Dealing with IBS - The Naturopathic Way

Hello and welcome to episode 15 of the Sharing Plant Wisdom podcast with London-based naturopathic herbalists Sophie and Marie. The topic of this episode is Irritable Bowel Syndrome (or IBS).
IBS affects 20-30% of the population. Main symptoms: change in bowel habits, abdominal pain and distention. Other symptoms include: Mucus in the stools, heartburn (acid reflux), nausea and vomiting, urinary urgency, worsening of premenstrual symptoms, sexual dysfunction. Fibromyalgia, chronic fatigue, TMJ disorder, anxiety and depression are all comorbidities of IBS.
The 4 subtypes of IBS:
-          IBS-C: constipation is the main symptom
-          IBS-D: diarrhoea is the main symptom
-          IBS-M: alternating constipation and diarrhoea
-          IBS-U: unsubtyped
You can find the Bristol Stool Chart here:
https://www.nice.org.uk/guidance/cg99/resources/cg99-constipation-in-children-and-young-people-bristol-stool-chart-2
A “normal” stool is around 3-4 on that scale.
If you notice dark blood in your stools or if you experience nocturnal episodes of diarrhoea please consult your general practitioner immediately.
In 84% of patients, IBS can be explained by either SIBO (Small Intestinal Bacterial Overgrowth) or SIFO (Small Intestinal Fungal Overgrowth).
Here are some of the few life factors that can negatively impact your gut microbiome:
- How you were born: babies born vaginally receive primary inoculation from the microbiome of their mother’s vagina and rectum as they pass through the birth canal. Immediate skin-to-skin contact also contributes to the establishment of the newborn microbiome.
- Being exposed to dirt and germs as a child is more beneficial long-term than a super “clean” environment.
- Antibiotics, painkillers and proton-pump inhibitors all compromise the balance of gut microbes 
- Stress disrupts the gut microbiome, so does alcohol
- Gastrointestinal infections can have long-term consequences on gut health
- Environmental toxins (heavy metals, molds)
- Trauma and early life adverse events are strongly correlated with GIT issues
In practice, we would advise the '5 R' protocol to overcome IBS:
- Remove: remove the unwanted gut bacteria or fungi AND remove trigger foods and drinks (most common culprits can be found on the FODMAP foods list:
https://www.gloshospitals.nhs.uk/media/documents/FODMAP_dietsheet_for_website.pdf
Herbs that help in this phase include: Juglans nigra, Berberis aquifolium, Coptis chinensis, Hydrastis canadensis, Curcuma longa, Tabebuia impetiginosa 
- Replace: support the digestive system by providing digestive enzymes (pepsin, papain, bromelain), hydrochloric acid, bile. Herbs that help during this phase include Berberis vulgaris, Gentiana lutea, Cynara scolymus, Cinnamonum zeylanicum, Foeniculum vulgare. 
- Reinoculate: with probiotics containing bifidobacterium and Lactobacillus. 200-300 billions CFU , up to twice a day on empty stomach 
- Reintroduce: foods and drinks given up in phase 1. One food/ w 
- Rebalance: holistic approach 
Herbs for gut hypersensitivity: Matricaria recutita, Verbena officinalis, Viburnum opulus, Hypericum perforatum
Best thing to do for your IBS is to keep blood sugar levels steady. Bacteria and yeast LOVE sugar!
SIBO tests discussed: Lactulose breath test, Organic acids test, comprehensive stool test 
But also, don't forget to chew your food, eat in a calm state of mind, exercise regularly, sleep. 

In health, 
Marie & Sophie