Case Study 2 – IBS – Effective Steps To Improved Gut Health

IBS Symptoms

Irritable Bowel Syndrome (IBS) is a common condition that affects the digestive system and causes a collection of symptoms such as constipation, diarrhoea, bloating, nausea, pain and flatulence.

Quite often undiagnosed, the symptoms can affect all aspects of life – it can cause a lack of concentration at work, low libido, it can impact social get-togethers and can mean avoiding places without bathrooms.

I worked with Stuart for almost a year to help him get back to a place of relief, so I will share with you how functional testing and nutritional therapy can help .

Stuart’s Symptoms

Stuart came to see me with bloating, debilitating stomach cramps, fluctuating constipation and diarrhoea and generally feeling uncomfortable.  He wanted to understand why this was happening.

He had struggled on and off for 10 years, after a severe episode of gastroenteritis, also known as ‘stomach flu’.

He was generally an active person with a good social life and a busy job, but found his symptoms were impacting every aspect of his life.

He loved cooking and eating well but also liked the social side of eating at nice restaurants.  But since he recent digestive episode, he found he was eating plain food and losing weight.

The Challenge

Stuart was keen to understand why he was struggling with his IBS so we talked about performing a functional stool test to understand the root cause of his symptoms.  He decided it was worth the investment and it helped me to target the underlying issue more efficiently.

We used the GI Ecologix by Invivo which highlighted low gut immunity which can mean the gut lining is compromised, perhaps due to his gut infection 10 years ago.

It showed he had low pancreatic enzyme sufficiency.  The pancreas secretes digestive enzymes to help break down food effectively, and low function can be an underlying driver in IBS.

There was low diversity of beneficial bacteria in the gut, the good guys! plus an overgrowth of pathogenic bacteria which can occur when there are limited beneficial bacteria.

Certain bacteria in the gut can produce gases after feeding off fermentable carbohydrates in the diet.

The most common gases tend to be methane and hydrogen, which can cause IBS symptoms such as constipation and diarrhoea, flatulence and pain and can be linked to SIBO.

Stuart had high levels of these bacteria alongside high levels of E.coli and a potential pathogenic bacteria overgrowth – B. fragilis Enterotoxigenic.

Bacteria in the gut is needed, the good and the bad.  The problem occurs when certain bacteria start to take over so when I assessed Stuarts stool results, I was looking for an overall pattern.

IBS Case Study – The Solution

I had gathered lots of information – the stool test, a thorough health case history and a 7-day food intake diary to help me to create an initial protocol.

My approach was based on the 5-R Functional Framework to Gut Health;

The first R is Remove – Remove any foods, allergens and intolerances. I was able to ascertain if Stuart had any reactive food substances in his diet based on his reactions to foods from our consultation.

Secretory IgA plays an important role in protecting the gut mucosal lining (which separates the outside environment from the inside of the body).  When low like in Stuart’s case, this can mean that pathogenic bacterias are able to thrive.

The mucous lining is also needed for absorbing nutrients from foods and when compromised it can open up the spaces between the cells in the gut wall (known as leaky gut) which can increase the sensitivity to other foods.

I temporarily eliminated Gluten from Stuart’s diet as it contains a protein called zonulin which can further impair the gut lining.

This was to help reduce inflammation in the gut and reduce any triggering factors which might be at play.

The second R is Replace – the stool sample showed low pancreatic enzyme sufficiency which could make it hard for the body to breakdown food for nutrient absorption.  I included a broad spectrum digestive enzyme to support this.

I also focused on eating hygiene techniques and stress relief, especially around mealtimes.  Stress can impair digestion through reducing stomach acid secretions, so it is vital in cases of IBS to relax and eat slowly and mindfully.

Stuart found almost immediate relief from his symptoms but this was for a short time only, which indicated that there was still underlying bacteria that needed addressing.

I added in a complex antimicrobial support to deal with this and after a short spell, I swapped it to a different extract to ensure the bacteria didn’t become resistant.

The third R is Reinoculate.  I supported the gut lining from the start by adding in supportive mucosal supplements.

After taking antimicrobials, it is important to replenish the gut again to help the good bacterial to thrive so Stuart also began a full spectrum probiotic.

I also added in a stomach acid replacement supplement to help naturally ‘kill-off’ unwanted bacterial overgrowths.

Low stomach acid can be often be the root cause to not only bacterial overgrowths but also nutrient deficiency such as B12, Zinc and protein.

The forth R is Repair.  To continue to help Stuarts gut lining to repair, we focused on a diet that was rich in key nutrients that can often be in short supply in a disease state. These included antioxidant and vitamin B-rich foods.

The fifth R is Rebalance.  IBS symptoms can be caused by underlying pathology and supplements can create a relief in symptoms.

But in order for the body to thrive and heal long-term, lifestyle factors such as stress, sleep and lack of recuperation need prioritising – the body needs to refill its cup!

Stuart continued to incorporate an anti-inflammatory diet with low processed foods but understood the importance of these factors.

Throughout our time working together, I continued to assessed Stuarts supplements to make sure he wasn’t taking any unnecessarily.

Supplements are fantastic if there is a deficiency (eg B12 and zinc in a vegan diet) but it is important to naturally increase nutrients through the diet where possible.

The Results

Stuart saw a huge improvement in his gut health within 6 months, with no more episodes of diarrhoea or bloating.  Stuart followed my recommendations and at our last appointment reported to have more energy, had gained weight and had a better mood.

Stuart could have retested using another functional stool test to see an improvement in markers but I didn’t feel it necessary due to an improvement in his symptoms.

He was able to focus on his busy job, use the gym again and see friends without worrying about digestive episodes.

His diet was now full of supportive nutrients and not restrictive and bland.

Stuart’s Words

I got in touch with Becky following some health issues and we have worked together for the last year or so. Becky is very knowledgeable and the information and resources she provides are fantastic, but more importantly she’s also kind, understanding and incredibly patient.

It has been a long process, but Becky really has made a huge difference to getting my health back on track.  I can’t recommend her enough.

If you need help with your digestive symptoms, get in touch!