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IBS - It's Not All In Your Head

April is IBS Awareness Month, and there's no better time to shed light on one of the most misunderstood digestive conditions affecting millions of people worldwide. If you've ever experienced unexplained abdominal pain, bloating, gas, diarrhea, or constipation, you're not alone — and more importantly, there are answers.

My personal experience with IBS is one of the reasons I went into Naturopathic Medicine - IBS has been part of my picture for decades. That personal connection has made me more passionate about treating others and understanding the details - what it is, what causes it and how to treat and/or manage it.

What Is IBS?

Irritable Bowel Syndrome (IBS) is a common condition that affects the digestive system. Symptoms can range from loose stools and constipation to bloating, belching, and gas. Many people find that their symptoms are triggered by eating, stress, or uncertainty about their daily routine. The impact can be significant — disrupting sleep, limiting social activities, “picky eating”, affecting work performance, and causing embarrassment or frustration. It is an umbrella term - meaning there are many different causes. My goal is to dig deeper.

The Role of Disorders of Gut-Brain Interaction (DGBI)

One of the most important — and often overlooked — causes of IBS-like symptoms falls under a category called Disorders of Gut-Brain Interaction (DGBI). These are conditions where the communication between your brain and gut becomes disrupted. In adults, there are 22 separate DGBI conditions, including IBS, functional bloating and distention, dyspepsia, and functional heartburn.

Here are some of the key mechanisms behind DGBI that can contribute to IBS symptoms:

  • Sensitive Gut Nerves– The nerves in your gut may become overly sensitive, causing pain or discomfort from what would otherwise be normal digestive processes.

  • Altered Gut Movement– The muscles in your gut may move food too quickly or too slowly, resulting in diarrhea or constipation.

  • Disrupted Gut-Brain Communication– Signals between your gut and brain can be misinterpreted, causing symptoms even when there is no structural problem present.

  • Microbiome Imbalance– An imbalance in the gut's bacterial environment can contribute to a wide range of digestive symptoms.

  • Immune System Alterations– Low-level immune activation can keep the gut in a heightened state of alertness, perpetuating symptoms. I can see this in lab tests.

  • Stress and Anxiety– Due to the close connection between the brain and gut, emotional stress and anxiety can significantly worsen IBS symptoms.

It's Not "Just in Your Head"

A common misconception about IBS and DGBI is that it's purely psychological. This is simply not true. While the brain and gut are closely connected, the symptoms are very real and require proper management. These are genuine gut conditions that can be influenced by stress and mental health — but they are not caused solely by them.

Other Contributing Factors to IBS

Beyond DGBI, several other factors can play a role in IBS. Some include:

  • SIBO (Small Intestinal Bacterial Overgrowth)– Research suggests a strong overlap between IBS and SIBO, making it an important condition to investigate and rule out.

  • Hormonal Fluctuations– For menstruating individuals, conditions like PMS can aggravate gut symptoms significantly.

  • Mental Health– Anxiety and stress are major contributors to gut symptoms and should never be overlooked in treatment planning.

What Can You Do?

If you suspect IBS, it's important to work with a qualified healthcare provider to:

  • Rule out other conditions such as SIBO, or endometriosis

  • Assess mental health factors like anxiety

  • Review current supplements and medications

  • Explore evidence-based treatments tailored to your unique symptom profile

Final Thoughts

IBS is definitely not a one-size-fits-all condition. Each person's experience is unique, and the underlying causes can vary widely — from microbiome imbalances to gut-brain communication issues to hormonal triggers. This IBS Awareness Month, if you're struggling with IBS symptoms, reach out to a healthcare professional. You deserve answers — and relief.

Dr. Karen

Digestive Health - Where is the pain?

When someone tells me they have stomach pain I always ask them to point to where the discomfort is, since we tend to use that reference loosely. The abdomen is complex with lots of parts (remember the game Operation?!) therefore pointing to the area of pain gives me the best reference of which area or organ is the actual issue. 

I continue to see a lot of digestive concerns in my practice and treat it differently depending on the area of discomfort. An abdominal exam also gives me an idea of what to treat…something that many of my patients claim no one has done yet throughout their years of abdominal complaints! 

So where is your pain?

Let’s go through the main areas of the abdomen along with the common issues in those areas. This is quite simplified, however it may help you zone in on the true cause of your concern and possible treatment options.

Upper abdomen: 

  • Esophagus 
  • Stomach

Common concerns:

  • Heartburn, reflux, GERD - Pain in the upper chest or under ribs in the middle is typically due to low stomach acid instead of high stomach acid (refer to this blog for a full explanation if your mind is blown!), creating a weak lower esophageal sphincter (LES). We want to strengthen the sphincter, sooth the stomach and ultimately increase stomach acid.
  • Food feeling heavy or sits there - This is a common symptom of low stomach acid, or silent reflux.
  • H.pylori - This bacteria has run rampant in your stomach and is now causing damage. It is treated with triple or quadruple antibiotic therapy along with natural remedies to sooth and protect the stomach lining. Some options are DGL, marshmallow root, melatonin and even broccoli sprouts.

Middle abdomen:

  • Liver
  • Gallbladder
  • Pancreas
  • Upper intestines 

Common concerns:

  • Gallbladder insufficiency - Is there a mild pain under your right lower ribcage, worse when eating fat or fibre? When the digestive juices (HCl, bile, digestive enzymes) are not stimulated properly there is stagnation in the liver/gallbladder causing issues. We need to stimulate bile production and release with bitters, choline or other herbs. 
  • Gallbladder stones or sludge - Prolonged stagnation eventually creates stones or sludge. People on an oral contraceptive pill, taking a heartburn medication such as Nexium, or have a history of parasites have a higher risk of creating stones. We need to be more careful with treatment in this case.

Lower abdomen:

  • Lower intestines/colon 
  • Appendix 
  • Uterus/Ovaries 

Common concerns:

  • SIBO (Small intestine bacterial overgrowth) - To put it simply, bacteria that should only be in your large intestines has ascending upwards into the small intestine. There are several causes of SIBO to long to discuss here. Symptoms could vary from bloating and heartburn, to chronic constipation and/or diarrhea. Getting tested with your ND is helpful.
  • Constipation - If SIBO is not the root cause, common reasons for constipation would be lack of routine, bacteria imbalance, magnesium deficiency, lack of fibre in the diet or even dehydration. 
  • Chronic bloating - The more common reasons for chronic bloating are food sensitivities, bacteria imbalance, or SIBO. A simple detox or elimination diet can do wonders in decreasing bloating at times.
  • Endometriosis - Do you have disperse pain, worse during your menstruation? Endometriosis can cause scarring and adhesions within the abdomen leading to more pain during certain times of the month. These cases require more extensive testing and treatment. 

These concerns are covering the more common and simple causes of digestive complaints. I suggest consulting with a Naturopathic Doctor like myself to help with correct treatment or with support for more complex cases. 

In health & happiness,

Dr. Karen