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IBS - What are the Possible Causes?


Irritable Bowel Syndrome is a problem I see so often in clinic and it is problematic on many different levels. If you have been diagnosed with this condition, you may well have been suffering with it for years and, while a diagnosis can – at first– offer comfort in finally having a recognised problem, the satisfaction is short lived because often that’s where all support ends, and you’re left no further forward in actually fixing what the problem is.

The difficulty begins because IBS is essentially meaningless; it’s a catch-all term used to encompass a huge variety of digestive issues. If you’re serious about getting to the bottom of the problem (no pun intended), I’m happy to discuss your symptoms and help find a way forward.

In my experience, it’s likely to be one of the following conditions.

1 SIBO (small intestine bacterial overgrowth)

Around 60% of people with IBS will have SIBO. Though you might have heard about good (and bad) bacteria in the gut, really what experts are talking about is the balance of bacteria in the large intestine: the colon. The small intestine shouldn’t have any bacteria, and the each day the body should perform a flush to sweep bacteria from the small intestine and into the large intestine. This flush is called the ‘migrating motor complex’. For a huge variety of reasons (historic food poisoning being the most common, but also low levels of stomach acid or adhesions play a role, among others) the bacteria are not swept away. The trouble is that these bacteria can ferment the food in your small intestine, causing gas, belching, bloating, pain and a variety of other symptoms, including constipation and/or loose stools, and even anxiety. A breath test can establish which gases are present, and we can devise an action plan based on your results.

2 Lactose intolerance

This is when your body is not able to tolerate lactose, a type of sugar found naturally in milk and other dairy products. Essentially, bacteria in your intestine feed on these milk sugars, leading to a host of IBS symptoms, like bloating and gas, nausea, constipation or diarrhoea. It can go hand in hand with other digestive complaints, such as coeliac disease or increased intestinal permeability (‘leaky gut’). Lactose intolerance can be diagnosed via a simple at-home breath test.

3 Fructose malabsorption

The symptoms are very similar to lactose intolerance. Fructose (which is found in fruit, honey and many processed foods) is a sugar, which, like lactose, is digested in the small intestine. Some people cannot absorb fructose, and what is not absorbed is fermented by intestinal bacteria, causing bloating, cramping, gas and distension of the stomach. You might also experience brain fog and headaches. A breath test will diagnose the condition.

4 Dysbiosis

This is an imbalance in the levels of beneficial (good) and pathogenic (bad) bacteria in the large intestine or colon. This is now common due to overuse of antibiotics and alcohol, an increase in high sugar diets, and stress. Symptoms can vary from a sluggish bowel or diarrhoea, pain, bloating and flatulence, to chronic bad breath, joint pain, fatigue and food sensitivities. Dysbiosis is also implicated in a variety of health conditions like diabetes, heart disease and obesity. A stool test can help establish whether your gut bacteria are out of balance, along with a host of other markers that might be useful in getting to the root of your digestive problems.

5 Yeast overgrowth

Where the gut environment becomes out of balance (due to dysbiosis), yeast can thrive. Diets high in sugar feed the yeast – although if you think you might have a yeast overgrowth, it’s worth noting that long-term yeast problems can mean that the yeast cells are pathogenic or disease causing, and that the yeast has switched its metabolism to also be able to digest protein and fat. Symptoms of yeast overgrowth include recurring thrush, gas or bloating, fatigue, bad breath, cravings for sweet foods, joint pain and brain fog. A stool test can establish the presence of candida or other yeast overgrowth.

6 Food Intolerance

A food intolerance is different to a food allergy, producing low grade inflammation through the body and symptoms that are far ranging, but altogether less dramatic. The symptoms of a food intolerance can include weight that won’t shift, bloating, migraines, headaches, coughs (frequent), runny nose, itchy or overly waxy ears, stomach cramps, diarrhoea, constipation, fatigue, achy joints, etc.

Although the symptoms might seem less dramatic, it really is worth dealing with food intolerances, especially if you’ve had niggly issues for years. This is because the low grade inflammation created through the body if your system doesn’t like something you are repeatedly feeding it, will almost certainly lead to worse stuff in the future because that’s the way these things work. ALL chronic disease is caused by inflammation of one sort or another. If you find you have a food intolerance, this is your body telling you your gut needs some TLC to restore, rebalance and heal. Without this vital step, you’re likely to end up (over time) with more intolerances and more symptoms.

Some people struggle with digestive problems for years. If you are ready to make fixing your gut health a priority, I would love to work with you. Please click the link below to book your free IBS health check now.


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