TESTING FOR CAUSES AND TREATMENT OF IBS

A detailed clinical history is taken firstly to eliminate the possibility of inflammatory Bowel Disease such as Crohn's disease, Ulcerative colitis or diverticulitis. Second to determine when symptom started, what triggers episodes, the progression of the disorder, the severity and frequency as well as any co-morbid symptoms of anxiety, depression, sleep, fatigue and cognitive deficits. Particularly in ASD, where IBS can be a primary cause of nutrient malabsorption, maintaining the behavioural deficits..

Rome IV criteria

The Rome IV criteria is used as the basis for the formal diagnosis of IBS

Contributing factors to IBS

Red blood cell Essential fatty acid profile

The red cell Essential Fatty Acid (EFA) Profile test is a specialised blood test that gives detailed composition of fatty acids in the red blood cells and is an excellent marker for identifying specific EFA deficiencies. Deficiencies in Omega 3 EFAs may be associated with leaky gut, nutrient malabsorption and mental health issues.

 

Every cell in the body has a lipid membrane protecting its boundaries. The brain consists of 70% lipids and 40% of the brain is made up of the long chain Omega 3 EFAs (EPA and DHA, which we get from fish). Studies have consistently found that deficiencies of Omega 3 EFAs (derived from fish) are associated with serious brain and systemic dysfunctions.  Many of these studies prove that Omega 3 EFAs are essential for brain function. It is known that deficits are associated with all kinds of psychiatric disorders, cardiovascular disease, diabetes, cancer and Neurodevelopmental disorders.

Omega3 EFAs and Gut function

Cell membrane bi-lipid layer
Cell membrane bi-lipid layer

The gut cell wall, the epithelium, is constantly exposed to billions of organisms and toxins daily. The importance of the protective effect of the lipid membrane of each cell in the epithelium cannot be understated. If the lipid membrane is lacking in Omega 3 fatty acids, the protection may fail and unfriendly organisms and toxins can irritate the gut wall, possibly giving rise to Irritable Bowel Syndrome and Inflammatory Bowel Diseases. Of course EFA deficiencies are not the only possible causes of epithelial dysfunction, there are other nutrient co-factors and systems which also need to be considered

Red cell Essential Fatty Acid profile test is used to determine whether the percentage of fatty acids in the red cells are normal or not. The test results are used to help determine which type of fish oil (correct ratio of EPA and DHA) and which nutrient cofactors may be necessary.

EXTENDED FAECAL MICROBIOLOGY PROFILE

This test done at Bioscreen Medical laboratory at Melbourne University is the only one used at the clinic for determining the profile of commensals (normal community of bacteria) in the gut. This innovative laboratory does the only commercially available test in the world that estimates the populations of commensal bacteria properly. The faecal sample is refrigerated and kept in an anaerobic pouch to ensure that no oxygen reaches the sample prior to analysis. Anaerobic bacteria would otherwise die on exposure to air, while aerobes would continue to reproduce during transportation if the sample was not refrigerated.

Intestinal permeability

Gut epithelial cells and nutrients
Gut epithelial cells and nutrients

Leaky gut is an expression which means that the gut lining has become impaired or is “leaky”, allowing molecules of partially digested food or bacteria and toxins to cross the gut barrier and irritate the gut wall or cross into the blood stream. To test for intestinal permeability, a measured amount of two sugars, Lactulose and Manitol, is given and all urine passed for the next six hours is collected. The recovery of the sugars in the urine is used as a marker to estimate intestinal permeability, with higher than normal recovery suggesting a “leaky gut”.

To repair the gut wall a compound of nutrients including Glutamine, Threonine, Serine, Proline, N-Acetyl Glucosamine and Glycine may be prescribed to repair the gut wall and improve nutrient absorption.

Dietary habits and Nutritional uptake

Many patients with IBS have a relatively poor diet, although many others have excellent diet. Hence for some, their nutrient uptake may be inadequate for good health due to malabsorption. Dietary assessment, remediation and nutritional supplementation are also essential components of treatment.

A detailed clinical history is taken firstly to eliminate the possibility of inflammatory Bowel Disease such as Crohn's disease, Ulcerative colitis or diverticulitis. Second to determine when symptom started, what triggers episodes, the progression of the disorder, the severity and frequency as well as any co-morbid symptoms of anxiety, depression, sleep, fatigue and cognitive deficits. Particularly in ASD, where IBS can be a primary cause of nutrient malabsorption, maintaining the behavioural deficits..

QEEG functional neuroimaging

QEEG Neuroimaging is used to determine whether the anxiety and depression are secondary to cellular malnutrition, or are primarily due to other brain based factors, such as abnormal brain asymmetry or abnormal brain power levels, or other brain patterns that are known to predispose to anxiety and/or depression.

Treatment for IBS

IBS treatment may involve some of the following components, based on clinical presentation:

  • Elimination of Enteric pathogens, parasites and protozoa.
  • IgG sensitive foods are eliminated.
  • Other foods that trigger bloating, discomfort and loose stools are also eliminated. There may be a lack the enzymes to breakdown these foods. For example: Lactose intolerance due to deficits in lactase enzyme. This is not to be confused with IgG sensitivities to cow's milk.
  • A healthy diet based on the Harvard Medical school Food Pyramid is recommended.
  • In severe cases our own Gut Recovery Diet is used to starve specific overgrown bacteria.
  • Promote oily fish consumption.
  • Specific short-term antibiotics may be used to promote optimum Gut microbiology profile.
  • Specific nutrient Supplements are used to promote optimum cellular nutrition, gut, immune and brain cell repair.
  • Specific probiotics are supplemented, based on the Extended Faecal Microbiology analysis.