-recognized gut support,
supplements, things like probiotics or digestive enzymes, and sometimes SIBO or stool testing.
You can always go deeper and look deeper with other diagnostic testing if you don't get the
results that you're hoping for. But in the beginning, I feel like these are reasonable
approaches before moving on to more complex options. Second thing that I want to focus on
is the fact that most conventional doctors will tell you that there is no clear underlying cause
for IBS. Remember I said I was going to talk about this in a second. Well, from my perspective, this
is categorically wrong. And here's why: Recent research by Dr. Mark Pimentel, who's the recent
SIBO research star, indicates that approximately 60% of IBS cases may actually be caused by an
underlying SIBO infection. There's a very close correlation between these two groups of people.
And if you don't know what SIBO is, it stands for Small Intestinal Bacterial
Overgrowth. This includes all three types of SIBO, including methane SIBO, hydrogen SIBO,
and hydrogen sulfide SIBO, which can correlate alternatively with IBS-D, IBS-C, and mixed IBS.
I recently made a video about Dr. Pimentel's recent research discoveries so I will leave
a link for that up here, you can check that out later. The good news about SIBO is that
not only can you test for it, but there's also treatment for it. So, when a lot of these cases,
you may actually have an infection that's directly testable and treatable. So that's amazing.
Now, for the remaining 40% of cases that are not directly caused by SIBO, food intolerances are
a major underlying potential cause as are other types of GI infections, which might be visible on
something like a GI map stool test, or other kind of stool test. IBS-D can also be caused by excess
bio-acids or by a low pancreatic function. And I would hope that if you had IBS-D that your doctor
would've screened you for these things in his office when you were doing some kind of workup,
or you can also request testing for these things from your normal doctor or your GI doctor.
Now, in some IBS cases, it may not be possible to get clear on what those underlying causes are. And
this is certainly frustrating, but this doesn't mean that you're alone with no options. There
are definitely ways to move through that soup of unknowing and arrive at answers. And this is
the kind of stuff that I teach my clients inside my Calm Digestion Method Program.
So, I'm curious to hear from you if you have a sense or an idea about what might be causing
your IBS. So go ahead and leave me a comment down below this video about what you think is
your underlying cause. So, the third thing I want to talk about that doctors may be recommending is
once you've been conventionally diagnosed with IBS, they may then recommend medications to
help manage your symptoms. These can include medications to help with gut motility, if
you're constipated or antidiarrheal things if you have diarrhea or anti-pain or nausea medications
to help with those symptoms, as well as gas reducers if you're suffering from bloating or
extensive gas pressure in your digestive system. Now, I know that a lot of you would rather not use
medications. And I certainly am in the boat that if I can at all avoid medication and I
absolutely want to, I don't really believe in general in using them.
At the same time, sometimes these medications can really give people a quality of life back, and
there's not really any shame in taking advantage of that to help you get yourself back on track
while you are digging deeper for bigger answers. But what most of these medications don't do,
of course, is deal with the underlying causes of your IBS. And as long as you're clear on this and
you feel okay about that, there's reason not to use these medications. But what I find challenging
here with doctors is that they often seem to come at the situation from a perspective of, "Well,
this is enough, this is all we have for you." And I really don't believe that. I really believe
that there is a lot more that's possible for you as an IBS patient to get relief. All right. The
fourth thing I want to talk about the doctors might recommend but might kind of miss the
mark a little bit with is the diet conversation. Being a nutrition professional, of course, I know
a lot about using the diet to manage digestive conditions. And certainly, a lot of doctors will
self admit that they don't really know a whole lot about this topic. So, fortunately, these days,
many doctors who are treating IBS patients do actually recommend things like the low-fodmap
diet, which has a lot of great data to back it up as a strategy for reducing your IBS symptoms.
And I'm always really grateful when my clients tell me, oh, my doctor recommended that I tried
the low-fodmap diet, but what's not entirely helpful is what happens to a lot of people
is they will be given a sheet of paper that just gives them a list of foods to eat and not to eat,
and that's all the instruction they get for how to manage their IBS diet like the low-fodmap diet.
To get the most out of any therapeutic diet, including the low-fodmap diet.
There's a lot more to it than just working with a list. And most people using these
diets need a little bit more support to get the results that they're looking for. So,
here's a short list of why you need a little bit more support than just the simple piece of paper.
Number one, the diet is not meant to be followed long term. And what this means is that you need
some kind of exit strategy. You need to go in, get the information you're looking for, and then
have a way to get off of that diet or to reexpand your diet beyond that limited elimination phase.
Secondly, you're not likely sensitive to every single food on that list,
only some of them. And so you need a strategy to figure out which specific ones are bothering
you and which ones you can safely add back in. Ultimately, this maximizes your food freedom
and your flexibility to live your life while you're dealing with your digestive challenges.
Number three is that the food intolerances that are triggering your IBS symptoms may or may not be
caused by fodmaps. And so you need a strategy to evaluate, well, is this the problem, or should I
be paying attention to something else? And number four, people often need a good bit of support
working this new routine into their family life, into their kitchen, into their daily habits. And
so this is a place where a coach or professional of some kind can be really helpful to give you
ideas about how to work this into your day-to-day reality because not easy making diet changes.
So, again, I think it's great that doctors are recommending the low-fodmap diet, but I think
that there needs to be a lot more support and effort put into helping people with that process.
So, if you're someone who really wants to resolve your idea symptoms from the ground-up,
I really want to encourage you to download my Roadmap to Gut Recovery, which shares the
strategies and tools I use to help my clients find their personalized plan for calm digestion.
You can grab your free copy by going to confluencenutrition.com/roadmap.
And I will be sure and leave a link for that below this video as well. So you can head down
there and click on it to get there easily. All right. I really want you to get out there and get
strategic with your IBS symptoms to really try and dig in and get to the root causes.
If you liked this video, please consider clicking the like down below this video,
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I'm here for you to help you improve your digestion. So until next time, see you.