IBS & What’s Really Going On

Hello. Welcome. You’re listening to Dr. Martha Reid at Doctors Choice Integrative Medicine in Downtown Vancouver, a space where I bring passion, inspiration and nourishment to the conversation of your health.

As I was leaving the clinic for lunch yesterday, I stepped out onto our porch. And for those who have you never been to our clinic, we are in this incredibly beautiful heritage cell house in the West End of Vancouver and you step out onto the porch and there’s this lovely little picket fence and all of this greenery and wisteria vines, and it just feels like it belongs in a different time. Step forward a few feet and you’re in the bustle of downtown western Vancouver in Davie Village.

So, as I stepped out onto the porch, this lovely gentleman walked in through the gate with a compelling look in his eye that he had a question that needed an answer. And he said to me, he said, “Hi, are you Dr. Martha Reid?”. And I said, “Yeah, yeah, I am. How can I help?”. And he said, “Well, I was just up the street over at Garden Health, the local health food store.” I said, “Oh yeah, I said, they’re awesome. They’ve been there for forever”. And he said, “Well, I was in there looking for some medicines for my gut because I’m struggling with digestive issues and they were virtually sold out. And so their owner, Diana, suggested that I come and speak to you.” And he said, “I’ve got what I’ve been told is irritable bowel syndrome, and I’m in a lot of pain, a lot of the time, and I’m gassy and I’m bloated and my poops are all over the place and I don’t really know what to do about it. I saw my doctor and they sent me to a gastroenterologist who thinks it might actually be IBD.”.

And so for those of you who don’t know, IBS is irritable bowel syndrome. IBD is a few steps down the road from that, and it’s irritable bowel disease and branches into two forms over either Crohn’s or colitis.

So back to the story. And the gentleman said, “Well, I saw the gastroenterologist who thinks it might be IBD, but I don’t really know what that means, and I don’t know what to do about it. And I’m really wondering why this is happening, and it seems so many people are dealing with similar things and you know what’s going on.”. I looked at him and I said, “Well, without doing a full workup on you, I don’t know exactly what’s going on with you, but I can certainly speak to what IBS and IBD are and how they generally happen.”.

So in a nutshell, when we’re thinking about gut health, it’s not just about your gut. I said to this gentleman, I said, “your gut is largely controlled by your nervous system. So the fact that you tell me you have irritable bowel syndrome and then potentially irritable bowel disease tells me there’s something quite significant happening in your nervous system and that may have been going on for quite some time.”. And he looked at me. And so I continued and I said, “well, because in a nutshell, the body (at its very bottom rung – its very basic level), there are two functions that are happening simultaneously: Your digestive system delivers the nutrients to the internal aspects of the body, for the body to be well and to maintain itself into correct imbalances. And then the other side, which is the nervous system that largely controls the gut function.

So if our nervous system is out of balance, in other words, we have stress running in the background and that stress negatively impacts the function of our gut. So then our gut can’t adequately digest the foods that we eat – it can’t absorb the nutrition from that food properly to deliver those nutrients across the gut lining into the bloodstream, so those nutrients can become the tools to effectively heal the gut cells at the end of the day. So as stress is running, gut function is limited. And, in a nutshell, when we think about the gut and we think about the health of the gut, what is involved in digestion so that we can absorb the nutrition. Well, first off, we put food into our mouth and we assume often that it’s in our body… It’s not. It’s just in the first tunnel going through the mountain of your body, so you put food in your mouth. And when your gut is functioning optimally, the saliva that you make starts to break down the carbohydrates in your food and your teeth chomp and break apart that food, and then you swallow it down the waterfall of your oesophagus, which is this tube connecting your mouth down to your stomach and it goes splash into the pool of stomach acid in your stomach. Well, we only have stomach acid if we’re in a restful and digestible state in our nervous system.

So, bringing it back to that other function of gut health, which is the nervous system, our nervous system has two speeds: sympathetic, dominant state (which is fight or flight stress response), and parasympathetic, which is rest and digest.

We are evolved to be in parasympathetic state.

We are meant to be there 99.99% of the time, but we don’t live there. We tend in our world to live in a sympathetic, dominant state. Fight or flight. And literally speaking, fight means fight for your life or flight and run like hell for your life.

So, when you go into fight mode, sympathetic, dominant, sympathetic, dominant state, anything that is non essential to see your survival in that moment within the body does not function optimally. So if we think about that, when you go into fight mode, it is all hands on deck to save your life in this moment.

So, your musculoskeletal system will work, your muscles move in the bones, your heart well, pump the blood to the lungs to get the oxygen to burn up. To provide the fuel to those muscles to move the bones. Your brain will work to react and get you out of the situation. But digestive health is not not a priority. Detoxifying the body, not a priority. Balancing the microbiome, the collection of microorganisms that live within that gut to keep that gut functioning healthy and well, if not a priority when you’re fighting for your life.

The problem is that we end up stuck in this fight mode, so as a result, digestive function over time shuts down and stops functioning optimally. We won’t make that saliva properly to break down our foods because it is not a priority when we’re fighting for our lives. Nobody is spitting saliva on a sabre tooth tiger to win. And unfortunately, in the nervous system, the body does not know the difference between a true threat for survival. Sabre tooth tiger. Warring tribes starvation. Poison. Any perceived threat. Negative thought, negative emotion. Oh my God, I’m going to be late for work, Oh my God, I don’t even have a job anymore, I’ve just been put on lockdown, Oh my goodness gracious, I don’t think my husband loves me. What if he’s having an affair?

Any negative thought, any negative emotion, has a negative impact on the gut function. The production of digestive enzymes, saliva, stomach acid, pancreatic digestive enzymes, liver gallbladder bile. Stress has a negative impact on the health and vitality of the microorganisms within the gut, whose job it is to maintain the health of that mucous membrane of the gut, which protects your digestive cells and enables the proper digestion and absorption of nutrients across the gut barrier. So the minute stress fires, digestive function is limited, but we continue to eat in those moments. We continue to put food into our mouth and swallow it down the dry waterfall of our oesophagus at this point and into the stomach. But we don’t properly digest that food or kill the microorganisms that would be deleterious or detrimental to our health because we don’t have the stomach acid.

The food then leaves the stomach and enters the small channel going into the start of the small intestine. Not properly broken down, not properly digested. So the food is not in a form capable of absorption at this point. And all of that has to do with the fact that we were in a stressed out state, conscious or not, because a lot of the triggers for our stress are unconscious to us. As I’ve learned from my training and then my clinical experience, our predominant stress pathway is largely laid down when we’re children.

So, the triggers for our stress, for many of us, are no longer conscious. We’re not aware that we’re running a stressed picture for ourselves, but our gut is and it is no longer functioning optimally in those moments.

So, the stressors can be a true threat. They could be a food sensitivity, they can be chronic illness, they can be toxins in the bloodstream, they can be immune dysfunction, they can be caffeine, they can be sugar, they can be boot camp. There are all sorts of things that create stress for us on our body only has two speeds. When it comes to stress, it’s either fight or flight, rest and digest. So the minute we’re triggered into fight mode, digestive mode shuts down. And this is the foundation of irritable bowel syndrome resulting down the road, potentially in irritable bowel disease. So ultimately, I said to this gentleman, I said, “If you want to look at what is running this picture for you and how to correct it, we can’t just treat your gut. It’s not just going to be about establishing a healthy microbiome, it’s not going to be just taking digestive enzymes or aids to support that gut picture. Because if we don’t treat the nervous system simultaneously, it will continue to unravel the work we’re doing on the gut.”

So what I said to him is “Think of your body as a canoe” (and this is one of my most favourite analogies that I share with my patients. And it’s really only come to me in the last year and a half through this pandemic)…

My body is a canoe. And it’s a small canoe, but I only need enough space for one. I do not control the water on which my canoe floats. I don’t control what’s going on around me, but I do have say over the sea worthiness of my boat.

And so the canoe is my health, and if my health is one gunnel of that canoe is my nervous system, the other gunnel of that canoe is my gut. My gut is responsible for breaking down the foods I eat and delivering the tools across the gut barrier to support my body to stay well. It can only function if my nervous system is in check. So when the water gets rough? Get off the seat of your canoe. Sit your ass down in the bottom of the boat. Hold on to your stress response and keep it in check.

Navigate your nervous system with the other hand, stick it firmly on the rail of your gut health, your microbiome, the food you eat, how well you digest and hold. Hold those rails firm and strong and your boat will float.

We have a ton of tools in the naturopathic medicine world to support navigating the health of your ship, to stabilise both the nervous system and support the well-being of your digestive system so that your boat remains afloat, regardless of what is happening in the water beneath you.

Thank you so much for spending this time with me and joining this conversation, if any of the things that you’ve heard today have landed with you moved, you resonated with you and you’d like to pipe in, I would sure love to hear from you. Some of the best conversations happen right in the medicine house with me and the easiest way to do that. Pop over to the website www.doctorschoiceintegrative.com. Book a discovery conversation with me (it’s called a discovery call) and it’s a complimentary 15 minute slot where we can explore health together. I’d love to do that with you. Hope to see you there.