Dr Waters has a very part-time brick and mortar office at 1101 E Elizabeth St in Fort Collins, CO. She currently sees about 98% of her patients by either videomedicine or telemedicine. When clinically necessary, and on a case by case basis, she may offer to do a homer visit.
IBS, or irritable bowel syndrome, is a very common condition and is one of the most common reasons that people see a gastroenterologist. People who have IBS often have abdominal discomfort or pain, bloating, diarrhea, constipation or alternating diarrhea and constipation after eating. Some people only have one or two of these symptoms.
Many people who have IBS think that there is nothing they can do about it so they just modify their diet to avoid the foods that cause them adverse symptoms. This enables them to manage their life better in the short-term, but often causes more problems in the long-term. Gut inflammation from any cause, including IBS, if present for an extended period of time, will cause leaky gut. The tight junctions between the cells that line the gut get looser, and allow partially-digested proteins to get through. When these proteins enter the blood, the immune system identifies them as foreign, since they are not supposed to be in the bloodstream. The immune system then mounts an immune response to them, and that person develops a food sensitivity. People who ignore gut inflammation often get to a point where they don't know what to eat because they have developed reactions to many foods. When this happens, they often develop nutritional deficiencies which can further diminish the health of their body.
The foods that often cause symptoms early in IBS are those that are high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). These are good prebiotic foods-those foods that nourish our gut flora. After avoiding these foods for an extended period of trime, our gut flora becomes less diverse and less healthy. As I tell my patients, you want to 'keep the seats on the bus full' of beneficial bacteria so that any pathogenic, or disease-causing, bacteria that manage to get through the stomach (this often occurs when you have low stomach acid) don't 'have a seat', and they have to pass right through the colon and out with the stool.
Small intestinal bacterial overgrowth, or SIBO, is present in 80% of those who have IBS symptoms. While it has not been definitively established that SIBO causes IBS, most patients are able to resolve most of their symptoms after SIBO treatment. It often takes a few months longer to resolve the food sensitivities. SIBO is diagnosed with a breath test that follows a 1 to 3-day prep diet. For more information, see my SIBO testing, SIBO, healing leaky gut, and resolving food sensitivities pages.
Clinically, I have noticed that when I do a stool test and treat whatever I find on the stool test and in the several blood tests that I usually run on new patients, the patient's IBS symptoms resolve and I don't need to test for or treat SIBO (small intestinal bacterial overgrowth).