The 4 R's of Gut Healing For Irritable Bowel Syndrome

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What is irritable bowel syndrome (IBS)?

It is estimated that 5 million Canadians suffer from irritable bowel syndrome, with approximately 120,000 Canadians being diagnosed each year. IBS is a chronic gastrointestinal disorder that affects the small and large intestines. It commonly presents as abdominal cramping and pain, bloating and gas, mucus in the stool, and diarrhea and/or constipation. Unlike ulcerative colitis and Crohn’s disease, which are both inflammatory bowel diseases, IBS does not cause permanent damage to the bowel tissue, and does not increase your risk for colorectal disease.

How is IBS diagnosed?

Diagnosis of IBS is often a process of ruling out other conditions. A colonoscopy or barium x-ray may be ordered to rule out inflammatory bowel disease, a stool test might be taken to rule out parasitic infections, and finally breath tests may be ordered to rule out H. pylori and lactose intolerance. To help this process researchers have developed a set of criteria for diagnosing IBS based on symptoms, after other conditions have been ruled out. This diagnostic criteria is called the ‘Rome Criteria.’ Based on this criteria, diagnosis can be made if the person has abdominal pain and discomfort lasting at least 3 days a month in the last 3 months, associated with two or more of the following symptoms: improvement with defecation, altered frequency of stool or altered consistency of stool.

How can I get my irritable bowel under control?

The naturopathic approach for managing irritable bowel syndrome includes a process of removing aggravating factors, regenerating the health of the GI mucosa, reinoculating the intestines with good microflora, and replacing crucial digestive factors. This process is called the 4 R GI Restoration Program, which is outlined below.

1) Remove

The first step to healing the gut involves removing aggravating foods from the diet, and pathogenic bacteria/yeast from the intestines. Depending on the individuals symptoms and medical history, a variety of tests are recommended to rule out lactose intolerance, food allergies and sensitivities, celiac disease, small intestinal bacterial overgrowth (SIBO), and/or dysbiosis of the large intestine.

If celiac disease is positive, a lifetime avoidance of gluten is recommended. Food sensitivities, and allergies, on the other hand can change over a period of a person’s life. Food sensitivities can be challenged after 3-6 months of avoiding the foods, while food allergies may need to be avoided longer. If there are anaphylactic symptoms associated with the food allergy, these foods are often re-tested periodically, and are strictly avoided long-term, unless subsequent tests come back negative.

If an imbalance of bacteria is detected in the small or large intestine through breath and stools tests, antimicorbial herbal medicines, and sometimes antibiotics/antifungals are recommended to kill off the bad bacteria and/or yeast in the digestive tract.

2) Repair

Chronic exposure to aggravating foods or pathologenic bacteria/yeast can cause damage to the epithelial lining of the intestines. Supplementing with an amino acid called L-glutamine, and omega 3 fatty acids can help repair the intestinal lining and restore healthy digestive function.

3) Re-inoculate

Re-incoculating the gut with health promoting ‘friendly’ bacteria (ie. ‘probiotics’) helps to promote a healthy balance of GI microflora. This balance is important for GI tissue health, immune function, and intestinal barrier function, and digestion.

4) Replace

Supplementing with digestive enzymes, and stomach acids can be beneficial in certain circumstances. Stomach acidity, and digestive enzymes facilitate the breakdown of food. A deficiency of these compounds is common, especially as we age, which compromises digestion, absorption of nutrients, and elimination of waste.

Along with the 4 R program, it is important to recognize that chronic stress can also contribute to digestive imbalance and IBS symptoms. Thus, stress reduction through cortisol (ie. stress hormone) balancing, and the incorporation of relaxation-promoting activities is also strongly emphasized in a comprehensive naturopathic treatment plan.

In health and happiness,

Dr. Meghan van Drimmelen | Naturopath Victoria BC

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