Irritable bowel syndrome - do you react to ONE food or to all foods?
The problem of "digestive complaints" seems to be omnipresent. If you ask Dr. Google, you will find countless blogs, diets and self-help groups for people with a wide variety of symptoms and diagnoses: SIBO, candida, FODMAPs, histamine, lactose or fructose intolerance, lectin intolerance and, if it gets even more detailed, for people who cannot tolerate salicylates, tyramines, oxalates, .... The problem is that the symptoms described for the individual diagnoses overlap and the corresponding recommended diets regularly contradict each other. This causes confusion and a feeling of powerlessness - as if nothing can be done about your symptoms due to their complexity. But thank goodness this is not the case!
Hardly any people left without "irritable bowel syndrome"
If you ask people about their digestion and how they feel about food, you rarely get a short answer. In most cases, the answer is very nuanced - you know what would actually be healthy, how you should eat, but even if you took the time to do so, certain things are simply not tolerated. People complain of general digestive complaints - stomach pain, bloating, reflux - to more nuanced complaints - constipation, diarrhea, rashes - and also very diffuse symptoms - headaches, brain fog, mood swings, insomnia - that they associate with what they eat but often can't attribute to a specific food group.
For many people, these symptoms are so pronounced and have such a massive impact on their quality of life that they seek help from a doctor - and the diagnosis is usually very vague. Irritable bowel syndrome, reflux, dysbiosis, leaky gut. In more severe cases, intolerances are looked for - such as lactose or fructose intolerance. Tests are carried out for coeliac disease or autoimmune diseases such as Crohn's disease or ulcerative colitis. Unfortunately, in most cases the symptoms do not change with the diagnosis and the associated medication - or they do, but the body shows in other areas that the cause of the symptoms has not been addressed.
Functional medicine is causal medicine
In functional medicine, digestive complaints are not seen as an end point but, like other symptoms, as an indication of existing imbalances. They have a cause - possibly genetic, nutrient deficiencies, malfunctions or lifestyle factors - but they also have an effect, because if our digestive system shows symptoms, a permanent focus of chronic inflammation develops, which costs the entire system resources (energy, immune capacity, nutrients), while the inflammation and the resulting oxidative stress can attack and damage the body's own structures - barriers, receptors, vessels, organs - nutrient absorption is reduced and the immune system is constantly triggered.
From the point of view of functional medicine, it is therefore important to identify the actual cause of the symptoms present, to correct them and at the same time to compensate for the consequences of the existing imbalance.
Functional medicine uses functional diagnostics
In order to understand why a symptom occurs, a detailed medical history is necessary. With the help of specific questions, various dynamics can be narrowed down so that the next step can be to look for the exact causes with the help of functional diagnostics.
It is therefore important to understand whether there is a general digestive insufficiency and whether the symptoms arise because the digestive process as a whole is restricted.
Whether only certain foods cannot be digested and whether the symptoms are due to physiological obstacles (reduced gastric acid production, impaired pancreatic or liver function, microbial imbalances, impaired motility) or due to certain food ingredients (gluten, lactose, fructose, histamine, lectins, salicylates, oxalates). In addition to the detailed symptom analysis, functional tests such as food intolerance tests (e.g. KBMO FIT - test now ), microbiome analyses (e.g. GI Map or GI 360), organic acids (e.g. OAT, OAP or Organix) or genetic profiles (e.g. DNA Health, DNA Core, DNA Histamine) can be used based on the symptom presentation.
Not all irritable bowel syndrome is the same
It quickly becomes clear that an "undesirable" reaction to a food or food group can only be remedied in the long term if the cause is identified, the food in question is eliminated for a period of time if necessary, the "processing" (=digestion) of this food is improved and the damage caused by the malfunction (leaky gut, microbial imbalances, irritation/inflammation in the wider digestive tract, leaky brain) is repaired. And this also makes it clear why the conventional approach in medicine, which assigns a (single) intervention to a specific diagnosis, has difficulties here. Not all irritable bowel syndrome is the same and, depending on how advanced the dysfunction is, it may take some time, various measures and a lot of patience to calm the system and restore the important balance.
Digestive insufficiency as the lowest common denominator
If we cannot digest food, it becomes a disruptive factor. And it doesn't matter whether the food is healthy or unhealthy, good or bad. If it is not broken down adequately, it disrupts our body and is recognized as a foreign body. This is a reaction of the immune system, i.e. immune activation. If the immune system is activated, this always means inflammation. Inflammation in the gastrointestinal tract in turn leads to impaired functionality - in other words, reduced digestive capacity can be both a cause and an effect, but it is always impaired. This is why functional medicine always addresses this easy-to-solve issue and supports both digestion and the ability to absorb nutrients so that regeneration can take place.
Food intolerances: genetic or acquired
In the case of food intolerance, the body does not react primarily via the immune system. The best example of a food intolerance is lactose intolerance - people react with symptoms to the consumption of lactose because they lack the enzyme lactase, the enzyme that the body needs to break down lactose. The lack of the enzyme leads to digestive problems such as flatulence, diarrhea, nausea and vomiting, which we then experience painfully. The cause can be genetic (genetic lactose intolerance, genetic reduced ability to break down histamine), but it can also be "acquired", i.e. have developed over time because the intestinal barrier has lost functionality for various reasons and can therefore no longer produce the necessary digestive enzymes sufficiently.
Histamine intolerance
In many cases, the body is simply confronted with an oversupply of a certain substance (e.g. histamine, salicylates, oxalates) - and cannot compensate for this with the necessary degradation capacity. The oversupply can again have various causes: something can be consumed too much (e.g. histamine-containing foods) and/or the body itself produces an excessive amount of it in this phase of life (e.g. due to increased oestrogen levels or microbial overgrowth). There can also be various reasons for the reduced breakdown capacity: Genetics, nutrient deficiencies, structural weaknesses (intestinal barrier, pancreas, liver). So if the body is showing symptoms, it is important to get to the bottom of the "why" and work on the cause while reducing exposure and alleviating symptoms.
Food allergies
A food allergy is a negative (health) reaction that occurs reproducibly due to a specific immune response in response to exposure to a specific food. Namely an IgE-driven type 1 reaction. Food allergies are usually immediately noticeable, e.g. in the case of a peanut allergy - these are immediate reactions. Those affected usually react directly and sometimes extremely to the food in question. An allergic shock (anaphylaxis) can occur, which can also be fatal.
Food sensitivities
This is to be distinguished from so-called food sensitivity. This is an immunological, often delayed reaction to food which, unlike allergies, is not mediated by IgE antibodies but by IgA or IgG antibodies. The symptoms of food intolerance can be extremely varied and - which makes their identification particularly difficult - can occur with a very long delay. Anyone who is sensitive to wheat, for example, can react with brain fog three days after consumption - and will of course not be able to identify the "culprit".
Food intolerances can manifest themselves in a wide variety of ways, from systemic symptoms (fatigue, sweating, reduced concentration and performance, brain fog, behavioral changes, anxiety) to digestive complaints (abdominal pain, flatulence, nausea, diarrhea, constipation) to breathing difficulties, pain, swelling, water retention, itching and rashes/eczema. Here you can test yourself for food sensitivities!
Causes for the development of food intolerances
Stress is the main cause of digestive disorders - and therefore the cause of all digestive-related symptoms. A permanent sympathetic state (permanent stress) has a lasting negative effect on our digestive performance. This condition causes a lack of stomach acid and slower intestinal peristalsis. The food remains in the stomach for too long and is passed undigested into the intestine, which massively irritates the mucous membranes of the gastrointestinal tract. This permanent irritation causes the intestines to become porous, resulting in increased permeability. Possibly even a leaky gut syndrome.
These (partially) undigested food components can pass through the disturbed intestinal wall barrier and trigger an immune reaction at the transition to the blood system. After a few intermediate steps, this leads to a massive production of IgE and IgG antibodies, which can then trigger the symptoms mentioned above. The immune system is permanently in turmoil! This definition points to two fundamentally important aspects - a healthy digestive process and a healthy and functional intestinal mucosa. If there is increased permeability (a so-called leaky gut), insufficiently digested food particles can increasingly pass through this protective barrier - and ultimately trigger our immune system. You can test yourself for a leaky gut here!
Leaky Gut
The causes of a so-called leaky gut are manifold. These include, for example
- Vitamin D deficiency
- Medications such as NSAIDs, SSRIs, hormones, contraceptive pills, chemotherapy, antibiotics
- Microbial imbalances in the gut
- Microbial colonization
- Lack of contact with dirt and germs in everyday life
- Gluten stimulates the release of zonulin, which "opens the floodgates of the intestinal mucosa"
- Stress
- Highly processed foods
- Toxic substances and chemicals
- Nutrient deficiencies
- Ineffective digestive processes
- Food intolerances
Test don't guess
Of course, the question now arises as to the best way to treat an "irritable bowel syndrome". And the answer is simple - it depends! However, it is important that the intervention:
- Recognizing and eliminating the cause
- The triggers (temporarily !) removed
- enables regeneration and
- Not (!) eliminating all trigger foods in the long term
To make this possible, it is important to recognize and eliminate the "culprits" (i.e. foods and physiological stumbling blocks). Otherwise, what we see in our practice every day will happen - it will be eliminated and eliminated until at some point there is hardly anything left to eat and everything simply leads to symptoms.
Bring light into the darkness and test yourself now!
In our experience, "testing" is of central importance in order to develop the most efficient strategy possible and is therefore the basis of any intervention. Do you have digestive problems? Or irritable bowel syndrome? Or symptoms that you can't put your finger on? A good introduction to this topic is our "Food intolerances" workshop - this is available with and without a test. Don't let digestive complaints throw you off balance and start today with a better understanding of yourself, your body, what it needs - and what it is less able to tolerate!