Gut Health & Digestion

What is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is very common and affects about 10-15% of the general population. Symptoms can include abdominal pain, cramping, gas, bloating, diarrhea and/ or constipation. IBS may be categorized as type C (constipation) or D (diarrhea) or M (mixed). Many patients who suffer from these symptoms undergo extensive gastrointestinal evaluation including a colonoscopy without revealing obvious solutions. There is evidence that IBS is a disorder of the communication between the gut and the nervous system and falls into the category of Disorders of Gut-Brain Interaction (DGBI).

Disorders of Gut-Brain Interaction (DGBI) used to be called functional gastrointestinal disorders. From 2016 to 2026, they were diagnosed by the Rome IV criteria. In 2026, the Rome V the criteria for IBS were published and specialists are transitioning to using Rome V for diagnosis:

Recurrent abdominal pain or discomfort must be present at least 3 days per month in the last 3 months, associated with two or more of the following:

1. Related to defecation

2. Associated with a change in frequency of stool

3. Associated with a change in form (appearance) of stool

*Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis

The diagnosis is not based on any laboratory or imaging findings - therefore, many IBS patients become frustrated with “normal results” while knowing that something feels wrong.

What is the gut microbiome and gut dysbiosis?

There are trillions of microscopic organisms “microbes” (bacteria, viruses, and fungi) living in your gastrointestinal tract, predominantly in your large intestine. This living ecosystem is called your gut microbiome. The “good bacteria” help with digestion, building essential vitamins, and maintaining healthy gastrointestinal cells. When the microbiome is imbalanced, we call this dysbiosis. This can mean a decrease in the number and/ or diversity of beneficial microbes or an increase in harmful microbes.

What can cause dysbiosis?
Medications - especially antibiotics
Diet - high in processed foods and sugars, low in fiber
Stress, anxiety, lack of sleep
Environmental toxins - alcohol, smoking, pollutants

People who have gut dysbiosis may feel abdominal cramping, gas, bloating, nausea, diarrhea or constipation. They may develop GI infections with pathogenic “bad” bacteria, such as Helicobacter pylori or Clostridium difficile. In recent years, the medical world is starting to recognize the important role that the gut microbiome plays in influencing the immune system, the nervous system, and metabolism. There are been studies implicating gut dysbiosis in diabetes, obesity, inflammatory bowel disease (IBD), asthma, allergies, autoimmune diseases (rheumatoid arthritis, multiple sclerosis), and cardiovascular disease. The more we learn, the more we realize the importance of maintaining a healthy gut microbiome.

Is there a test for gut dysbiosis?

Yes! And this is one of the most common functional tests that Dr. Jennifer Tang orders in her practice because she understands how critical balancing the gut microbiome is to your overall health. A stool test done from home can analyze the bacteria and other organisms in your stool to tell us where you need help. From there, Dr. Tang will be able to create an individualized plan for you that includes dietary and lifestyle recommendations, nutritional supplements, and if needed, either pharmaceutical or botanical antimicrobials.