Confused about IBS? The causes of IBS have remained unknown, and no test existed to diagnose this common health issue–UNTIL NOW! For the first time, research shows how food poisoning causes some types of IBS, and a new test diagnoses IBS with up to 98% certainty. Find out about this groundbreaking research, if the test can help you, and read a firsthand Q&A with Dr. Pimentel, one of the tests' creators.
This post is sponsored by Gemelli Biotech. All thoughts and opinions are my own. Thank you for supporting the brands that make it possible for Root + Revel to provide free content and healthy living inspiration.
Is Irritable Bowel Syndrome (IBS) real?
For decades, IBS has been covered by a cloud of uncertainty and confusion. As a patient with IBS symptoms, you’re often told things like, “It’s all in your head,” or that “IBS is not a real disease.”
But IBS is real. In fact, it's the most common disorder diagnosed by gastroenterologists, affecting an estimated 25 to 40 million people in the U.S. alone. Women are at even higher risk than men, making up roughly two-thirds of all IBS patients. IBS accounts for up to 12% of primary care visits and costs society around $21 billion annually in medical expenses and lost productivity. (source; source)
Up until now, no test existed to diagnose IBS, making it a head-scratcher for doctors and patients alike. Symptoms existed, but there has been no clear cause or reliable markers, making it a large and expensive guessing game.
That's why when I recently heard about a new, licensed diagnostic blood test called ibs-smart™️ that can help you get definitive answers by testing for specific biomarkers of IBS in your blood caused by food poisoning, I was majorly intrigued.
How does it work? Is it reliable? How accessible is the test for the average person? Does the test finally reveal the cause of IBS?
We're answering all of that and more in this post! Keep reading for the answers.
This topic hits home for me, as I was diagnosed with IBS-C (constipation induced) and Leaky Gut a few years ago. Sarah, Root + Revel's business manager, also suffers from IBS.
In fact, quick story: when Sarah was traveling around Southeast Asia in 2011, she got extremely ill after eating some fish at a market in Laos. Not only was it a few days of debilitating fatigue and diarrhea, but after that, she says her gut has never been the same and to this day she continues to struggle with a sensitive tummy, despite doing all the ‘healthy' things she can to nourish her gut. Could it be possible that her food poisoning led to IBS and Leaky Gut?
Before we get into what exactly ibs-smart™️ is, let's recap exactly what doctors and researchers know (or don't know) about this health ailment.
What is IBS?
IBS is a health issue found in your intestines (gut). The most common symptoms are belly pain, stomach cramping, gas, bloating, chronic diarrhea and/or constipation.
There are three different types of IBS, so each person may not have the same symptoms:
- IBS-D–IBS With Diarrhea: You may often have loose stool, feel an urgent need to go to the bathroom, have cramps or belly pain
- IBS-C–IBS With Constipation: You may find it hard to go to the bathroom, may not often move your bowels, and may have an urge to go but can't
- IBS-M–IBS Mixed: You may have symptoms of both IBS-D and IBS-C
What Causes IBS?
Up until now, causes of IBS have been unknown. But with new research, we now know that IBS is an organic disease and can be caused by food poisoning.
A significant volume of research shows a clear link between food poisoning and IBS, especially IBS-D. A recent review conducted at the Mayo Clinic of over 45 studies showed that one in every nine patients who experience food poisoning develop IBS.
IBS can develop many years after the initial infection that introduced harmful pathogens to the microbiome, and many people don't remember the original instance of food poisoning that may have led to their current IBS symptoms. Just because you don’t remember the food poisoning doesn’t mean it did not happen. Sometimes food poisoning is mild and you can be confused between food poisoning and the start of the diarrhea you now consider IBS.
How exactly does food poisoning lead to IBS?
We're gonna briefly get a bit technical here.
It has to do with a toxin called Cytolethal Distending Toxin B, or CdtB for short. It turns out that every one of the most common bacteria that cause food poisoning releases CdtB.
When a toxin like CdtB enters your body, your immune system fights back with an antibody–in this case, anti-CdtB. Anti-CdtB can confuse your body into developing another antibody called anti-vinculin. This harms a naturally occurring protein in your body called vinculin that helps cells migrate and connect to each other.
This is an autoimmune response and leads to gut nerve damage and improper functioning of the Interstitial Cells of Cajal (ICC) and Migrating Motor Complexes (MMC), which regulate the contractions of your gut.
This can ultimately result in IBS-D and IBS-M, sometimes many years after the initial infection. (source)
IBS Diagnosis: Can You Test for IBS?
Up until now, IBS has always been known as a diagnosis of exclusion; this means that after extensive lab testing, studies, and procedures, everything comes back normal and so by process of elimination your doctors diagnose you with IBS. Essentially it's just a name given to a collection of symptoms that doctors have no medical explanation for.
I often joke that IBS is code for “we don't know what's wrong with you.” Which honestly is not a funny joke, as I know how debilitating a disordered gut can be.
But I believe this is why people often question if IBS is even “real”–with no specific test for it, doctors merely look at your symptoms and rule out any other diseases they can test for. So even if you’re diagnosed with IBS through a process of elimination, you’re still left in doubt without concrete, evidence-based answers.
That's why ibs-smart™️–the only licensed diagnostic blood test for IBS-D and IBS-M–is so revolutionary; doctors can now use this test to diagnose IBS by making the time-consuming exclusionary diagnostic pathway obsolete.
You no longer have to wait months or even years to receive a diagnosis–eliminating the need for costly, invasive procedures like colonoscopies and CT scans and numerous consultations with your gastroenterologist–and, more importantly, to get on your way to treatment and renewed health.
Note that this test ONLY measures IBS when it's been caused by a previous event of food poisoning; if you have IBS from another source, the test will come back inconclusive as there aren't biomarkers for IBS-C.
So, while ibs-smart™️ isn't a complete solution to IBS diagnostics, it is a HUGE step forward in our understanding of IBS and can give some patients clear answers and peace of mind about their symptoms so they can move on to treatment.
R+R Resources: IBS Treatments
Conventional medicine focuses on managing the symptoms of the disease, usually with unnecessary prescriptions and invasive surgeries. Often, even these harsh treatments provide no relief.
It can be extremely frustrating as a patient to be put through a battery of tests and procedures, only to be given no answers and STILL have your symptoms persist.
Of course, here at R+R we're all about holistic, natural approaches to healing. We've already written a post about 5 Ways to Heal Leaky Gut + IBS Naturally, so head on over to read that for more advice on supporting your gut health!
ibs-smart™️: The First IBS Test
Cutting edge research by scientists at Cedars-Sinai Medical Center in Los Angeles (ranked by US News and World Report as one of the top 10 hospitals in the nation and third in the nation for Gastroenterology) has led to the discovery that two antibodies–anti-CdtB and anti-vinculin–are elevated in the blood of patients with predominant and mixed-type irritable bowel syndrome (IBS-D and IBS-M). (source)
The doctors went on to develop ibs-smart™️, the groundbreaking blood test that measures the levels of those two antibodies in your blood to determine your likelihood of having IBS-D or IBS-M.
ibs-smart™️ is over 90% specific in distinguishing IBS from IBD (inflammatory bowel disease). If your ibs-smart™️ results are elevated, you have up to 98% certainty of having IBS–meaning you can be almost certain you have IBS and you should start treatment as soon as possible.
Your IBS Questions Answered: Q&A with Dr. Pimentel
Mark Pimentel, MD, is currently the head of the Pimentel Laboratory and executive director of the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai. He's the co-founder of Gemelli Biotech, the company that developed ibs-smart™️, and was nice enough to answer some of our burning IBS questions!
Q: What inspired you to develop the ibs-smart test?
A: For years, I saw firsthand the level of frustration patients experienced with the existing diagnostic process for IBS. They were spending so much money on tests (including invasive procedures) just to rule out other diseases. They were left with a list of negative results and an unsatisfying diagnosis. Patients would always ask: “How do you actually know I have IBS?”
I understood the struggles IBS patients experience on a daily basis. It was hard not to feel sincere empathy and I believed we needed to do better for our patients. We needed to understand the underlying pathophysiology of IBS and develop ways to rule in the diagnosis with certainty.
Q: What's the difference between Leaky Gut and IBS? What's the difference between SIBO and IBS?
A: Post-infectious IBS is caused from food poisoning, while Leaky gut refers to complications with intestinal permeability. There are theories that the infection that caused IBS can also contribute to increased permeability but there is more research that needs to be done here.
IBS is an umbrella condition and SIBO is one of the factors that can cause IBS. For example, peptic ulcer disease is an umbrella of all ulcers in the stomach. We believe the bacteria H. pylori causes 60-70% of stomach ulcers but the name peptic ulcer disease is still there.
Back to SIBO and IBS, we believe about 60% of IBS is really SIBO. But also, not all SIBO is IBS. Some SIBO is caused by build up of bacteria from bowel obstruction or adhesions, narcotic use, uncontrolled diabetes and other causes.
Q: Other than food poisoning, what are the other top causes of IBS, according to your research?
A: Unfortunately, other specific causes are not yet identified. In other words, food poisoning accounts for possibly 60% of all IBS-D (diarrhea-predominant IBS) but the remainder must have other causes.
For example in IBS-C (constipation-predominant IBS), methane from methanogenic archaea in the gut appears to be a cause. Combining these two can account for a large swath of the whole group of IBS.
Q: If someone has IBS not caused by food poisoning, will the IBS Smart test still come back positive?
A: No. ibs-smart is a marker specifically looking for food poisoning as a cause of IBS. It informs the patient and doctor of that causative factor. This is really important because we think particularly the anti-vinculin antibody component of the test may be causative (but we need more research).
Q: Once someone tests positive for IBS, what are the top things they can do to treat it? Is IBS even ‘curable'?
A: An elevated result from the ibs-smart test guides the patient and doctor to take strong measures to prevent food poisoning from occurring again. Another infection could drive antibodies to higher levels causing symptoms to worsen.
We believe that this blood test has the potential to lead to a cure, as it measures an antibody that could be causative (anti-vinculin). In addition, the levels of the measured antibodies in blood may predict a patient’s response to antibiotics.
Thank you, Dr. Pimentel! For more with Dr. Pimentel, watch this video where he and Dr. Kapil Gupta talk more about IBS!
IBS Diagnosis: How to get the ibs-smart Test
The test is only available through doctors, so talk to yours and see if this test is right for you.
Your doctor can order testing kits here. If you're not sure if your doctor offers ibs-smart, the ibs-smart team can find out for you–simply fill out this form and they'll get back to you, or email them at firstname.lastname@example.org!
For more about this process and how the testing process works, see their website here.