Inflammatory Bowel Disease (IBD) is a chronic inflammatory condition that includes Crohn’s disease and ulcerative colitis, both of which involve ongoing inflammation of the gut. It is an autoimmune condition which means that the body’s immune system is attacking its own tissue.
Symptoms are generally more severe than experienced in IBS and include abdominal pain, diarrhoea, fatigue, weight loss and sometimes nutritional deficiencies.
Once diagnosis has been achieved, the standard medical approach would be to control the inflammation using immune suppressants and corticosteroids. Whilst this approach can be highly effective at reducing the inflammation and preventing complications, it does not usually address the underlying issues that caused the condition in the first place and may lead to further imbalances in the gut microbiome and digestive processes.
A functional medicine approach to IBD looks beyond symptoms alone and focuses on identifying and addressing the root causes driving inflammation and immune dysfunction.
Microbiome imbalances
Explore microbiome imbalances including overgrowth of pathogenic bacteria, yeast and other problematic species that have been linked to IBD. This would be done via a Microbiome (stool) test.
Assess for intestinal permeability
There are some markers on the stool test that can give us clues around the state of the gut lining, for example Calprotectin and SIgA. There is also a specific gut barrier test (KBMO) which is a blood spot test which is very insightful. Working on healing the gut lining can help dampen the autoimmune cycle, reduce inflammatory toxins (LPS) moving from the gut into the blood stream and can also help improve nutrient absorption.
Assess for food triggers
I find that most patients with an IBD know what their main triggers are but there may be other triggers that they are unaware of and can be picked up in a food sensitivity test. (IgG)
Explore nutrient deficiencies
Some nutritional deficiencies can be picked up from a comprehensive health questionnaire whilst others may need a blood test. The Genova Diagnostics NutrEval test (urine and blood) can evaluate for more subtle nutrient needs where there is not enough of that nutrient to fulfil all the requirements of the cell or when the vitamin is not being activated e.g Vitamin B12.
Look at the impact of stress and how to reduce that: Stress is something that can be hard to control due to lifestyle commitments, however there are certain changes that can be made and breathing techniques that can be put in place to help switch the nervous system into the parasympathetic state of rest and repair.
Assess for hormonal influences
Hormones can have a large impact on the gut, especially in women and this needs to be taken into account during a Functional Medicine assessment considering factors such as adrenal and thyroid function, oestrogen and progesterone balance.