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In our previous discussions, we highlighted the crucial role of gut health in overall well-being. Now, we turn our attention to a common gut-related disorder: irritable bowel syndrome (IBS). Many of us experience symptoms of indigestion, but how can we distinguish between what is “normal” and what might be a more serious issue? How can we accurately measure and address indigestion?

The management of IBS aligns closely with our commitment to personalized, data-driven care. Since indigestion varies significantly from person to person, it is essential to identify specific food triggers through precise measurement. At NEM, we use evidence-based tools to tailor treatment to everyone’s unique needs. We are excited to introduce a new tool that can objectively measure the gases released during digestion and help manage IBS more effectively.

In this article, we will discuss:

The Basics of IBS

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder affecting about 10% to 20% of people worldwide (1). It is characterized by symptoms such as abdominal pain, bloating, and altered bowel habits (2). These symptoms are often triggered by certain foods, stress, and other environmental factors, making IBS a complex condition to manage.

While the exact causes of IBS are unclear, several factors, including genetics, gut motility issues (the movement of food in the gastrointestinal tract), increased pain sensitivity, infections, inflammation, and psychological factors, may contribute to its development (3).

Diagnosing and managing IBS is challenging due to the lack of a specific biological marker and the overlap of symptoms with other conditions (1), (4). Stress-related triggers can make diagnosing and treating IBS more complex, as stress can worsen symptoms like abdominal pain and irregular bowel movements. This overlap with other disorders can lead to patient uncertainty and unnecessary treatments. Although the Rome III criteria offer guidelines for diagnosing IBS based on symptoms, healthcare providers do not consistently use them.

Thus, understanding the complexity of IBS and raising awareness about accurate diagnostic methods are crucial for cost-effective patient care.

The Role of Gut Microbiota in IBS

A key aspect of IBS involves the gut microbiota—the community of bacteria in our intestines (3). These bacteria play a protective role in a healthy gut by either directly killing harmful pathogens or preventing them from adhering to the gut wall. However, in people with IBS, an imbalance in these bacteria, known as dysbiosis, can occur, potentially allowing harmful pathogens to trigger symptoms.

The composition of gut microbiota can change over time due to various factors, such as diet, stress, and lifestyle. These changes can influence the balance of good and bad bacteria in the gut, impacting the severity and frequency of IBS symptoms. Given the dynamic nature of gut microbiota, understanding and managing this balance plays a vital role in treating IBS.


Want to learn more about gut health? Check out this guide on nourishing your microbiome with fiber.

People with IBS often experience higher levels of anxiety and depression than those without the condition (5). Stress and major life events can worsen IBS symptoms, making the condition itself a source of stress. Chronic stress disrupts the body’s ability to maintain balance, contributing to IBS. It also affects gut-brain communication, leading to symptoms like pain, diarrhea, and constipation (6).

Stress is linked to inflammation, immune responses, and disruptions in the intestinal barrier, all of which can worsen IBS symptoms. Additionally, stress can cause imbalances in the gut microbiome (dysbiosis), which is considered a key factor in the development of IBS (7).

If you want to learn more about managing stress, read our article.

Introduction to the Gut-Brain Axis and Its Role in IBS

The gut-brain axis is crucial for understanding digestive health, especially in conditions like IBS (6). Often called the body’s “second brain,” the gut communicates with the brain through a network of neurons, hormones, and biochemical signals. This connection regulates functions such as food intake, immune response, and emotional well-being.

In IBS, the gut-brain axis becomes dysregulated, leading to symptoms such as abdominal pain, altered bowel habits, and heightened stress sensitivity (6). The gut microbiome significantly influences this interaction, creating a bidirectional relationship where the gut impacts brain function and mood, and vice versa.

Addressing stress-related IBS requires recognizing how stress affects gut bacteria, making stress management essential for alleviating symptoms. Incorporating data-driven tools like breath analysis can enhance IBS management by accurately identifying individual food triggers. Unlike anecdotal treatments, breath analysis provides a scientific, evidence-based approach that ensures patients receive personalized, effective care.

Current Approaches to IBS Management

Since there is no cure for IBS, managing the condition focuses on reducing flare-ups by identifying and avoiding triggers. Traditionally, IBS management has relied on dietary adjustments (i.e., the low-FODMAP diet), medications, and lifestyle changes. Patients often work with dietitians to identify trigger foods and develop tailored eating plans. However, this process can be time-consuming and may not always provide consistent relief.

Psychotherapeutic interventions such as cognitive behavioral therapy (CBT), hypnotherapy, mindfulness-based therapy, and relaxation techniques have shown promise in managing stress-related IBS symptoms (9). While these therapies can be effective for some, individual responses vary, and ongoing adjustments are often necessary. 

Innovative Techniques: Breath Analysis for IBS Management

Breath analysis is a promising noninvasive tool for IBS management, detecting gases such as hydrogen (H2) and methane (CH4) produced by bacterial fermentation of unabsorbed carbohydrates in the intestines (10). It can assess carbohydrate malabsorption—a common trigger for IBS symptoms like bloating, diarrhea, and constipation—allowing targeted treatments like antibiotics or dietary modifications.

While breath analysis does not diagnose IBS itself, it identifies gases contributing to key symptoms, offering valuable insights into digestive health. For example, it measures orocecal transit time (the time food takes to move from the mouth to the cecum, the start of the large intestine), which can help detect abnormal digestion patterns.

Advantages and Limitations of Breath Tests

Breath tests are practical and safe tools with many benefits (5):

  • Symptom Evaluation: Effective for assessing a range of IBS symptoms, including diarrhea, constipation, and bloating.
  • Non-Invasive: Provides a non-invasive alternative to more invasive tests like aspirates or biopsies.
  • Data-Driven Dietary Guidance: Helps guide dietary interventions by identifying specific carbohydrate intolerances.

However, breath tests also have limitations:

  • Potential for Errors: Delayed gastric emptying may result in false negatives, while rapid small bowel transit could lead to false positives.
  • Impact of Medications: Antibiotics, laxatives, and enemas may skew results by affecting intestinal flora or transit time.
  • Limited Scope: They primarily assess carbohydrate malabsorption and bacterial overgrowth, but may not address other IBS triggers or gastrointestinal complexities.

At NEM, we mitigate these limitations by considering medications, medical history, and stress levels before testing. Our approach combines breath test data with other health insights to deliver accurate and comprehensive IBS management.

What other innovative technologies are used by NEM for health management?

NEM utilizes several cutting-edge tools, including breath analyzers and continuous glucose monitors (CGMs), to offer personalized, real-time data for health management. Breath tests help identify food-related digestive issues by measuring gas levels, while CGMs track glucose responses to inform nutrition and lifestyle changes. Together, these tools provide a complete picture of each client’s health, enabling more precise management strategies.

Curious to learn more about CGM? Check out these articles: 

How NEM utilizes breath tests for clients with indigestion

At NEM, we take a precise, data-driven approach to managing indigestion through breath analyzers. Unlike traditional methods that rely on generic lifestyle changes or restrictive diets (e.g., the low FODMAP diet), breath analysis allows for more targeted identification of food triggers. This enables clients to make informed dietary choices without unnecessarily avoiding nutritious foods.

We integrate these breath test results with other health data, such as biomarkers and medication use, to provide a comprehensive, personalized plan for managing digestive issues. This holistic strategy ensures effective management of indigestion and supports overall well-being.  

Silviya Demerzhan, Ph.D.

Chief Scientific Officer, Nordic Executive Medicine
Medical review by: Dr. Mahir Vazda MD

 

References

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