IMAGINE HAVING A CONDITION with symptoms so severe that you can’t leave the house, yet your doctor calls it a “functional,” or “psychosomatic,” disease — meaning that it’s all in your head.
But it’s a very real problem for the 60 million people — that’s 20 percent of Americans — who have irritable bowel syndrome (IBS). These people are plagued by uncomfortable and often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain.
I have many patients with IBS, some of whom have suffered for decades without relief. Their previous doctors couldn’t find the cause of the illness, so they were told to just get more fiber or take Metamucil, or were prescribed sedatives, anti-spasm drugs, or antidepressants.
That is NOT the answer. Most of those treatments don’t work, because they don’t address the underlying causes of why your digestion is not working. Emerging research has helped identify the underlying causes. For over 15 years I have been successfully treating irritable bowel syndrome and other digestive conditions using a very simple methodology based on functional medicine that helps identify and remove the underlying causes and restores normal digestive function and health.
Today, I am going to share 5 steps you can follow to cure IBS. But first I want to tell you about a patient of mine …
Alexis and Her Lifelong Irritable Bowel
At age 45, Alexis had suffered from IBS for 33 years — almost all her life! Her major symptom was sudden, painful, cramping diarrhea. She was doing the best she could to prevent it. She didn’t consume dairy, didn’t drink or smoke, and took Citracel every day. Yet nothing helped.
She would go to the bathroom 4 to 5 times before she even left the house in the morning. And she couldn’t go out of the house at all without knowing where all the closest bathrooms would be in case she had what she called “s— attacks.” That wasn’t Alexis’ only problem … She also felt full and bloated after every meal, which starchy foods made worse.
She had taken many antibiotics over the years and had many yeast infections. An upper endoscopy or scope into her stomach had shown that she had gastritis, or inflammation of the stomach. She also had severe premenstrual syndrome (PMS), with irregular periods, breast tenderness, sugar cravings, headaches, and agitation. She also had unusual symptoms like rectal itching (often a clue to yeast infections or food allergies). And she was tired all the time.
Alexis tried to eat healthy, but her diet was less than ideal. She had a bran muffin and coffee in the morning and a salad for lunch. But her “drug of choice” was sugar — in the form of cakes, ice cream, Jell-O, diet sodas, and other junk food. Not surprisingly, she was also about 20 pounds overweight.
To help Alexis, I simply identified and treated the UNDERLYING CAUSES of her digestive problems! To understand how I did that, you first have to understand a little bit about how the gut works.
These are the two main causes of IBS: Food allergies and overgrowth of bacteria in the small intestine.
How Gut Imbalances Can Lead to IBS
Imagine a tennis court. That is the surface area of your small intestine, where food is absorbed. Your small intestine is also the site of about 60 percent of your immune system. And this sophisticated gut-immune system is just one-cell layer away from a toxic sewer — all of the bacteria and undigested food particles in your gut.
If that lining breaks down — from stress, too many antibiotics or anti-inflammatory drugs like aspirin or Advil, steroids, intestinal infections, a low-fiber, high-sugar diet, alcohol, and more – your immune system will be exposed to foreign particles from food and bacteria and other microbes. This will trigger and activate immune response, allergy, and will irritate your second brain (the enteric nervous system) creating havoc that leads to an irritable bowel, an irritable brain, and other system wide problems including allergy, arthritis, autoimmunity, mood disorders, and more.
The microbial ecosystem in the gut must be healthy for you to be healthy. When your gut bacteria are out of balance — when you have too many pathogenic bacteria and not enough healthy bacteria — it makes you sick. You’ve got about 3 pounds of bacteria — 500 species — in your gut. In fact, there is more bacterial DNA in your body than there is human DNA! Among all that gut bacteria, there are good guys, bad guys, and VERY bad guys.
If the bad guys take over — or if they move into areas that they shouldn’t (like the small intestine which is normally sterile) — they can start fermenting the food you digest, particularly sugar or starchy foods.
This is called small bowel bacterial overgrowth, and it’s a major cause of IBS.
The major symptom it causes is bloating, or a feeling of fullness after meals. What causes this bloating? The overproduction of gas by the bacteria as they have lunch on your lunch!
Small bowel bacterial overgrowth can be diagnosed by a breath test, which measures gas production by the bacteria, or by a urine test that measures the byproducts of the bacteria after they are absorbed into your system.
Bacterial overgrowth is a real syndrome and was recently described in a review paper published in the Journal of the American Medical Association.(i) The condition can be treated. In fact, a major paper was recently published in the Annals of Internal Medicine that showed using a non-absorbed antibiotic called rifaximin for 10 days resulted in a dramatic improvement in bloating and overall symptoms of IBS by clearing out the overgrowth of bacteria.(ii) This medication is now under FDA review for approval as a new treatment for irritable bowel syndrome.
That’s great news for many IBS patients. But, unfortunately, not all patients with the same diagnosis are created equal. There’s more than one factor that leads to IBS. Another major cause of IBS is food sensitivities. Not true allergies, but low-grade reactions to foods that drive so many chronic symptoms including IBS.
A landmark paper, was recently published in the prestigious British medical journal Gut that found eliminating foods identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms.(iii) Another article, an editorial in the American Journal of Gastroenterology, stated clearly that we must respect and recognize the role of food allergies and inflammation in IBS.(iv)
So the research tells us that these are the two main causes of irritable bowel — food allergies and overgrowth of bacteria in the small intestine — but there may be others, including a lack of digestive enzymes, parasites living in the gut, zinc or magnesium deficiency, heavy metal toxicity, and more.
And this is precisely why it is so critically important to personalize treatment based on the unique circumstances that exist for each person who suffers from IBS — the solution is most certainly not one-size-fits-all. But solutions can be found if we look carefully at the underlying causes and treat them.
Which leads me back to Alexis …
How I Helped Alexis Heal from IBS
I prescribed Alexis a non-absorbed antibiotic, an antifungal drug for her yeast problem, and had her eliminate the foods to which she was allergic. I believe in treatment that addresses the underlying cause of the problem. If there is a bacterial or yeast infection, then medications are often the best treatments. The key is to effectively treat the cause. If medications do that, then I use them.
Then I gave her supplements of healthy bacteria to normalize her gut and zinc to help with her digestive enzymes (chronic diarrhea can result in zinc deficiency).
I also gave her extra fiber to feed the healthy bacteria, fish oil to reduce gut inflammation, a multivitamin, and herbs to balance her hormones (which are greatly affected by abnormal bacteria).
What happened then may shock some, but I wasn’t surprised. It is the same result I have seen in patient after patient when the principles of functional medicine are applied …
Alexis came back to see me two months later, and she was a different person. Not only did she lose 20 pounds, she had not had a “s—- attack” and was having normal bowel habits for the first time in 33 years! She also had more energy, and her PMS vanished.
She looked and felt 10 years younger and was free of the suffering she had endured for over three decades.
Do you have to suffer like Alexis did? No. We have the science, the understanding, and tools to deal with this chronic problem and the suffering it causes 1 in 5 people. There is no need to wait for any more studies. I have been treating IBS in my practice for over 15 years with dramatic success.
In fact, just recently, one of my patients told me that, for the first time in his life, he didn’t have any more stomach pains or digestive problems. He had previously been so bad that he had to have a phone installed in his bathroom!
To take advantage of these discoveries today, simply follow these five steps.
5 Steps to Curing IBS
- Get tested. Try to get a test for IgG food allergies and eliminate the foods that test positive for 12 weeks. Or simply try an allergy elimination diet for a few weeks.
- Test yourself. If you can’t afford the test mentioned above, then just eliminate the most common food allergens for 12 weeks — that’s dairy, gluten, yeast, eggs, corn, soy, and peanuts. And then reintroduce them to see if they cause symptoms. This is an effective way to isolate the foods that may be causing you problems. I have created a simple program to follow based on a comprehensive elimination diet called The UltraSimple Diet.
- Get rid of the unwanted visitors in your small bowel. Ask your doctor to prescribe rifaximin (Xifaxin) and take two 200 mg tablets three times a day for seven to 10 days. This is often the best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome. You may also need an anti-fungal such as nystatin or fluconazole for two to four weeks.
- Repopulate your digestive tract with good bacteria. I don’t usually recommend brands, but when it comes to probiotics the quality varies so much that I suggest taking two specific brands. Take one packet of VSL3 or other high potency probiotic twice a day for one to two months. This probiotic has over 450 billion organisms per packet. I also recommend a probiotic called S. boulardii take two capsules twice a day for two months. This is a special probiotic that helps to further normalize gut function.
- Try digestive enzymes with meals to help break down food while your gut heals. You also may benefit from nutrients that help heal the lining of the gut including fish oil, GLA (from evening primrose oil, zinc, vitamin A, glutamine and others.
By taking these steps and seeking out the underlying causes of IBS, you can dramatically improve your health and overcome your digestive disorder.
Please leave your thoughts by adding a comment below—but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!
To your good health,
Mark Hyman, MD
References
(i) Lin, H. (2004). Small intestinal bacterial overgrowth. The Journal of the American Medical Association. 292:852-858.
(ii) Pimenetel, M., Park, S. Mirocha, J. Kane, S., and Y. Kong. (2006). The effect of nonabsorbed oral antibiotics (rifaximin) on the symptoms of irritable bowel syndrome. Annals of Internal Medicine. (145)8:557–563.
(iii) Atkinson, W., Sheldon, T.A., Shaath, N., and P.J. Whorwell. (2003). Food elimination based on IgG antibodies in irritable bowel syndrome: A randomized controlled trial. Gut. 53:1459–1464
(iv) Shanahan, F. and P.J. Whorwell, M.D. (2005). IgG-mediated food intolerance in irritable bowel syndrome: A real phenomenon or an epiphenomenom? The American Journal of Gastroenterology. 100:1558–1559.
I have been diagnosed with IBS and have tried many different diets etc. I am currently on the ultrasimple diet and have been eating quite a few nuts as a snack to help me stay away from sugar. I have been experiencing excessive gas and I am wondering if the nuts would cause that. I have heard of soaking them to help with digestion and I would like to know your suggestions on this.
Hi Susan,
Yes, we suggest soaking some nuts- like almonds for example to increase digestion and metabolism. Thank you for your interest in Dr Hyman’s work.
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Hi, Could you give an alternative to rifaximin (Xifaxin) as I don’t think this is available in Ireland.
Thank you.
Hi Sonia,
Have you tried addressing your symptoms with diet, probiotics and enzymes? It is best to work with a local functional medicine provider who can order you the appropriate tests to diagnose if you have yeast or bacteria in the gut. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you in Ireland who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org/practitioner_search.aspx?id=117 and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
This is so eye opening. I’ve suffered for years. Had an endoscopy and colonoscopy last year, basically the doctor told me it’s all in my head. He told me to take Medamucil and that was is. No follow up treatment. I’ve been to 3 doctors in the last few years and they have all told me the same thing. I am still suffering, that’s how I found this page. I’m glad I did. Now I have to find a local doctor who will help me. My social life is non-existant now because of my ibs issues. I get anxiety going new places because I’m unsure of where the bathrooms will be which only makes my symptoms worse. Thanks for the information!
Good article! I wonder why it’s titled “5 Simple Steps to Cure IBS without Drugs” when step #3 is “go ask for drugs!” ?
Hi Sam,
While Dr Hyman does talk about certain Rx medications here, the use of this antibiotic (Xifaxan) is the best available treatment for small bowel overgrowth and is well worth the investment in your health.
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Is there any risk in ‘sterilizing’ your gut using Rifaximin? I have the prescription but am nervous to use it because I was warned it might eliminate TOO many bacteria and leave you at risk for further bad bacterial infections. Thoughts?
Hi Sarah,
You should follow your Doc’s prescription and inquire about supplementing with the appropriate gut-healing nutrients (probiotics, enzymes, zinc etc.) Please see the article for the protocol Dr Hyman suggests.
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Helpful information. Lucky me I discovered your web site unintentionally, and I’m surprised why this coincidence didn’t happened earlier! I bookmarked it.
Hi, what do you recommend for IBS-S? I’m taking fiber/magnisium/vitamin D/ginger root supplements, exercise 4 times a week, drink lots of water (pop/soda only few times a year), take a probiotic every day. I eat out once a week, rarely junk food, i eat 8-10 bananas and 2 lbs of apples every week, try juicing here and there. I have a hard time with sweets and consume alcohol 1-2 times a week. I’ve had IBS-S since i’ve traveled to Europe (almost 6 months now)….Would Xifaxin work for me?
Dear Sof,
Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.
Wishing You the Best of Health!
Dr. Hyman Staff
Do you take the probiotics while taking the antibiotic or do you start them afterwards?
Hi Annette,
Both! For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Hi,
I’ve been experiencing IBS symptoms since the fall.( Diarrhea) I am a vegetarian and eat very limited amounts of processed foods. No dairy and plenty of fiber. Whole grains as well. My big splurge was a bit of cheese pizza. I was recently prescribed Cipro and Flagyl for what we thought was diverticulitis. The Cipro was first for two weeks. The anal itching I had went away immediately and my stools became very normal and easy to pass and huge! Now that the antibiotics are done, I am experiencing the usual symptoms.
Did the first round of Cipro normalize my gut for a while? And did this give a clue as to what is going on.
Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.
Wishing You the Best of Health!
Dr. Hyman Staff
hi i had ibs-d for over three years,where i’m from doctors do not know anything about this sickness,i really would like to know if Dr Hyman could help me.
Hi Christopher,
Thank you for your interest in Dr Hyman’s work with IBS. Unfortunately Dr Hyman cannot provide personal medical advice in this forum. If you would like to make an appointment at Dr. Hyman’s UltraWellness Center in Lenox, MA please go to:http://www.ultrawellnesscenter.com/becoming-a-patient/ When you are finished reading through the material you may call the office at After you have reviewed this, please contact our office to make an appointment. By phone, (413) 637-9991; by email, office@ultrawellnesscenter.com
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Hi i was going to doctors for ten years now they did test but every time they told me there is nothing wrong with me,but i keep getting sicker.One doctor told me its all in my head the other said i have nerves stomach after two years treating a nerves stomach nothing changes . my stomach will cramp up making me feel like am having a heart tack sometime my body shake so much in the night my sleeping is poor my stomach pain so much and am always full am not hungry can you please help me
Hi Roslyn,
Thank you for your interest in Dr Hyman’s work. Unfortunately Dr Hyman cannot provide personal medical advice in this forum. If you would like to make an appointment at Dr. Hyman’s UltraWellness Center in Lenox, MA please go to:http://www.ultrawellnesscenter.com/becoming-a-patient/ When you are finished reading through the material you may call the office at After you have reviewed this, please contact our office to make an appointment. By phone, (413) 637-9991; by email, office@ultrawellnesscenter.com
However, our best advice for getting started today, is to work on an anti-inflammatory diet such as that in Dr Hyman’s The Blood Sugar Solution. You can get started here: http://www.bloodsugarsolution.com
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Hi,
I have IBS, I have so much gas in my stomach and thats why so much Fart goes down . I am in so Bad condition . I need to stop Fart .
will u plz plz plz plz give me some way to stop it . Please , I need your help .
Thanks in advance
HI Mas,
Thank you for your interest in Dr Hyman’s work. Unfortunately Dr Hyman cannot provide personal medical advice in this forum. If you would like to make an appointment at Dr. Hyman’s UltraWellness Center in Lenox, MA please go to:http://www.ultrawellnesscenter.com/becoming-a-patient/ When you are finished reading through the material you may call the office at After you have reviewed this, please contact our office to make an appointment. By phone, (413) 637-9991; by email, office@ultrawellnesscenter.com
In the meantime you might look into an antiinflammatory diet protocol such as those in Dr Hyman’s The Blood Sugar Solution or The UltraSimple Diet. http://www.bloodsugarsolution.com or store.ultrasimplediet.com
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
I’m 47 yr old woman with IBS problem for the last 17 yrs.After reading your article on IBS I felt I can be treated.My symptoms are— some loose motion s’time constipation, bloating dryness in the mouth after getting up from bed, dryness & itching in the upper back(fungal infect.which doesn’t go with anti fungal oint.),a small cut on the opening of left nostril for last three months, sugar craving after noon’s sleep,earlier rectum itching was there not now,perfect weight,regular in exercises. My Dr. gave Enterogermina, Pentotas-D & husk.After loose motion feels pain in the legs, weakness, main problem motion is ir-regular. I’m from India. Dr. can you help me or advice me for my problem.
Hi Preeti,
Thank you for your interest in Dr Hyman’s work. Unfortunately Dr Hyman cannot provide personal medical advice in this forum. If you would like to make an appointment at Dr. Hyman’s UltraWellness Center in Lenox, MA please go to:http://www.ultrawellnesscenter.com/becoming-a-patient/ When you are finished reading through the material you may call the office at After you have reviewed this, please contact our office to make an appointment. By phone, (413) 637-9991; by email, office@ultrawellnesscenter.com
In the meantime, you can look into the suggestions Dr Hyman has in this article:
http://drhyman.com/blog/2010/07/23/is-hidden-fungus-making-you-ill/
For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
Looks like an interesting and reasonable protocol. I am just wondering whether this has been tried also with the patients suffering from other internal inflamattory diseases, like cholangitis or pancreatitis?
Hello, I just wanted to say thank you for sharing this information on IBS. We are honoring IBS Awareness Month this April with some new posts and information about this common disorder on our medical research blog. Too many people are suffering in silence with irritable bowel syndrome, but we can help them by getting more people to openly discuss this illness. Plus as you know, one of the best ways that a person can manage their IBS is to learn as much as they can about it.
Since I have IBS the pain is not that bad anymore since the supplements I took help reduce my pain! I’m not going to give up and will keep fighting for it!