Irritable bowel syndrome (IBS) is a problematic diagnosis. Many people who are diagnosed as “IBS” actually have a condition alternative doctors call “dysbiosis.” Dysbiosis means disrupted intestinal flora, and the symptoms are identical to those of "IBS": unexplained cramps, bloating, gas, diarrhea, digestive distress, intestinal fullness and the feeling that “things aren’t right in there.” Food intolerances and a very limited diet are also often part of the clinical picture.

Dysbiosis is usually accompanied by chronic recurrent intestinal infections. Though the most common causative organisms are bacteria, fungal forms and parasites are often present as well.

IBS is what I call a “garbage can diagnosis.” By this I mean it is used when all the usual tests fail to reveal a specific cause for the patient’s symptoms. Having excluded all the other diagnoses, the doctor--unable to admit he doesn’t know why the patient has these symptoms--desperately needs a label. “IBS” to the rescue! Ask any doctor what "IBS" means in terms of pathophysiology (i.e., causation) and you will draw either a blank stare or some hand-waving description of turmoil involving neurotransmitters, disrupted nervous system function, and psychic imbalance. Though this may sound good, it is meaningless in terms of defining the problem.

“Irritable bowel syndrome” is more a descriptive term than a diagnosis. Okay, so the “bowel” is “irritated.” What’s causing the “irritation”?

In my experience, most people with these kinds of symptoms have diagnosable and treatable infections. However--and this is where mainstream internists and gastroenterologists usually miss the boat--these patients also have a disturbed intestinal ecosystem.

Disturbed intestinal ecology, or dysbiosis, occurs when the protective intestinal flora is damaged. The mucosal surface lining a healthy intestinal tract is normally “infected” with over 400 species of microbes, but the predominant forms are the “probiotic” bacteria: Lactobacillus acidophilus, Bifidobacteria, and E. coli species. These bacteria help us to maintain health in numerous ways, and without them we are in (am I actually saying this?) “deep do-do.” Probiotic bacteria prevent overgrowth with pathogenic bacteria, reduce inflammation, upregulate antibody production, assist in digestion, play a role in recycling hormones, protect and enhance immune function, and strengthen intestinal mucosal barrier function, to name just a few.

In order to facilitate rapid absorption of nutrients from the food we eat, the surface area of the intestine is large, perhaps the size of two tennis courts if laid out flat.

When our healthy flora is damaged, unwanted (“dysbiotic”) bacteria move in and set up shop in (“colonize”) the mucosa. They use the living space and eat the food that was meant for the good guys. These are often putrefactive and fermentative bacterial forms, so they cause gas and smelly bowel movements. And the body knows they shouldn’t be there, so it speeds up peristalsis (the waves of muscular action that push food along) in an attempt to expel them. This is what causes the loose movements and diarrhea.

An equally important feature of the disturbed gut ecology (i.e., the dysbiosis that is mistaken for IBS) is damage to the immune cells that line the intestinal tract. Because the intestinal contents pose our largest threat from the “outside,” most (80%) of the immune cells (lymphocytes) in our bodies are positioned there to protect us from the toxins, bacteria, viruses allergens and other undesirable chemicals that can be found in the bowel contents.

It is important to realize that the contents of the intestinal tract, are outside our body. The mucus membrane lining the bowel separates those contents from the inside of the body. When this membrane is damaged and dysfunctional, as in dysbiosis, unwanted bugs can grow there and unwanted materials (allergens and toxins) can slip past this membranous barrier and gain entry to the bloodstream, which then takes them everywhere else in the body.

Intestinal inflammation and infection damage the protective flora--the Lactobacillus acidophilus and (more importantly) the Bifidobacterial populations that occupy the mucosal surface of the intestinal tract. The good bugs are replaced by the bad, and the consequences are disastrous.

Once the flora is damaged, it is very easily reinfected with “bad bugs” because the protective good species are not implanted on the mucosal gut surface. When a large percentage of this intestinal membrane has become infected with unwanted, dysbiotic microbes, any or all of the symptoms of “IBS” are likely to appear: nausea, gas, bloating, diarrhea, cramps, and ongoing or recurrent food intolerance.

The double whammy of immune damage and chronic inflammation creates an ongoing susceptibility to frequent and recurrent infections or ongoing bad bug dysbiotic infections. These infections are often mistaken for--or accompany--true IBS.

A compromised mucosal surface allows toxic material and partially digested food molecules to gain entry to the bloodstream and general circulation, so we also often see systemic symptoms. These include systemic immune stress, liver toxic overload, allergic symptoms, autoimmune arthritis, and other symptoms.

Mainstream gastroenterology is, for the most part, oblivious to these kinds of issues. The medical labs they use do not have the training or expertise to identify the problem, and it is a waste of time and money to do their kind of microbiological testing. The only lab I recommend for this purpose is Great Smokies Diagnostic Laboratory (1-800-522-4762), and the test to do is their Comprehensive Digestive Stool Analysis (CDSA). This test requires no visit to a lab; you can do it at home.

Armed with the information from the CDSA, your alternative doctor can work with you to get your bowels back to functioning properly again. It takes time and work. The basic strategy is to 1.) kill the bad dysbiotic bugs (we use both natural (Tricycline or Tanalbit) and/or drug antimicrobials), 2.) repopulate with probiotic microbes (acidophilus or Probiotics and Bifidobacteria), 3.) removal of food allergens (which irritate and inflame the mucosa and encourage the bad bugs) with digestive enzymes, and 4.) herbal nutritional medicines like Earth Dragon that support the healing of the intestinal mucosa and other aspects of digestive function.

Since a healthy body depends on a healthy intestinal tract, it is important to identify and treat dysbiosis--whether or not it has been misdiagnosed as "IBS."