Episode 427: The Link Between IBS and Osteoporosis
The Whole View, Episode 427: The Link Between IBS and Osteoporosis
Welcome back to episode 427 of the Whole View. (0:34)
Stacy shares that she's the one who actually requested this topic.
Stacy says she has many people in her life with gut-related issues.
Yet she doesn't really know the difference between IBS, IBD, Crohn's, and Colitis.
She's not sure how she's gotten to this point. But she does know she needs to take a step forward in her knowledge base.
Stacy and Sarah talk about gut health on this show because of how important it is.
And just like the universe, the knowledge on this is ever-expanding.
Stacy believes that this topic is foundational to understanding gut health.
Sarah shares she's been researching the gut microbiome for over six years.
When she decided to write a book about it, she thought it would be the same amount of information as in her other books.
However, she's found that it changed her perspective on literally everything she and Stacy talk about.
Sarah thinks she's finally at a place in her research where she finally has a handle on the vast amount of research there is out there.
Listener Question Regarding Osteoporosis
Sarah dives in with a listener question. (5:05)
"Sarah and Stacy- I am so inspired by your podcast. My husband and I have been listening for years. We binged them all initially, and now listen weekly while preparing dinners together. We have benefited greatly from your advice and recommended products. I have Sarah’s Paleo Approach and sleep books, we use our Joovv everyday, I switched us all to safer Beautycounter products from Stacy about two years ago. So thank you for making such a positive difference in our lives!
My mother was just diagnosed with full blown osteoporosis, notably in her right femur bone. Her bone test four years ago was healthy. My question is whether her struggles with IBS and gut health might have played a role in her diagnosis, and what could she do now to improve it?"
Stacy jokes about how much she loves nice, positive, complimentary questions.
She suggests that before they get into answering the question directly, they look at the root cause.
There is a reason that osteoporosis exists, and it's something they've discussed on previous shows, as well as nutrient deficiencies.
This inevitably leads to IBS and other issues, and how that plays into nutrient deficiencies.
Stacy suggests they back and talk a bit about those other gut-related issues first.
Sarah agrees that explaining the issue is a lot like a spiderweb.
It has many different threads coming out of the middle and linking many of the other conditions.
What Are The Differences?
Sarah goes back to Stacy's questions at the beginning of the show, regarding the differences between IBS, IBD, Crohn's, and ulcerative colitis. (7:53)
IBD stands for Inflammatory Bowel Disease, while IBS stands for Irritable Bowel Syndrome.
Crohn's and ulcerative colitis are included under IBD.
What separates them is which part of the bowel is impacted by the autoimmune diseases.
Celiac disease is not characterized as an IBD due to its link with gluten as a trigger but is an autoimmune disease that causes inflammation in the bowel.
Sarah goes on to explain that IBS is a diagnosis of exclusion. It's the label given once all other bowel issues are tested for and ruled out.
Sarah expresses how frustrating IBS can be because it's such a catch-all.
You go in with an irritable gut, and when you test negative for all the things they can test for, they go, "congratulations, you have an irritable gut.
Sarah shares her personal story of getting diagnosed with IBS-C.
It can be classified as diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), with alternating stool pattern (IBS-A). People can experience:
* Abdominal pain, cramping, or discomfort
* Gastrointestinal: change in bowel habits, constipation, diarrhea, inability to empty bowels, indigestion, nausea, passing excessive amounts of gas, or urgent need to defecate
* Also common: anxiety, depression, discomfort, loss of appetite, or symptoms alleviated by defecation
Stacy asks Sarah whether the depression she spoke of could be caused directly by gut health issues or as a side effect of the symptoms' discomfort.
Sarah shares some of the research that emerged in recent years that points to possible causes.
Possible Causes of IBS
IBS might not be just one thing, but possibly a bunch of different things that all get a diagnosis of exclusion label. (16:40)
Sarah goes on to explain that the research in the last 10 years has pointed to two main possible causes that are probably closely related.
And are also a probable link to IBS and other health issues, including mental health.
Sarah says one of the most common factors causing IBS patients' symptoms is a food intolerance, with some studies reporting it in up to 89% of their patients.
Patients with IBS understand that specific types of food trigger their symptoms: usually.
These include legumes, vegetables, lactose-containing foods, fatty foods, stone fruits, and artificial sweeteners.
This includes food allergies and is studied via blood tests and trial and error removal.
Another way this is often studied and combated is by putting people on low FODMAP and gluten-free diets, which have shown greater even results.
Stacy takes a moment to underline the fact that there are medications out there that don't even have the 70% improvement rate that these dietary changes do.
Stacy wonders how many doctors are prescribing low FODMAP diets.
Sarah shares that she doesn't have those numbers, but she can say no one talked diet with her through her IBS experience.
Stacy shares when you struggle with these symptoms for so long, you don't really know what "normal" is.
Often, doctors aren't given information and description that would prove helpful because nothing is out of the ordinary to the patient.
Sarah explains that the issue here is that IBS is kind of a useless diagnosis because there are so many shades of it. 24:57
Sarah thinks that one of the things adding to this percentage of success is that many people who see improvement by going on a low FODMAP diet have never tried changing their diets before that point.
She said that the reason so many people might be responding to a FODMAP diet is that they're eliminating wheat from their diets.
FODMAP intolerance is most typically caused by gut dysbiosis, which co-occurs (chicken vs egg) with stress, poor digestion, leaky gut.
This growing body of literature shows that with IBS, there is a loss of bacterial diversity, the establishment of problematic and opportunistic pathogens-like species in the gut, a lack of probiotic species, and many other things we know are associated with health conditions in general. (26:24)
That kind of imbalance in the microbial community in the gut by itself can drive IBS symptoms but can also explain the reactions we see in dietary interventions.
About 60% of the inputs that determine what bacteria are growing in our digestive tract is diet.
And the other 40% is lifestyle, exposures (environmental toxins, supplements, drugs, hormones), stress, sleep, etc.
Sarah explains that the gut microbiome's composition can shift dramatically in just a few days or weeks, depending on what the "starting microbiome" looks like.
What happens in the gut microbiome when diet changes are made is it's finding a new equilibrium.
This eventually reaches stability in about six months.
Unknown vitamin deficiencies (such as Vitamin D), lifestyle factors, and heavy metal or pesticide exposure are also known to drive gut dysbiosis.
Sarah explains that this means you might have a gut-bacterial-profile that produces a lot more gas when you consume gluten or a FODMAP-rich food.
Sarah sums up that FODMAP intolerance is basically a measurement of gut dysbiosis.
The Unrealized Impact
Stacy shares how she's rece…