Managing IBS is frustrating! We know because at Ignite Nutrition we hear stories every single day of our clients who have tried EVERYTHING and don’t feel any better. The symptoms of IBS have real impacts on your quality of life. We know how challenging it is to go to restaurants and worry that you’ll be spending most of the time in the bathroom, fear eating before a meeting at work because you might pass gas or choosing to avoid eating altogether to avoid feeling bloated and ill. When it feels like there’s no answers, it’s no surprise to us that our patients search for answers on the Internet and try alternative therapies. However, searching IBS therapies on Google is like entering the Wild West. There is no shortage of people trying to sell you the miracle cure, and it’s tempting when nothing else has worked. What’s the harm in trying right?
We hate seeing people taken advantage of, shilling out hundreds of dollars on therapies that have no evidence and leave you no further ahead than you were before you started.
So, let’s review some of the popular alternative IBS therapies we get asked about and see if they’re worth your time and money.
Stool Microbiome Analysis
Stool analysis is an up-and-coming test that we see some of our clients pursuing. Stool testing is what it sounds like, you send off a sample of your stool to a lab for analysis and you receive a report that describes the number of pathogens, bacteria, parasites, fungi and yeast present in your colon. Some companies also provide advice on recommended changes to diet, supplements, or lifestyle to improve the gut microbiota.
The problem with these tests is the science behind the gut microbiome is still so young. Just because we can analyze your gut microbiota from stool samples doesn’t mean we fully understand the implication of the information or know what to do with it. Gut microbiota vary wildly person to person and we don’t have a standard reference range for gut bacteria. Therefore, if your test indicates you have a high level of bacteria, you must ask, what reference range are they using to make that claim?
Another concern is the lack of specificity in testing. Test results often report the genus of bacteria but not the strain. For example, test results may show a high level of Escherichia coli (E. coli) and while we may think that’s bad, it depends on the strain. Not all strains of E. coli are harmful, some are neutral and some are even helpful.
The lack of established reference range and specificity of bacterial strains can lead to unnecessary antibiotic treatment. Additionally, the claims that certain bacteria are signs of disease or that we can give information on how to modify the diet based on our gut microbiome is not established in the evidence.
The future looks promising for diagnosing and treating diseases based on gut microbiome, but the evidence isn’t there yet.
Bottom Line: Gut microbiome sequencing is not yet ready to provide individualized medical advice. Save your money!
Immunoglobulin G (IgG) testing
When my client brings in their IgG results to their appointment, I cringe because I know they paid a couple of hundred dollars for a test that all major allergy organizations recommend against using due to its lack of evidence. IgG is an antibody found in the body. It acts as a memory antibody – telling your body that you’ve eaten that food before and it’s okay. It plays an important role in what we call ‘immune tolerance’ – recognizing safe foods as safe. The problem with testing it? Everything you regularly eat will of course register as high! This creates a ‘confirmation bias’ – making the test very believable – after all, no wonder you feel unwell, since these are all foods you eat regularly!
If you’ve done the test, I know what you’re thinking – when you removed your highly sensitive foods, you felt better! This is similar to when someone goes on any sort of restrictive diet. Eliminating large groups of food from the body forces you to plan, cook at home more often, and rely less on convenience and highly processed foods. It’s much more likely improving your diet quality is what improves your symptoms. Not only that, but if you were seeking digestive symptom improvement, many of the common high IgG foods are also foods that are high sources of FODMAP’s. FODMAP’s are carbohydrates that can cause digestive distress – so it is no surprise you may feel better when you remove them.
Choosing to eat balanced meals, cook more often and rely less on highly processed foods while STILL including things like wheat, dairy, and eggs into the diet could lead to the same results. That’s why one of our very first steps of IBS management is nutrition basics. Assessing the amount and types of fibre in the diet, discussing how to balance meals, and developing skills to plan and prepare meals can give you similar symptom relief WITHOUT the restriction and high cost of invalid tests.
Bottom Line: Say no to IgG testing. If your practitioner is adamant, ask them to show you supporting randomized control trials for your condition!
IV Vitamin Therapies
Giving vitamins by IV is not novel to the medical community. Total parenteral nutrition (TPN) is a method of providing all nutrients required to sustain life via intravenous for those whose gut is not functioning, usually in acute care hospitals. Additionally, IV infusions of Vitamin B12 and iron are commonplace when levels become too low. However, elective IV therapies given by alternative medical practitioners are new, and clinics offering these services are popping up everywhere. These IV therapies claim that they can help with increasing energy, fighting cancer, managing chronic diseases, and of course improving gut health and IBS.
The truth of the matter is, there is no evidence to support these claims. In fact, I was unable to find even one scientific study that trialled IV therapy in IBS patients. The very limited amounts of studies on IV therapy are pilot studies in a very small population, are poorly designed and did not show any significant benefits.
At best IV nutritional therapies have no effect and lead to expensive urine as your body excretes the excess vitamins but at worst have some potentially negative and serious consequences. Anytime you insert an IV, you put yourself at risk of infection. Additionally, high doses of some vitamins and minerals are harmful. Vitamin A at high doses can damage the liver, high levels of potassium for someone with kidney disease can cause a heart attack, and fluid and electrolyte overload for anyone with a heart condition can cause a heart arrhythmia.
Bottom Line: Get your vitamins through food – not IV’s!
Research in gut health is exploding. There are daily discoveries about the impacts our gut has on bodily systems and functioning. While it’s fascinating, science it’s still young and we have a lot to discover. That unfortunately doesn’t stop the wellness industry from capitalizing and creating predatory therapies to “reset” and “restore” gut health.
You can find a variety of protocols and remedies claiming to reset gut health but they usually begin with a long and generic list of symptoms caused by your gut microbiome imbalance including headaches, fatigue, bloating, brain fog, etc. The healing protocol involves testing for bad bacteria through a variety of tests (hydrogen methane breathe test, intestinal permeability screening). Following testing, there is a period of eradicating the bad bacteria through herbal antimicrobials and/or restrictive diets that cut out gluten, dairy, and sugar. And finally, gut health restoration occurs through a series of supplements including pre and probiotics, vitamins, minerals and digestive enzymes.
While this step-wise approach makes sense, in theory, the science simply does not support these gut-reset protocols. They are a series of non-evidence based medicine that are extremely expensive, stressful, and time-consuming. While some report feeling better after following the protocol the results are more likely placebo effect and a change in dietary patterns that eliminates highly processed foods, and not a result of the treatment.
Bottom Line: Skip unnecessarily restrictive gut-reset protocols.
It is overwhelming to look through options for IBS treatment and sort through who is telling you the truth and who is trying to sell you some snake oil. Next time you’re considering an option stop and consider – does it sound too good to be true? Does the treatment require a large investment or offer a big promise? Is there a reason traditional practitioners are not offering the treatment?
But don’t give up hope! IBS is a manageable condition. There isn’t a miracle “cure” or a magic bullet. Instead, it does take some work on your part to go through the 4 pillars of gut health. Our qualified team of Registered Dietitians and Registered Psychologist can help get you the relief you deserve.