Want to know the truth about what's causing your IBS?

Up to a third of people in the UK have IBS at one stage and there are multiple root causes.

What's yours?

Because a diagnosis of IBS is not a root cause.

It is a description of symptoms.

According to the NHS, Irritable Bowel Syndrome (IBS) is a common condition that affects the digestive system and causes symptoms including stomach cramps, bloating, diarrhoea and constipation.

IBS can present in different ways. Some people predominantly experience constipation (IBS-C), some diarrhoea (IBS-D), and some a mixture of both (IBS-M).

The latest Rome IV criteria define IBS as recurrent abdominal pain, on average at least one day per week in the previous three months, associated with two or more of the following:

• Pain related to defecation

• A change in stool frequency

• A change in stool appearance or consistency

Symptoms must have begun at least six months before diagnosis.

Importantly, IBS is a diagnosis of exclusion.

That means other conditions need to be ruled out first.

If you haven't been diagnosed with IBS but are struggling with bloating, reflux, abdominal pain, constipation, diarrhoea, excessive wind or changes in bowel habits, please see your GP. It is incredibly unlikely to be anything sinister, but it absolutely needs investigating properly. I never work with anyone until appropriate medical checks have been completed.

And if you have a family history of autoimmune conditions, ruling out coeliac disease becomes especially important. Coeliac disease itself is an autoimmune condition and can easily masquerade as IBS.

Inflammatory Bowel Disease (IBD) can also look like IBS, especially at the beginning. Simple blood tests can help rule this out.

Some people experience post-infectious IBS following food poisoning or a stomach bug. Others may have thyroid dysfunction, hormonal changes, pelvic floor issues, endometriosis or chronic nervous system dysregulation contributing to their symptoms.

Once the more serious causes have been excluded (not all of which are mentioned), that's where the real detective work begins.

Because what is behind your IBS may be completely different from what is behind someone else's.

You do not have to simply live with it.

I have helped a huge number of clients regain confidence in their digestion and get back to enjoying life without constantly worrying about bloating, discomfort or where the nearest toilet might be. But the key is always personalisation.

So what can actually sit behind IBS?

One of the biggest drivers I see in practice is SIBO, or small intestinal bacterial overgrowth.

In fact, this month alone I identified five new cases through breath testing.

SIBO occurs when bacteria that should primarily live in the large intestine begin thriving in the small intestine. This can cause bloating shortly after meals, excessive burping, abdominal discomfort, constipation, diarrhoea, or a combination of both.

Breath testing helps us determine whether hydrogen-producing bacteria, methane-producing microbes, or both are present. Methane-dominant overgrowths are often linked to constipation, while hydrogen-dominant cases more commonly present with diarrhoea.

Knowing which type is involved allows us to create a much more targeted plan.

Dysbiosis

Alongside SIBO, dysbiosis is another major driver that I see time and time again.

Dysbiosis simply means an imbalance within the gut microbiome. Previous antibiotic use, chronic stress, infections, alcohol, highly processed diets and other lifestyle factors can all contribute. In my clinical experience, SIBO and dysbiosis are among the most common reasons people continue to struggle with IBS symptoms. Both SIBO and dysbiosis can respond well to the low FODMAP diet, but it's not a diet to take lightly and we really want to know if it's right.

Digestive symptoms can also arise from maldigestion and malabsorption.

Maldigestion means food is not being broken down properly.

Malabsorption means nutrients are not being effectively absorbed.

Both can contribute to bloating, diarrhoea, nutrient deficiencies, fatigue and ongoing digestive discomfort.

Bile flow/gallbladder

Bile flow issues are another piece of the puzzle that often gets missed. Bile is essential for digesting fats, absorbing fat-soluble vitamins and maintaining healthy bowel movements.

Poor bile flow can contribute to bloating, nausea, constipation and symptoms after richer meals. Think about this one if a fatty meal gets you running to the loo with greasy stools.

H.pylori

Another piece of the puzzle can be H. pylori. This is a bacterium that lives in the stomach and, for some people, can contribute to symptoms that are often labelled as IBS, including bloating, reflux, excessive burping, nausea and discomfort after eating. It may also interfere with healthy stomach acid production, which impacts digestion further down the line. When someone's symptoms fit the picture, testing can help us determine whether it is something we need to address.

Stress deserves a mention too.

The brain-gut connection is incredibly powerful. Emotional stress affects gut motility, digestion, microbial balance and symptom sensitivity. Supporting the nervous system is something I work on with every client because it forms part of the bigger picture. Stress does not mean your symptoms are psychological, but it absolutely influences how the gut functions.

And then there are food intolerances.

This is probably the question I get asked most often. The truth is, I don't find intolerances to be the root cause as frequently as people expect.

More often, I see underlying issues like SIBO, dysbiosis, poor digestive function or gut inflammation driving symptoms.

That said, genuine intolerances certainly do exist. If we suspect one, the gold standard remains very straightforward. Remove the food completely for four weeks, then carefully reintroduce it and observe what happens.

No expensive intolerance tests. No guesswork.

Just a proper elimination and reintroduction process.

If you think a food intolerance could be contributing to your symptoms, message me and we can discuss the best approach.

Comprehensive Stool Testing

Testing can be an incredibly valuable part of understanding what is happening beneath the surface.

The comprehensive stool testing I use through specialised laboratories provides a huge amount of information that simply isn't available through routine testing.

We can assess:

• Markers of gut inflammation

• The balance and diversity of beneficial bacteria

• Pathogenic bacteria that may be contributing to symptoms

• Yeast overgrowths such as Candida

• Parasites

• Digestive enzyme production

• Fat digestion and absorption

• The health and integrity of the gut lining

• The production of beneficial short-chain fatty acids that nourish the colon

• How effectively your bacteria are functioning, not just which bacteria are present

These tests allow us to move away from guesswork and create a genuinely personalised plan.

Clients regularly tell me that testing was one of the best things they ever did for their health because it finally gave them answers and a clear direction forward.

SIBO testing

SIBO breath testing has been equally transformative for many people. Understanding whether hydrogen or methane-producing organisms are involved changes how we approach treatment and often explains symptoms that have persisted for years despite trying multiple interventions.

I will soon be sharing an IBS & SIBO case study in my newsletter which beautifully demonstrates just how powerful targeted testing can be. It completely changed one client's health journey and allowed us to address the true drivers behind their symptoms rather than simply managing them. Here's one I wrote last year.

There are also some very simple things you can try today that may help support digestion while we investigate what is really going on.

DO

• Try a cup of hot water or ginger tea before meals to stimulate digestion.

• Apple cider vinegar with the mother may help some people. Try one teaspoon before meals if appropriate for you.

• Think about your food before eating. The sight and smell of food help activate the digestive process.

• Chew properly. If you had to spit out your mouthful, nobody should be able to tell what you were eating.

• Try a few cubes of pineapple or papaya before meals. They naturally contain digestive enzymes that may support digestion.

• Consider a quality digestive enzyme supplement if appropriate.

• Take a short walk after eating. Even ten to fifteen minutes can support digestion and blood sugar regulation.

DON'T

• Eat every meal at your desk while answering emails.

• Eat when highly stressed or rushing around.

• Wolf your food down without chewing.

• Drink excessive amounts of fluid with meals if it leaves you feeling uncomfortable.

• Assume that because something is common, it is normal. It isn't.

Although IBS affects millions of people, ongoing bloating, pain, constipation, diarrhoea and digestive discomfort should never simply be accepted as your normal state.

There are often answers.

There are often solutions.

But they need to be personalised. What is behind your IBS is not necessarily what is behind someone else's.

If any of this resonates with you, or you would like to explore what might really be driving your symptoms, send me a message. Let's talk about where to start.

If it isn’t, please book yourself in for a free 20-minute Reboot your health call to get an idea of what you can do right away and what might be possible for you. Book your Reboot your Health call

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