DR. ELIZABETH MILLER NATUROPATHIC DOCTOR
Understanding IBS and SIBO Through the Mind-Gut Connection
Get diagnosed, get treated. Reset Your Gut Health and FEEL BETTER
What is Irritable Bowel Syndrome?
Irritable Bowel Syndrome (IBS) is like a puzzle with pieces that constantly shift, leaving many feeling frustrated and at a loss. Small Intestinal Bacterial Overgrowth (SIBO) is often correlated with IBS, and is caused by a bacterial overgrowth in the small intestine creating an abundance of gas and bloating. While it’s tempting to focus solely on nutritional factors, supplements or medication for these conditions, there’s another critical piece of the puzzle that can’t be ignored: the mind-gut connection.
Often when patients are evaluated for IBS, everything inside their gut appears normal on imaging. Yet, despite this, they are left feeling confused and wondering what’s really going on. This is where the brain-gut interaction comes into play.
IBS is classified as a functional gut disorder, meaning it is a disorder that affects the normal functioning of the gut, even when anatomically everything looks normal. In other words, it’s a disorder of the intricate communication between your brain, nerves, and digestive system. This ongoing dialogue controls the muscle movements in your bowel, gastric secretions, and motility, ensuring digestion runs smoothly. But when this communication breaks down, IBS symptoms emerge.
What Causes IBS?
Picture this: in someone without IBS, the muscular movements in their gut are like a well-choreographed dance – coordinated and consistent. But for those with IBS, it’s more like a dance where the partners can’t quite synchronize their steps. This miscommunication can lead to symptoms like painful cramping, diarrhea, constipation, or a frustrating mix of both.
Now, here’s the twist: the root of these symptoms isn’t necessarily a problem with your gut itself; it’s a hiccup in the conversation between your brain and your gut. This breakdown in communication causes irregular muscle contractions and uncomfortable spasms, which manifest as IBS symptoms. If there is an overstimulation of these muscles, we can result in fast transit time, lack of water and nutrient absorption, and diarrhea. If the opposite happens and the muscles are not moving at a fast enough pace, we can end up with constipation, dry stool, and pain with passing a bowel movement.
But there’s more to the story. Alongside this miscommunication, many with IBS also experience heightened sensitivity in their gut – a phenomenon known as visceral hypersensitivity. Essentially, their gut nerves are on high alert, amplifying sensations of pain and discomfort in response to normal stimuli.
This hypersensitivity sheds light on why seemingly harmless foods can trigger intense symptoms in those with IBS. Take FODMAPs, for example – fermentable carbohydrates found in certain foods like legumes, onions, garlic or starches. While not inherently harmful, they can exacerbate symptoms in those with sensitive guts by creating more gas in the intestines and drawing in more water. This can result in a widening of the intestines, which may not cause any symptoms in some people, but for people with hypersensitive nerves in their gut, it can lead to cramping, bloating, and pain.
IBS and FODMAPs
In patients with SIBO, this reaction to FODMAPs is amplified even higher as the bacterial overgrowth will ferment the FODMAPs into excessive gas, expanding the intestines even further. Patients with visceral hypersensitivity will feel the bloating and discomfort even more than someone without this hypersensitivity, often leading to an inability to fully resolve SIBO symptoms just from eradicating an overgrowth through antimicrobials and nutrition. Therefore if we are not also working on calming down the nerves of their gut, many patients will feel as if they have not resolved their SIBO, as they will still be left with abdominal discomfort.
Stress and IBS
In addition to hypersensitivity and dysfunctional gut-brain communication, our stress and emotions also play a pivotal role in how we perceive sensations and pain in our gut. Chronic stress can lead to a lack of blood flow to our digestive tract, resulting in alterations in digestive secretions and gut function. If we are chronically having low gastric secretions from altered stress signaling, we can wind up developing SIBO as it can create an environment where bacteria thrive. Low mood, anxiety or heightened stress can also alter the way our brain perceives pain, leading to our brain over-reacting to gut stimuli, and aggravating IBS symptoms.
Treatment Plan For IBS
So, where does this leave us in terms of treatment? While nutrition and supplements certainly play an important role, addressing the root cause of hypersensitivity through approaches like vagus nerve stimulation, stress management and gut-directed hypnotherapy is crucial. Naturopathic treatments for stress focus on fixing biochemical imbalances of our stress hormones and neurotransmitters (adrenaline and cortisol), to heal your stress on a cellular level. By taking a full mind-body perspective to your digestive symptoms, we can reset your gut’s sensitivity so you can enjoy a wider range of foods without fear, and have more control of your IBS or SIBO.
Your Doctor: Meet Dr. Miller
Dr. Miller has a special focus in gut health in her practice, and sees a large population of SIBO, chronic bloating and IBS patients. She completed her doctor or naturopathic medicine degree at the Canadian College of Naturopathic Medicine, and holds a Master’s and Bachelor’s of science in Human Health and Nutrition from the University of Guelph. Her extensive knowledge of nutrition and her strong foundation in scientific research allows for a very thorough approach to your care.
Dr. Miller discovered naturopathic medicine after struggling with chronic irritable bowel syndrome for many years. She saw multiple doctors with no solution, as IBS was not well understood at the time. To take matters into her own hands, she devoted her master’s thesis to IBS research, and from here was introduced to naturopathic medicine which helped her immensely. Today Dr. Miller devotes a large part of her practice to treating digestive concerns and chronic bloating as it is very near and dear to her heart. Her goal is to blend the balance of nutrition, modern research, lab testing and traditional medicine to get to the root of her patient’s IBS and chronic bloating.
