IBS Functional Medicine

Irritable bowel syndrome (IBS) is a tricky condition that often leaves people suffering from digestive symptoms for years. In this article, we’ll discuss how we approach evaluation and treatment for IBS from a functional medicine standpoint.

IBS is an intestinal disorder commonly characterized by abdominal discomfort in combination with diarrhea and/or constipation. Up to 16 percent of Americans may suffer from IBS, and this condition is more common in women and young adults (1).

Unfortunately, individuals with IBS are also more likely to report a lower quality of life and higher depression scores than people without this condition (2).

Conventional treatment for IBS is largely based on which symptoms the individual reports. Certain medications may be prescribed like laxatives, fiber, anti-diarrheals, or even low-dose antidepressants. In some scenarios, the healthcare provider may recommend eliminating foods that could make symptoms worse, like dairy, caffeine, and fatty foods.
 
Unfortunately, conventional medicine often fails to effectively reduce IBS symptoms.

Functional medicine is a different approach to treating health conditions and preventing disease by finding the root cause. Instead of treating your IBS symptoms, a functional medicine provider would dive deeper to find “the why” behind your symptoms.

In a functional medicine assessment for IBS, your provider will ask you in-depth questions to identify the root causes of your symptoms such as:

Our assessment will also include questions about your diet, lifestyle, work and home environment, and sleep habits. A symptom questionnaire helps us understand the type, frequency, and severity of your IBS symptoms. This questionnaire will also ask you about symptoms that aren’t primarily related to your gut like brain fog, fatigue, skin health, and more. 

In addition to asking the appropriate questions above to start investigating root causes, we often recommend the following valuable IBS functional medicine testing in our functional medicine membership:

1. Microbiome/Stool Analysis:  We assess your gut bacteria, see how well you are secreting digestive enzymes, and evaluate for any signs of parasites, yeast overgrowth or inflammation.  These results help guide our treatment plan and also let us know when appropriate referrals are necessary. 

2. Root custom blood panel.  In addition to evaluating thyroid function with a full thyroid panel (because thyroid issues can worsen/contribute to IBS), we also look for nutrient deficiencies that can both contribute to poor gut health OR be caused by poor gut health (such as iron, zinc, and B12).  

N-acetyl-cysteine (NAC) is a powerful antioxidant that helps manage insulin resistance, a key factor in conditions like type 2 diabetes, metabolic syndrome (MetS), and PCOS. 

A 12-week randomized clinical trial in individuals with MetS found that 1800 mg/day of NAC significantly improved fasting blood sugar, insulin levels, and insulin resistance compared to a placebo. The study also showed increased HDL-cholesterol and reduced C-reactive protein, highlighting its anti-inflammatory and metabolic benefits (3).

In addition to improving insulin sensitivity, NAC supports liver health and detoxification, which are critical for metabolic function. It also strengthens the body's antioxidant defenses to protect cells from damage

Dosing of NAC: To achieve these benefits, we recommend 900 mg of NAC twice daily, for a total of 1800 mg per day.