Why am I so uncomfortable?

The technical term for digestive discomfort is "intestinal dysbiosis," which means that there is an imbalance of the "good" and "bad" bacteria in the bowel. There are several causes of intestinal dysbiosis, however for our purposes I am just going to give you a brief summary of the more "natural" causes: Inflammatory Bowel Disease, Irritable Bowel Syndrome, genetics, allergies, and hormonal imbalance. The reason for this is to clarify the differences between these causes, as there seems to be a common misconception that they can be the same thing - for example, I am quite often asked if my Fructose Malabsorption means that I am allergic to foods containing fructose, but this is not the case.

INFLAMMATORY BOWEL DISEASE

Inflammatory Bowel Disease (IBD) is an autoimmune response, causing inflammation of the intestines, however the root cause is unknown, and there is currently no known cure. IBD comes in two forms: Ulcerative Colitis, and Crohn’s Disease. Ulcerative Colitis is the less severe of the two forms, affecting only the inner lining of the large bowel, whereas Crohn’s Disease affects the full thickness of the intestinal wall, and can manifest in any part of the digestive tract. The symptoms of IBD include abdominal pain, diarrhea, nausea, weight loss, constipation, malnutrition and fatigue; and, if not properly managed and treated, can lead to bowel cancer. IBD is treated using daily medication, and sometimes dietary changes.

IRRITABLE BOWEL SYNDROME

Irritable Bowel Syndrome (IBS) is most commonly caused by the bowel being sensitive to certain foods. Common food sensitivities include lactose intolerance, fructose malabsorption, and non-Coeliac gluten sensitivity. However, the root cause is also unknown, and there is no known cure. The symptoms of IBS include bloating, flatulence, stomach aches, nausea, and diarrhea. IBS is usually treated through dietary changes.

GENETIC FORMS OF FOOD SENSITIVITY

While commonly thought of as a form of IBS, as the symptoms and treatments are very similar, Coeliac Disease does not fall under the umbrella of IBS. The root cause of Coeliac Disease is genetic, although environmental factors can also trigger the onset of the condition. Coeliac Disease is an autoimmune response to gluten, which causes the intestinal lining to become inflamed, but there is also no known cure.

There is also a genetic cause for sensitivities to fructose and lactose, called Hereditary Fructose Intolerance (HFI) and Congenital Lactase Deficiency. Both of these involve the body not being able to produce the enzymes necessary to break down fructose or lactose. Like Coeliac Disease, the symptoms and treatments are similar to for IBS, which also means that misdiagnosis as IBS is very common. There is no known cure for either of these, and the most effective treatment is to avoid all problematic foods. If not properly managed, these diseases can cause symptoms such as liver or kidney failure, and in extreme cases, may even be fatal. 

ALLERGIES

Allergies are caused by an immune response to what the body perceives as foreign substances, called “allergens.” Common allergens include nuts, shellfish, animal fur, dust mites, pollen, and so on. Allergies generally have genetic causes, and can range from being very mild to life threatening. Symptoms can include hay fever, skin rash, asthma, swelling, and vomiting, and in severe cases, anaphylaxis. Allergies are treated using antihistamine medications, and in some cases specific allergen immunotherapy, which can change the body’s immune response to certain allergens.

HORMONAL IMBALANCE

Hormones are used to regulate the body's chemical processes and functions, but sometimes they can become disrupted, and this can have a significant impact on the digestive tract. There are two main causes of hormonal imbalance: stress, and sex hormone cycles (i.e. cyclical changes in testoterone and oestrogen) - yes, hormonal imbalance can affect digestion for both men and women. The digestive symptoms of hormonal imbalance are very similar to the symptoms of IBS, which means that it can often be difficult to differentiate between the two. Hormonal imbalance can be treated through stress management, hormone therapy, or changes in diet.