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IBS Irritable Bowel Syndrome

IBS Irritable Bowel Syndrome

I specialise in the treatment of IBS as I find the NHS is ill equipped to deal with the challenges IBS presents. The NHS often fails to cure IBS and leaves people to get on with their lives with uncomfortable, painful and debilitating symptoms.    

The symptoms of  IBS*

Recurrent abdominal pain or discomfort, a marked change in bowel habit (loose stools, Diarrhoea and /or constipation) for at least six months and symptoms are experienced on at least three days of at least three months.

For a complete diagnosis two or more of the following symptoms must apply:

  • Pain is relieved by a bowel movement
  • The Onset of pain is related to a change in frequency of stool
  • The Onset of pain is related to a change in the appearance of stool.

To Book an appointment at one of our UK IBS clinics in London, Brighton, telephone or Skype  please call 01273 775480 or email emma@smartnutrition.co.uk

What is the cause of  your IBS? –  Your own individual health picture or jigsaw puzzle 

Over the past 10+ years I’ve seen thousands of people with IBS and each person has had their own individual set of symptoms and probable causes. No two people are ever exactly the same. This is one of the reasons the NHS finds it so difficult to deal with IBS. I always talk in terms of a person’s individual health picture which is made up of different sized pieces and although the majority of people with IBS will share quite a few of the same pieces the size of those pieces and therefore the relevance to that individual is always different. Below is a list of some of the probable pieces that need to be investigated when looking for solutions to IBS.

Poor Digestion – If the body is unable to digest food completely this can lead to a range of different digestive symptoms. For example if we cannot digest fats correctly then fatty meals can leave us feeling nauseous, bloated with discomfort and can lead to a fast transit time meaning diarrhoea can be a common problem which is often accompanied with light-coloured and smelly stools. If proteins aren’t digested properly then upper discomfort is common and people often talk about food feeling like it’s in the stomach the day after a heavy protein meal, such as steak has been eaten. A problem with  digesting carbohydrates can lead to more bloating and discomfort; higher up – just below the stomach or lower down in the belly  and is often due to the body not being able to break down the different sugars found in foods but can be due to bacteria in the digestive tract fermenting the carbohydrates and producing a lot of gas.   The GI Effects Comprehensive Digestive Stool Analysis can be used to determine the efficiency of the digestive process can help to determine whether this is an area you need to address.

In addition to being able to show how well you are digesting protein, fats and carbohydrates this test also looks at the health of your gut wall which is closely linked to food intolerance, it also includes inflammatory markers which can help differentiate between IBS and IBD, whether hidden blood or mucous present in the stool. Levels of good and bad bacteria are also checked (see Dysbiosis below) as ruling out parasites is an important part of addressing IBS along with checking for parasites.

Dysbiosis – an imbalance between good and bad bacteria, yeast and/or intestinal parasites within the bowel can cause many of the symptoms of IBS and greatly exacerbate the condition. A bowel infection may simply be something you picked up on holiday or a consequence of poor dietary habits and compromised immunity.  Either way, the offending invaders can easily be identified by having A comprehensive Digestive stool test and parasitology 

Yeast overgrowth   – An overgrowth of unfriendly yeast – Often Candida or Rhodotorula, Glabrata or Geotrichum can cause many of the symptoms of IBS and greatly exacerbate the condition. For more information about Candida or yeast overgrowth click here or for testing for candida please click here

Parasites  – I have seen a large number of people with IBS  in my clinics who have tested positive for parasites – 31%! If you have had a bout of food poisoning or have travelled abroad and experienced an upset stomach whilst away then these may be the cause or a contributory factor for your IBS.  Uf you have symptoms of loose stools, abdominal pain, lack of energy and a lot of gurgling and churning in the gut and especially if these happen on a cyclical basis parasites may well be the problem. I commonly see Blastocystis hominis and Dientamoeba Fragillis along with Giardia and endolaminax nana many others. For more information about parasites please click here or for information about testing for parasites please click here

In many cases people have had stool tests carried out with the NHS and parasites have not been found but the sophisticated test that I offer can find parasites that the NHS test has missed.  I would still recommend  a test even if the NHS have ruled parasites out.

Sensitivity to foods, additives or medicines – People with IBS may have colons that are more sensitive and reactive to things that might not bother other people, such as certain foods, additives and medications. If you think you have a food allergy or intolerance, you may want to consider A Food Allergy or Intolerance Test and there are also blood tests available to check reactions to common Food Additives.  The above test is checking for reactions to proteins in foods that recent research carried out in Australia has found that some people have a problem with the sugars in foods and have introduced the new FODMAP diet  which you will see explained below. There are a range of different sugars that people can react to the generally it is advisable to begin by avoiding them all and reintroducing them group by group with the help of a nutritional therapist.

FODMAPs – For those that are sensitive FODMAPs (Certain sugars found in foods)  are poorly absorbed in the small intestine and move along into the large intestine without being appropriately digested, where they react with healthy and unhealthy bacteria to produce unwanted gas. FODMAPs also act like a sponge in the large intestine, where they draw and hold excess fluid which can lead to bloating, wind, loud and volatile digestive noises,  loose stool and depending on which kind of gas is produced constipation.

What are FODMAPs


Oligosaccharides (eg. Fructans and Galactans)
Disaccharides (eg. Lactose)
Monosaccharides (eg. excess Fructose)
Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

It is possible to test for lactose intolerance and fructose malabsorption but guidance through an exclusion diet is the cheapest way to find out if these are a releavant factor in your IBS. Book a consultation to discuss exclusion diets and FODMAP’s. Call 01273 775480 or email emma@smartnutrition.co.uk

Small intestinal bacterial overgrowth SIBO

One study of more than 200 patients with IBS found that 78% tested positive for SIBO. Of those successfully treated for SIBO, 48% no longer met the Rome criteria for IBS.

SIBO refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine.  Symptoms of SIBO are bloating  that usually occurs higher up quite soon after eating, gas, diarrhoea, constipation, abdominal cramping,  burping after food, fatty stools and a lot of noise and gurgling. for more information about see below please click here or for information about testing for SIBO please click here

As many as 20 percent of the adult population or one in five have symptoms of IBS making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men and it begins before the age of 35 in about 50 percent of people.

Celiac Disease

Researchers have also found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. They cannot eat these foods without becoming ill because their immune system responds to them by damaging the gut. Coeliac disease can be confirmed via A Simple Blood Test.  If Coeliac Disease is confirmed Smart Nutrition could then help you to repair your gut lining and adjust to living on a gluten free diet.

Stress – Feeling mentally or emotionally tense, troubled, angry, or overwhelmed can stimulate digestive spasms in people with IBS. The gut has many nerves that connect it to the brain. These nerves control the normal digestive contractions and can cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. If you think stress may be a contributing to your condition, An Adrenal Stress Test can help pinpoint precise imbalances that can then be targeted.

Imbalanced female hormones – Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms. Consequently imbalances in female hormones can make IBS symptoms much worse. If your symptoms are worse around menstruation imbalanced hormones may be a contributory factor. A Smart Nutrition Consultation could help you to address you IBS and any underlying Hormone Imbalances.

Back Problems and poor posture – The Vegus nerve is responsible for the automatic part of your digestion – the mixing and churning of food, stimulation of the production of digestive juices and the movement of food along the digestive tract. Any back problems can hinder this nerve and also hinder digestive function.

Chemotherapy – Chemotherapy not only kills cancer cells it also damages our own body cells particularly those in the gut. This can make it more sensitive and reactive.

*The Rome III Criteria (which came up with the above definition for IBS) was created by the the Rome Foundation which is an independent non profit organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of functional gastrointestinal disorders (FGIDs). The  mission of the Rome Foundation is to improve the lives of people with functional GI disorders.