In this episode, Dr. Eric Osansky talks with returning guest Dr. Izabella Wentz about her new book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome. Drawing from both personal experience and clinical insight, Dr. Wentz explains why IBS is often more than just a stress-related diagnosis and how it can serve as an early warning sign of deeper imbalances, including thyroid autoimmunity.
The conversation explores the difference between IBS and inflammatory bowel disease, why some people diagnosed with IBS may actually have celiac disease or IBD, and the many possible root causes behind chronic digestive symptoms. Dr. Wentz discusses food reactions, SIBO, parasites, H. pylori, medications, nutrient deficiencies, thyroid hormone imbalances, stress, and lifestyle factors that can all play a role in gut dysfunction. She also shares why testing matters, why symptom relief is not the same as true resolution, and why approaches like the low FODMAP diet may only be a short-term tool.
This episode gives listeners a broader, more practical understanding of how gut issues connect with immune dysregulation and thyroid health. If you want a clearer, more balanced understanding of IBS, IBD, and what these digestive symptoms may really be telling you, you’ll get a lot out of this episode.
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Dr. Eric Osansky:
I am super excited to chat with return guest, Dr. Izabella Wentz. This time, we are going to be talking about irritable bowel syndrome (IBS). She has a new book IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome. Really excited to chat about this.
Let’s first dive into Dr. Izabella’s bio here: Dr. Izabella Wentz is a compassionate, innovative, solution-focused, integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis of IBS as well as Hashimoto’s thyroiditis.
Beyond her beautiful children, her most proud accomplishment is creating a road map that has helped thousands of people get into remission via her New York Times’ bestselling books Hashimoto’s Root Cause and Hashimoto’s Protocol.
She is hoping now to help broaden the understanding of getting IBS as well as IBD (inflammatory bowel disease) into remission with her newest book IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome.
Thank you for joining us, Dr Izabella.
Dr. IzabellaWentz:
Hi, Dr. Eric. It’s so great to be here with you again. I always love collaborating with you.
Dr. Eric:
Same here. This is going to be exciting, talking to you about IBS. As I mentioned in the bio, you’re really well-known for your books on Hashimoto’s. You also wrote a book talking about your adrenals. Why did you decide to write a book specifically on IBS?
Dr. Izabella:
It sounds kind of odd. My branding has been the Thyroid Pharmacist for so long. Thyroid, IBS, what is the connection there?
I’ll start with saying there is a personal connection for me. When I was in pharmacy school, one day, I was studying for an exam. I had two exams every week and was up really late at night, eating ramen noodles with god knows what, studying.
I woke up in the middle of the night with really awful digestive symptoms, to the point where I couldn’t even go to school that day, and I had to miss my exam. My lovely teacher said I needed to get a doctor’s note, so I went into my physician’s office, my primary care doctor, and he said, “You have IBS. This happens when you’re stressed out. You’re in pharmacy school. This is a really high curriculum.”
I had 40 hours of classes every week, and I had two exams every week. It was a pretty intensive process the first three years of pharmacy school. The last year was more clinical.
I had constant issues with having to run out of my classroom and into the bathroom. I had to carry an extra set of pants with me. It was a rough time.
That was really a big turning point in my health. With time, I ended up with additional symptoms. What started off as IBS ended up turning into anxiety. Then I had hair loss and so on and so forth.
What’s really been interesting to me is when I went through functional medicine training, IBS oftentimes precedes an autoimmune diagnosis. This was certainly the case in me. This IBS condition can actually lead us to have a dysregulated immune system. People end up with so many different conditions, where the gut is going to be at the root.
I decided to write this new book because my hope is to reach people before they get that autoimmune diagnosis. Maybe in the early stages of their autoimmune diagnosis. Many of my clients in the early stages of their autoimmune diagnosis had IBS, and we focused on getting the IBS into remission. Lo and behold, a lot of their other conditions went away.
It’s a really deep dive on gut health and all of the drivers, food sensitivities and beyond. SIBO and stress. This all can lead a person to have IBS.
Dr. Eric:
You were diagnosed with IBS prior to Hashimoto’s. How long after your IBS diagnosis were you diagnosed with Hashimoto’s?
Dr. Izabella:
Let’s see. My IBS diagnosis was in 2002-2003. The Hashimoto’s was around 2009.
Dr. Eric:
You probably had it underlying for a while before the diagnosis, I would imagine.
Dr. Izabella:
Right. When I first started working on getting Hashimoto’s into remission, I went gluten-free and dairy-free, which was part of my root cause presentation, not the only issues that were going on, but certainly getting off of those foods helped. I remember thinking, wow, it’s not supposed to hurt when you eat food? This whole time, every time I would eat food, I would be in pain. I thought that was just the normal digestive process, where you eat something and are in pain.
I also didn’t realize that I had abs. I had been going to work out. I was a big gym person, where I would go to work out. I always wanted to get a six pack, but I couldn’t. All of a sudden, I got off of those foods. Wow, where did my abs come from? I was constantly bloated. I didn’t realize that wasn’t normal.
Dr. Eric:
How common is IBS? I don’t know if you know any statistics.
Dr. Izabella:
Yes, actually. IBS accounts for 12% of visits to primary care physicians. It’s one of the most common functional digestive disorders affecting 25-45 million people just in the United States.
Dr. Eric:
Wow. 25-45 million?
Dr. Izabella:
25-45 million. That’s a lot of people.
Dr. Eric:
Yeah. How is it typically diagnosed? You probably start out with your primary care doctor. Maybe you go to a gastroenterologist. What do they use to diagnose IBS?
Dr. Izabella:
A lot of times, people think of it as a diagnosis of exclusion, which means we would do a bunch of different tests. You would test negative for everything. But that’s not what happens.
It’s a clinical diagnosis, where essentially, the physician takes a person’s medical history, self-reported clinical symptoms, and potentially, they might look at their current medications to provide that diagnosis.
When I look at the statistics of how many people get the diagnosis of IBS when they actually have Celiac or IBD, that is just wrong. Anywhere from 10-25% of people who have the IBS label might actually have one of these other conditions. There are conventionally available lab tests and diagnostics that can be done with a gastroenterologist. Most people do get their diagnosis from a primary care doc, not necessarily a gastroenterologist.
Dr. Eric:
Are you saying that it does happen where someone might be diagnosed with IBS, but they really have Celiac or IBD?
Dr. Izabella:
Yeah. In one study, 25% of people diagnosed with IBS actually had Celiac.
Dr. Eric:
Oh wow.
Dr. Izabella:
10% of people with IBD are misdiagnosed with IBS. I met people who thought they had IBS.
I remember I had this lovely woman who I met who was a professional surrogate. I was pregnant with my first child at the time. I was like, “Man, I would not do this professionally. Bless you for doing that,” giving people this wonderful gift. At the same time, I feel so terrible when I’m pregnant. “You must be one of those women who feels better when she’s pregnant.” “Absolutely, I have this horrific IBS normally, but when I get pregnant, it goes into remission.” I was like, “Oh, you know, actually that might be IBD.”
We do know that certain autoimmune conditions, IBD being one of them, can go into remission. Sure enough, she found out later she had IBD. For 10-15 years, she was told it was just IBS. Just IBS, right? Getting that proper diagnosis allowed her to get proper care.
Dr. Eric:
We were chatting before this, and you mention this in the book, too. Your husband has a history of IBD? Ulcerative colitis. Was he diagnosed relatively quickly, based on your experience with IBS? Did he get his ulcerative colitis diagnosed quick, or was it a drawn-out process?
Dr. Izabella:
Thanks for asking. It was during the time I was pregnant with our son. He just started to have some really odd symptoms. A lot of them were pain and some irritability, insomnia, some bloating. When I started going into labor, he was having some bleeding. I thought it was probably sympathy pain. “I’m busy. I can’t help you.” That didn’t resolve. We thought maybe he had hemorrhoids or something, but within two weeks of our son being born, we were like, something’s going on. Our primary care doctor said it was a red flag.
We were very fortunate to have a functional medicine doctor. This was after I had already had my healing journey and had functional medicine training. We weren’t going to see a regular primary care doctor who is too busy to talk to us. This wonderful doctor recommended my husband get a colonoscopy right away, and that revealed an ulcerative colitis diagnosis.
We were fortunate to catch it quickly, and we were also fortunate to be living in Boulder, where three of my dear friends were IBD and gut health experts. Having gone to an IFM training during my pregnancy on gut health, we developed a plan for him, and we got him into remission from IBD rather quickly, within a couple of months.
He did have a couple of flareups throughout that first year. We were able to dial everything in to really figure out what his triggers were.
The title of my book is “Finding and Removing the Root Cause of IBS.” There is an entire chapter on IBD and exactly what you need to do to get that into remission. Crohn’s, ulcerative colitis, microscopic colitis, those are all examples of IBD.
Chances are, if you’ve been told you have IBS, you actually have IBD. I want to make sure you have the proper road map for how to heal that. That will be different from treating IBS, whether you’re considering a conventional lens or a functional lens.
Dr. Eric:
With IBD, we’ll talk more about IBS, but wrapping up with IBD. Ulcerative colitis, Crohn’s, those are considered to be autoimmune conditions?
Dr. Izabella:
They are considered to be autoimmune conditions, but there is some controversy about that. To the best of my knowledge, I would consider them autoimmune conditions.
Dr. Eric:
Okay. I’ve seen both. Some say they are, and some say they aren’t. I wanted to get your opinion.
Dr. Izabella:
I’ve seen arguments for both sides, but I’m maybe going to say it’s autoimmune until I have other evidence. It is classified as an autoimmune condition as far as I know.
Dr. Eric:
How about IBS? Is there any relationship between IBS- You said earlier. There is that gut relationship. You could go anywhere you want with this question, but can you expand on what you mentioned earlier? There is the leaky gut component, that increase in intestinal permeability, the relationship between that and autoimmunity. I assume a lot of people with both IBS and IBD have that increased intestinal permeability.
We know with IBD, if you have one autoimmune condition, you’re at greater risk of developing another. With IBS, it seemed like it was. You developed IBS, and six years later, you had a Hashimoto’s diagnosis. Withclients, have you seen that also? With clients with IBS, or maybe not your clients, because you address the root cause.
Overall, the point is, if someone has IBS, it seems like they’re more susceptible to developing Hashimoto’s, Graves’, or a different autoimmune condition, correct?
Dr. Izabella:
Absolutely. They’re more likely to develop IBD or anxiety as well. There is a school of thought that believes certain cases of IBS are autoimmune. There is an inflammatory component.
In my client experience, looking at people’s histories, I do see that. They were diagnosed with IBS, and they were diagnosed with an autoimmune condition five, 10, 15 years down the road. There is this clear connection in many cases. Other times, there isn’t.
In my experience, every case of autoimmunity has three things that need to manifest in order for it to happen. That’s going to be the genetic predisposition, some kind of a trigger, as well as that intestinal permeability/leaky gut component.
What are the symptoms of intestinal permeability/leaky gut? We do know that some people might be asymptomatic. They might not have any symptoms.
For others, the symptoms might be IBS symptoms, diarrhea, constipation, bloating, pain with defecation, so on and so forth. There is going to be a large percentage of people with IBS, specifically diarrhea-predominant IBS, who also will have intestinal permeability when they are tested for it.
I’m not going to say that every case of IBS is going to turn into autoimmunity. That certainly would not be the truth. I wouldn’t be able to prove that. But there is a large percentage of people with IBS where I feel like the IBS is the message that lets us know that they have intestinal permeability, and that can lead to those holes in our gut that can lead to autoimmunity.
Dr. Eric:
You had IBS-D, it sounded like. Do you find it more difficult to treat IBS with constipation, IBS-C, compared to IBS-D?
Dr. Izabella:
I feel like there needs to be a different approach sometimes. In people with hypothyroidism, we really do need to focus on their thyroid hormone because just a little bit of hypothyroidism can cause that constipation, right? A lot of times, we are modifying things and thinking about slightly different approaches when we are treating-
My approach to health and healing is always there is this root cause approach underlying things you need to fix. There are also some symptom management tools that we need to consider for people.
For example, one of my big go-tos for constipation is going to be magnesium citrate. It is awonderful form of magnesium for constipation, not so good for diarrhea, because it does act as a gentle laxative. This might be a good starting point for a person.
If they have constipation, I might also be thinking of carnitine or thymine as potential muscle tone stimulants to help with peristalsis.
You can’t necessarily use the same bag of tricks for every kind of person with IBS. Certainly not with every symptom presentation of IBS.
My book is divided into different root causes and also symptom solutions. I actually cover acid reflux, diarrhea, and constipation, as well as bloating. Those are just so common in people with IBS.
Dr. Eric:
What are some of the IBS root causes? You mentioned food sensitivities. I’d love to have you talk about SIBO. I’ll let you take over. What are some of the things you mentioned in your book when it comes to the root causes of IBS?
Dr. Izabella:
One thing I’ll mention is there was a study done in 2011 with 303 people with. The doctor found that 98% of the time, they had treatable causes for their IBS. Some of the more common causes he found were Celiac and bile acid malabsorption. These were very common drivers.
In my experience, and from some of the research out there and the things I’ve seen personally, I could categorize it as essentially an umbrella term, where you have a label, and then you have various root causes that could be driving to those same symptoms.
Things like medications. Being a pharmacist. If somebody is on opiates, there’s a good chance they will be constipated. Imodium is an opiate derivative, and we know that is used for diarrhea and slows things down.
Birth control pills containing drospirenone as a progestin. Some of the common brand names were Yas or Yasmin. These have been found to induce IBS.
When I was in pharmacy school, if there was an exam question about what kind of side effect this medication causes, the correct answer was always digestive issues. If I didn’t know the answer, and I see digestive issues, that’s the one I’m going to pick. When in doubt, medications can really harm your gut.
Alterations instress hormone. Alterations in thyroid hormone. Digestive enzyme deficiencies, such as pancreatic enzyme deficiency. These can really lead to issues with fat digestion.
We talked about SIBO. There is also SIFO, small intestinal fungal overgrowth. Sometimes, mold can be a trigger for IBD. Toxins and chemical triggers.
Western lifestyle. Stress, alcohol use, dehydration, poor bowel habits. Not getting enough walking into your daily rhythm. I used to have this wonderful little dog. Whenever he was constipated, we would take him on a walk, and he always pooped. Same goes for humans. We have to move our hustles.
Nutrient depletions. Zinc and glutamine are two big ones when it comes to diarrhea. I mentioned carnitine, thymine, magnesium as some of the ones relevant to constipation.
Celiac is a biggie. That always needs to be considered. There are a ton of other food reactions, whether that includes high nickel foods, lactose intolerance, fructose intolerance, sucrose intolerance, alcohol, caffeine, carbonated beverages. For some people, artificial sweeteners can be really triggering for them. Some of them actually, when you eat them in high enough doses, they become osmotic laxatives, where they can cause gut irritation.
One thing that not a lot of people talk about, which I love talking about, is parasitic infections, bacterial infections, viral infections. Any kind of infection that can impact our gut wall can be potent producers of IBS and autoimmunity as well.
Dr. Eric:
A lot of potential causes, you’re right. As you know, I focus more on hyperthyroidism and Graves’. Just doing the research on antithyroid medications such as methimazole and PTU, seeing the impact that those have on the gut microbiome and the barrier. There are a lot of things. Antibiotics and PPIs, many people are aware of those. There are so many other medications that have a negative impact on the gut that we wouldn’t think of.
Dr. Izabella:
Yeah, absolutely. I advocate for anybody who is having digestive issues to do a medication review with their pharmacist to see if they have a medication that might be contributing. NSAIDs, aspirin. Metformin can be a really big driver of bile acid malabsorption and diarrhea. Various antibiotics. Sometimes, if people are overdoing it on magnesium, they can have some diarrhea. It’s a lot. We want to make sure we consider these things.
For the elderly population, that struggle with constipation, there are some medications like anticholinergics, antihypertensives, calcium channel blockers. These are all medications that I would really want to evaluate if somebody is struggling with constipation.
Dr. Eric:
Makes sense. Do you in your book talk more about not just the root causes but how people can further identify them? You mentioned that you might have to put together a medication list and run it by your doctor. When it comes to some of these other causes, there are so many that you mentioned. Does the book give some guidance on how to find and eventually eliminate some of those triggers?
Dr. Izabella:
I go through essentially the different potential triggers that a person can have. I give people a bit of a plan on what to do.
A great place to start would be eliminating foods. There are a lot of different food drivers for IBS. An elimination diet can be really helpful for determining that.
Really focusing in on your digestion next. What I mean by that is utilizing your parasympathetic rest and digest state. Potentially, not running around and eating at the same time. You want to get into that relaxation mode. Take some deep breaths. Saysome gratitude for your food. Chew your food properly to get those digestive juices going. You might want to consider some herbal bitters or digestive enzymes. That is probably the place I would start for most people.
If you don’t have symptom resolution, or if you have an autoimmune condition, or you really want to do your due diligence, we do talk about different lab tests people can do and things to ask their gastro doctor to do. We do come at it from an integrative approach. Me and the mouse in my pocket. I don’t know why I keep saying “we.” I do come at it from an integrative approach, where I talk about what things to discuss with your gastroenterologist and the testing to do as well as what are some functional medicine approaches.
I’m a proponent of test rather than guess, especially if you’ve been sick for a while. I know there are wonderful parasite cleanses on the market. You have to consider that I’m going to give you a symptom list with a high likelihood that you will have parasites or SIBO, but you still want to test for that. You don’t want to assume.
With parasites, there are different ones out there that could be causing digestive issues. Some of the herbs might only work for one. Medications might only work for one. If you have a different one, then you’ve taken a bunch of herbs and medications, and that guy is still alive and well and causing issues in your digestive tract if you don’t know what you got.
Dr. Eric:
Agreed. I am a big proponent of testing. Iadmit that tests aren’t perfect. I’ve had different people on the podcast who treat people for parasites without testing. There are others who do the testing.
I’m definitely in that category where even though the tests aren’t perfect, I like to test to see if we can find the problem. If you do a comprehensive stool test, you find the parasites, now you know how to treat them. You also have a baseline finding, so you can do a retest in the future to make sure it’s gone. You could also try to go by symptoms. Sometimes, you can’t go by symptoms.
Same thing with SIBO. It’s great to test. If it’s positive, maybe the person’s 80% better. Maybe you just keep on going with the treatment for a little while longer. Eventually, you want to do a retest and see if it’s negative.
The person I learned this from Allison Seebecker, who focuses on SIBO. She mentioned that even if someone is having symptoms, let’s say a couple of months of following a SIBO protocol, and they’re experiencing symptoms. If they’re 80% better, you don’t want to assume that the SIBO is still there, causing the remaining 20% of the symptoms. Maybe there is something else.
You might do a follow-up SIBO test. Maybe it’s still present, so you want to continue with the treatment or make some tweaks to the treatment. If the SIBO is not an issue, maybe someone has SIBO and a parasite. The SIBO has been resolved but not the parasite.
We’re on the same page as far as testing. If you do a bunch of testing, and you’re not getting answers, but you’re strongly suspecting there might be a parasite, I am not completely opposed to treating. I definitely prefer testing whenever possible.
Dr. Izabella:
I’m in agreement with that. The thing about SIBO is people sometimes think they take the herbs or the medications or the Elemental Diet, and it will be gone. The thing about SIBO is it islike a relative overgrowth. You want zero things growing.
You want to have a bald head. If you have long hair, and you took some herbs, you got a haircut. It’s still there. Maybe you took another set of herbs or medications. Now your hair is shorter. But you want to make sure that you fully shave down that SIBO. Testing will help us determine that, versus just assuming if it’s gone, even if you’re asymptomatic. That’s my two cents on that.
I have a chapter on SIBO in here. I do talk about, just like you mentioned, you want to make sure you rule out what’s upstream or downstream. If you have parasites, that could be opening up your valve, which could be causing bacteria from your intestines to come into your small intestine. We don’t want that. If you have H-pylori in your stomach, that can lead to an overgrowth of SIBO as well. The bacteria are not getting neutralized when they’re going down.
They often talk about SIBO treatment failures or SIBO as a root cause. It can be a secondary issue because someone might have another issue. Hypothyroidism is one example. If you have an underactive thyroid, your motility will be slow. Then you will be more likely to grow your hair, grow your SIBO. Not your real hair, but more likely to grow bacteria in that small intestine.
Dr. Eric:
How does that differ from a conventional approach? The conventional approach, they are not going to do testing for parasites. Some will test for SIBO. I don’t find it to be common. Elimination diets, usually not. What have you seen as far as the conventional standpoint when someone first goes to their medical doctor or GI doctor?
Dr. Izabella:
Only about 13% of IBS patients ever see a gastroenterologist. The history of how the IBS diagnosis came to be is back in the day, they were actually using lab tests to figure out if someone had IBS. All the labs came back normal. I think all of us in the thyroid space have heard that before. “My labs were normal.”
Here’s the thing. If you’re using the wrong labs, of course they will be normal. When you actually are using the correct, more advanced diagnostics, you can find these things. In this day and age, we have really advanced stool testing that we can utilize. We have advanced SIBO testing that we can utilize. These things weren’t around 30, 40, 50 years ago. Now, we can utilize this testing to figure out what a driving factor is.
Then we also have a lot more research about some of the lifestyle factors. We can really tailor that to a person.
As far as diagnostic tests, there are some red flag symptoms that would suggest more diagnostic workups. If someone, let’s say, has bright red blood in their stool or dark blood intheir stool, if they had weight loss, if their onset of IBS symptoms was after the age of 50, any kind of fever, so on and so forth, it’s recommended that the person get screened for IBD, bacterial infections, parasitic infections, etc.
Interestingly, one particular study found that 0% of IBS patients received those tests to rule things out. I don’t know everybody’s experience with IBS. I know my experience was a long time ago, and it was not super helpful. The doctor I saw was very compassionate and a lovely man, but he just gave me some medications. Those medications gave me blurry vision and constipation, which I was happy to have constipation for a change. At the same time, that didn’t really treat what was the underlying issue for me.
Dr. Eric:
Would you say now that your IBS is completely resolved, you’re not having any of those, hopefully not the urgent diarrhea, but no bloating, no gas, nothing that indicates that you have IBS?
Dr. Izabella:
I actually was able to get that into remission before I got Hashimoto’s into remission. It was much easier to get that into remission. I’m not bloated anymore. I don’t have abnormal GI. I have normal digestion. It feels amazing to eat food and not get a stomachache from it and not be bloated from most foods and not have to run to the bathroom and not have to plan my life around bathroom trips.
Dr. Eric:
For someone who is listening to this, and they’re thinking, “Maybe I have IBS. I’m not sure. Maybe I have IBD,” you mentioned approximately 13% of people with IBS end up going to a gastroenterologist. What is the next step?
If they are having symptoms that make them think they might have IBS or something different like IBD, should they go see a functional medicine practitioner? Obviously, read your books. That is probably the #1 thing. But in addition to reading the book, should they be thinking about functional medicine? Should they start with the book and see how they feel before actually scheduling an appointment with a functional medicine doctor? Go through the book, follow the elimination diet, make some of these other changes, and see if that causes change before seeing someone and doing some of the testing that we recommended? Would you say a combination of both?
Dr. Izabella:
I’m a big proponent of education, but education doesn’t replace medical guidance and supervision of course. This book is meant to be a guide for patients and for practitioners on the different causes and triggers and healing protocols for all the causes of IBS. I think this is a really great starting point for people to educate themselves.
I don’t know about you, but typically, the people who I personally work with or have worked with already have an IBS diagnosis or IBD diagnosis. They have gone down the rabbit hole of going to a gastroenterologist and primary care doctor. You definitely want to do that.
If you haven’t gone to a primary care doctor with your symptoms, you need to. If you haven’t gone to a gastroenterologist with your symptoms, you should. There is a list of labs that you can do to rule out things like cancer. You can have diarrhea from colon cancer. This is a very serious condition. Obviously, the approach will be way different than eliminating a few foods and not drinking coffee. This is always a good first step for everybody if they haven’t had that.
If you already have gotten the clearance from a gastroenterologist, and they don’t know what to do next, and you’re still not better, I would say- In one study actually, less than 25% of people with an IBS diagnosis got better with the conventional approach. Most of them continue to have symptoms.
If you’re someone who continues to have symptoms, working with a functional medicine practitioner is going to be really helpful. I hate to say this, but not all of them are created equally.I feel like in my line of work, some of the people I have worked with want to be healed, and they want to just surrender and have somebody heal them. It does take you being your own advocate and you speaking up for yourself.
Some of your practitioners might not even know about some of the root causes I have shared in this book. When you have this book and a wonderful practitioner working in synergy, and a patient advocating for themselves with a really educated practitioner, that is where I see the magic happening.
Dr. Eric:
Maybe in some cases, it makes sense to get your practitioner one of these books, too. They will be up to speed with some of the triggers. You’re right. There are some functional medicine practitioners who aren’t as familiar with IBS.
Anything else that I should have asked you that I didn’t ask you? Anything else you wanted to chat about, whether it’s something else in your book that we didn’t cover yet or anything else?
Dr. Izabella:
Hmm. Maybe some surprising foods that can cause IBS symptoms?
Dr. Eric:
Yeah, let’s go for it.
Dr. Izabella:
Gluten and dairy are some of the more common foods that can cause IBS symptoms. Also, raw lettuce and blueberries are very common triggers of IBS. Sometimes, high fiber foods can be a trigger. For some people, it’s fatty foods if they have a pancreatic enzyme deficiency.
In my literature review, and working with some clients, I have been really concerned about the widespread use of food additives and artificial sweeteners. So many of them can actually cause IBS symptoms.
Dr. Eric:
Blueberries? Lettuce, too. Especially the blueberries. That potentially could be a surprising food that causes some IBS symptoms.
Dr. Izabella:
A lot of raw foods, yeah.
Dr. Eric:
Do you talk in the book about some of the different- A low FODMAP diet is pretty popular when it comes to SIBO. I don’t know if you cover that in your book.
Dr. Izabella:
I do. To be honest, I am not a fan of the low FODMAP diet. I think it can be a helpful band-aid in the short term, but I have seen people on this diet forever. When you have SIBO, you have bacteria in the small intestine that feed off of certain foods, like FODMAP foods. You’re not giving them the food that they feed off of that causes you symptoms, but it doesn’t eradicate the bacteria. You’re basically just keeping them quiet at that point. Then it can lower your gut diversity, too.
I’m not a big proponent of it. Of course, if it helps your symptoms, then you could utilize that diet.
Also, the elephant in the room and the root cause is all those bacteria in your small intestine, you need to get rid of them, some kind of antimicrobial. The one diet that does actually starve them is the Elemental Diet. You could consider doing something like that if you are passionate about a dietary approach. The low FODMAP diet won’t do anything to get rid of your problem.
Dr. Eric:
Like you said, you don’t want to follow it long-term because there are concerns about the negative impact that it will have on the gut microbiome.
The Elemental Diet actually is treating it. With the Elemental Diet, it’s 2-3 weeks that you follow it. In some cases, maybe a little longer. But it’s not like they’re following it for three months. But low FODMAP is not a treatment. It might just make you feel better, if that.
Dr. Izabella:
Some people don’t feel that much better with it. It’s so popular, but there are other things that work better.
Dr. Eric:
This has been an excellent conversation. I’m sure my listeners have learned a lot about IBS and IBD. I didn’t expect to talk as much as we did about IBD. That is really common as well. Like you said, some people get misdiagnosed, so it’s good to understand the differences between them.
I agree with you. If you’re in the beginning of this, as far as seeing a gastroenterologist just to rule out some things if you’re not sure. Sometimes, it could be something bad. Most of the time, it won’t be colon cancer, but it could be. If it is something like that, you would want to get that diagnosed.
Where can people find out more about you? I assume they can get the book on Amazon. For those who are not familiar with you, your website, your podcast, anything else you’d like to share.
Dr. Izabella:
My website is ThyroidPharmacist.com. I am on Instagram, @IzabellaWentzPharmD. On Facebook. I have a YouTube channel I just started. People can watch my podcast and listen to it. It’s called Thyroid Pharmacist Healing Conversations. We had Dr. Eric on there recently. You can check out our interview.
The book can be found on Amazon, Barnes & Noble, wherever books are sold. I do have some preorder bonuses. If you go to ThyroidPharmacist.com/IBS, you will be able to get linked up to that.
Dr. Eric:
This was a great conversation. Excited about the book. I know it will help so many people, just like your other books. Thank you so much for doing this. We will have you back in the future. It seems like every year, you’re writing a new one. I have a feeling this won’t be your last one. We’ll have to have you back again.
Dr. Izabella:
Thank you so much. I really appreciate you having me. I am not sure if this will be my last book or not. I just had a baby, too, so I don’t know what my future holds. A very exciting time in the Wentz household. I really appreciate you having me and the work that you’re doing to save so many thyroids.
Dr. Eric:
You as well. Thanks again, Dr. Izabella.
Dr. Izabella:
Thank you.
***
Dr. Eric:
That was anawesome conversation with Dr. Izabella Wentz. That is her fifth book. Wow. I have three books. I have to catch up. I’m two books behind her. She has three books on Hashimoto’s, one on adrenal health, and then this one on IBS.
IBS versus IBD, for those who maybe are confused. Two different conditions. Irritable Bowel Syndrome versus Inflammatory Bowel Disease. Crohn’s and ulcerative colitis are types of IBD.
Stil questionable whether they are autoimmune. We had that conversation. She feels like they are. I’m not sure. I go back and forth. I thought at one point they were autoimmune, but some sources say they’re not. Either way, they can be a factor when it comes to autoimmune conditions.
Speaking of which, the IBS-autoimmune relationship. This can increase intestinal permeability, which is part of the triad of autoimmunity that I discussed elsewhere, and we chatted about it as well. That can make someone more susceptible to an autoimmune condition such as Graves’ or Hashimoto’s.
Celiac versus IBD. Dr. Izabella mentioned how the studies show that 25% of people diagnosed with IBS actually have Celiac. 10% of people with IBD also were misdiagnosed. There is some overlap. You figure it wouldn’t be that difficult to diagnose Celiac. IBS can be more challenging to diagnose. Celiac shouldn’t be that difficult. Crohn’s, ulcerative colitis, those can be more challenging.
H-pylori and IBS. She spoke about different gut infections like parasites and bacteria, specifically H-pylori. It’s interesting because she is right. H-pylori affects stomach acid. Low stomach acid can lead to overgrowth of bacteria, SIBO. SIBO is a factor in IBS. Approximately 70% of people with IBS have SIBO. Not all cases of IBS are caused by SIBO.
We also spoke about concerns with the low FODMAP diet. First of all, the low FODMAP diet is not a treatment for IBS or SIBO. The Elemental Diet is a treatment for SIBO. Many people don’t want to do this diet, but a low FODMAP diet is one concern.
I mentioned some concerns about long-term negative effects it could have on the gut microbiome. I am not saying people should never follow it. It’s just not a good long-term solution. You probably don’t want to follow a low FODMAPdiet for six months.
Something we didn’t discuss during the conversation, but I wanted to mention here. If someone had Graves’ or Hashimoto’s, and let’s say they have SIBO, I usually would recommend an AIP diet. If someone has SIBO, they might want to follow a low FODMAP diet. I don’t usually recommend doing both, following AIP and low FODMAP at the same time. One of those diets is pretty restrictive, let alone combining both of those.
Usually, I would recommend holding off on AIP, if you are going to start with the low FODMAP. It’s not a long-term diet. Address the SIBO first, that’s fine. It won’t hurt if someone wants to follow AIP while eradicating SIBO. Combining the different diets could be challenging.
Seeing a gastroenterologist. Toward the end of the podcast, Dr. Izabella was talking about how with certain GI symptoms, you want to see a GI doctor. I agreed. But I don’t want to give people the impression that everyone with bloating, gas, even diarrhea should see a gastroenterologist.
Keep in mind, if you go to a gastroenterologist, they will probably recommend an endoscopy, a colonoscopy. There is a time and place for those. I can’t say I’m a huge fan of those, but like I said, there is definitely a time and place. I won’t get into doing them preventatively, especially colonoscopies, here.
It depends on the person, the GI symptoms. Most of the time, when I am working withsomeone, if they have certain digestive symptoms, I won’t recommend to go see a gastroenterologist. If someone is having rectal bleeding, I would look into that. It could be hemorrhoids. There is a chance it could be cancer.
If someone is having some digestive discomfort and diarrhea, in that case, I’m not opposed if someone wants to go to a gastroenterologist, but I don’t think everybody needs to do that. Making some dietary changes initially is a good idea.
That being said, keep in mind it could take a few months to see a gastroenterologist. I suppose if someone wants to, they can always schedule an appointment to see one a few months out. It might take that long. And then make diet changes. If the diet changes don’t work, maybe do some functional medicine testing, like a comprehensive stool panel. Maybe a SIBO breath test.
Just wanted to clarify that I wasn’t suggesting foreveryone with GI issues to see a gastroenterologist.
That is pretty much it. Really enjoyed the conversation with Dr. Izabella. She wasn’t sure if there would be a sixth book in the future. I think there will be. If there is, we’ll definitely have her back. If not, maybe we’ll still have her back in the future. She is always welcome to be on the podcast. I really enjoyed being on her podcast as well.
Hope you found this episode to be valuable. Thank you so much for tuning in. Of course, I look forward to catching you in the next episode.