A Case of Bad Irritable Bowel Syndrome

– Michael Franklin, The IBS and Gut Disorder Centre

Susan was a 35-year old from Lanacashire who consulted me in the summer of 2005 with extremely bad abdominal pain, bloating, and diarrhoea. She gave all three symptoms 10 out of 10 on the scale which we ask people to use in our questionnaires. She also complained of heartburn, indigestion, and PMT. Amazingly, even though the symptoms had started when she was 15, Susan had had to put up with them for twenty years and had never found an answer.

She had been to various GPs and was not able to give any of them more than a 1 out of 10 on the GP rating scale we use in our questionnaires.

A very bright person, Susan had read French and German at Oxford, but her IBS symptoms had been so bad that it spoilt her time as a student and she did not have particularly happy memories of the experience.

Like a lot of people with IBS, Susan had read several times that it is associated with stress. My feeling about this is that stress seldom causes any symptoms or illness but it does, of course, exacerbate them. To blame many people’s IBS on stress alone is to do a great dis-service to thousands of sufferers. There is almost always a sound physiological reason or reasons for their symptoms: the difficulty is to find that reason.

Since I founded the IBS and Gut Disorder Centre three and a half years ago, and after practising as a nutritionist for twelve years, I’ve always maintained that the four major causes of IBS are:

Food Intolerances
Candida or other yeast infections
Unfriendly bacteria

Sometimes only one is to blame. In many cases two, three, or even four of these causes are all present in the same person. Unfortunately, people seldom look at more than one. That’s analogous to having four nails in your shoe – if you only get rid of one of them it will still hurt to walk!

The NHS does not look for any of these causes. What usually happens when you go to your GP complaining of constipation, diarrhoea, bloating, or abdominal pains, is this: your GP will try to establish whether the symptoms are bad enough to suggest Ulcerative Colitis, Crohn’s Disease, or advanced stages of cancer. If they do not sound like any of these, he will merely tell you that you probably have irritable bowel syndrome and that there is not much you can do with it. “You will have to learn to live with it” is a common remark.

If he does suspect any of the three latter illnesses, you will be referred to a gastroenterologist who will probably test you with the aid of a camera on the end of a tube which goes down your throat, or up from the other end. If it shows nothing, he too will tell you you have IBS and that there is probably nothing you can do about it.

This is the stage at which most IBS sufferers come to us. Sometimes we can sort out their symptoms just by recommending changes to their diet and treating them for yeast overgrowth with the aid of natural antifungals, the best possible probiotics to restore friendly bacteria, and the right product to heal intestinal permeability, sometimes known as ‘leaky gut’. Where the causes are not obvious from the three lengthy questionnaires we use, then we test the patient for food intolerances by means of a blood test (the only scientific way to test for food intolerances), or use the Comprehensive Digestive Stool Analysis to look for any or all of the major causes: parasites, unfriendly bacteria, candida, or yeast overgrowth.

In Susan’s case, partly because she did not have too much money to spend, and partly because of her answers in the questionnaires, I thought I would try and improve her symptoms just with the aid of probiotics and by changing her diet.

Susan told me that when she was a child milk made her retch and feel awful even though she did not remember actually being sick. Hearing this from a patient is very significant because it often suggests either dairy or full-blown lactose intolerance from an early age. Often, in spite of their early bad experiences with milk, the patient will have started drinking it again in their teens or, even if they have not gone back to milk, will have become a big cheese or yoghurt eater.

This was the case with Susan. In spite of her early childhood experiences, she now ate both cheese and yoghurt every day. I suggested she remove all cow’s milk dairy products from her diet along with the two food groups which encourage yeast overgrowth: sugar and yeast. In Susan’s case this meant giving up the one or two glasses of red wine she had every evening, and avoiding bread, as both of these are major sources of yeast. I also told her to avoid all fruit juice as this is a very concentrated source of fruit sugar, and to eat no more than three small portions a week of particular fruits that are low in fructose.

When I next spoke to Susan, only eight weeks later, she reported that the change had been extraordinary. She said, “My life has been transformed. I’m SO much better. I can’t believe the difference, my life has truly changed!”

Not all cases of IBS are quite so easy to solve. Where we think, on the basis of a patient’s questionnaire answers, that they very possibly have parasites or unfriendly bacteria, then we order a test for these. But where, as in Susan’s case, the questionnaire answers suggest Candida and food intolerances, the solution can be very quick to find and the results remarkable.

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Visit The IBS and Gut Disorder Centre on the Web at, or call 0845 456 0944.

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