Root Cause

[SonicVsMario]

Hi all,

So my IBS journey started with discovering I have SIBO. I have taken Rifaximin but still showing symptoms. I have read a lot on root cause for SIBO as being the only sure fire way of ridding yourself of the bacterial overgrowth but could the same thing be said for IBS. I know taking antidepressants are meant to eliminate many of the symptoms associated with IBS therefore is it not safe to assume that the root cause of IBS is also psychological too?

[Hetchins1946]

I feel that IBS is a complex group of things - different in different people.I agree strongly with you that there is a major psychological component *for some people* (including myself).

But for many people the predominant component is diet.

I'm not sure that drawing the conclusion of antidepressant treatment = psychology for IBS is valid because the mechanism of how antidepressants work is not fully understood.

I've said many times that people find it difficult to accept a psychological basis for their IBS and will therefore focus on the dietary 'solutions' because diet is much easier to control.

[Luisa22 in reply to Hetchins1946]

I wonder if the root cause is always about diet? I had the best diet anyone could have when I first developed IBS. But I did have a history of a lot of emotional pain. I'd eaten an excellent diet, and had no other chronic health issues for about 40 years. My microbiome should have been perfect.

When IBS started it took me some time to realise some of the wonderful aspects of my healthy diet had to be moderated to help me or I would suffer more. Once I did that, things got easier. So sadly, I can't eat what I used to, now. But initially I can't see that diet was the cause of my IBS.

[xjrs]

There are a variety of reasons for IBS, some we know about, some we don't.

1) Gut/brain axis - this is disrupted communication between the brain and the gut, either causing motility problems (too fast or too slow) or erroneously picking up pain signals from the gut which are normal bowel activity signals. This is the psychological aspect. For instance visceral pain found in some IBS sufferers can be caused by traumatic events even back to childhood. This is why gut directed hypnotherapy is recommended - to try to improve this line of communication and calm intestinal nerves.

2) Gut 'injury' for instance from food poisoning. This can lead to an imbalance of gut microbes with a dominance of bad bugs which cause symptoms.

3) Poor diet. Those with lots of bacterial diversity in their guts are less likely to have IBS symptoms. This comes from eating a varied diet. Restrictive diets low in fibre, high in protein, high in processed foods, reduce feed for the microbiome allowing bad bugs to take hold.

4) Genetic - IBS can run in families. I understand that if someone is predisposed to IBS and/or they are subjected to one of its triggers such as highly stressful events (gut/brain axis), gut 'injury' and/or poor diet, any one of these may be more likely to lead to IBS symptoms, than if these happen to someone who is not predisposed to IBS.

[Iesgobdafydd]

Great answers already. It is not safe to assume the root cause of IBS is psychological (stress/anxiety), because IBS is not a single illness with a single cause - it's a particular set of symptoms, and sets of symptoms can occur from more than one possible root cause. In my case, stress was not the root cause, but in many cases it does seem to be the root cause.

Like you I took the approach of looking for a root cause, and found it helpful, but it's worth remembering that there doesn't have to be one single cause for an illness, there could be more than one cause which create the problem together. For instance, stress combined with difficulty digesting a particular food might result in IBS for someone; removing either the stress or the poorly-tolerated food might restore normal health for them - they might be able to digest it fine when they're not under stress, and they might be able to cope with the stress without getting ill if they're not also putting extra strain on their digestive system.