Women's Health Doctor: Female Irritable Bowel Syndrome and Hormones

Dr. Nicole Sundene, NMD

Women's Health Specialist

"What natural treatments can I use to help my IBS symptoms?"

~Kelly T Scottsdale, AZ

Irritable Bowel Syndrome (IBS) also known as chronic digestive issues resulting in diarrhea, constipation or alternating diarrhea and constipation is best improved with Naturopathy. IBS is what brought me into the Naturopathic Profession in 1994 as I share in my story "Why I Became a Naturopathic Doctor." The relief I found from Naturopathic Medicine was truly astonishing and much better than any prescription drug I had tried from the variety of specialists I visited with. I saw multiple Gastroenterologists to no avail and nobody could seem to ever help me with the alternating Diarrhea, Constipation, and Gas I suffered with.

When women are noticing IBS symptoms flare with PMS, Perimenopause or Menopause that can indicate a hormonal Root Cause. Hashimotos Thyroiditis and Hypothyroidism can also impact digestion and cause constipation or diarrhea. Most hypothyroid patients struggle with constipation. With menopausal changes, your body becomes more dry and inflamed.

I hope any patients suffering with IBS symptoms feel comfortable talking to me about their embarrassing symptoms because back in the 90's I was terrified with anxiety to talk to my doctor about these very common Women's Health symptoms and that also was part of what delayed my ability to receive help for the IBS.

I was having massive stomach pain and problems and no MD I went to could ever help me. Each day in college I felt like a victim of IBS and never knew when it would strike. Would I have an episode during a test or a presentation? I felt terrified of the random pattern of the IBS and was never sure what to do, what to eat, or what medicine to take for my IBS.

Eventually, a friend recommended I see her Naturopathic Doctor who promptly tested me for Food Sensitivities and prescribed an IBS diet and Herbal Medicine supplements to help me finally get control of the IBS symptoms. The Naturopathic Doctor also talked to me about my stress levels as I was a college student that had just moved an hour from her parents for the first time and stressful life changes also seemed to be an underlying cause of my IBS. I had such a great experience with that Naturopathic Doctor that I decided to stop my pre-med plan to become an OBgyn and go to school instead to be a Women's Health Naturopathic Doctor.

Irritable bowel syndrome (IBS) is a functional disorder in which the large intestine or colon, fails to function properly.

IBS has characteristic symptoms that can include a combination of any of the following:

Abdominal pain and distension; more frequent bowel movements with pain or relief of pain with bowel movements; constipation; diarrhea; excessive production of mucus in the colon; symptoms of indigestion such as flatulence, nausea, or anorexia; and varying degrees of anxiety or depression.

The causes for IBS are not completely clear; physical and emotional issues, as well as dietary factors or irritants, have all been linked to this condition. Possible treatment considerations for IBS include increasing dietary fiber, eliminating allergic/intolerant foods, addressing the possible contribution of emotional components, and incorporating nutritional therapies. In many cases, IBS can be controlled by managing diet, lifestyle, and stress. From my experience as a Naturopathic Doctor treating a lot of digestive issues, I most commonly find there is a Food Sensitivity we can easily test for via a simple finger poke. Knowing which foods upset my stomach was a huge game-changer for me and explained why some meals I was fine when I was eating a small number of foods I was sensitive to, but it was the meals where I had unwittingly mixed ALL of my food sensitivities together that I would have a severe uncontrollable IBS flare! Mystery solved! Herbal medicine is then needed to heal the inflamed gut while we eliminate the triggers as in "Leaky Gut Syndrome." Eventually, the reactions to most of the foods on the Food Sensitivity test diminish and the patient can return to a normal diet rotating their allergens and continuing to watch for flares.

Nutrition Guidelines

• Eat at regular times. Try not to skip meals or go long periods of time without food. The emptier your stomach, the more sensitive it may be.
• Try to limit “stand-up, eat-on-the-run” type meals.
• Chew thoroughly and eat at a leisurely pace – if you must eat in a hurry, only eat a small amount at a time.
• Eat a balanced and varied diet.
• Gradually increase your intake of fiber. Too much fiber can upset your stomach just like not enough. If increasing your fiber causes diarrhea or constipation you likely have SIBO or Small Intestinal Bowel Overgrowth that your GI doctor can do a simply breath test to diagnose. I don't recommend treating SIBO with antibiotics but instead I use herbs and nutritional changes.
• When your stomach is empty, eat soluble fiber foods first. Make soluble fiber foods a large component of each meal (see fiber sources below).
• Drink plenty of fluids, especially water (at least 6 – 8 glasses a day). If you are dehydrated that will make you more constipated. If you have diarrhea you are losing fluids and may need more water daily with electrolytes to prevent dehydration.
• Eliminate all red meat, dairy, fried foods, egg yolks, coffee, soda, and alcohol from the diet. These are the most common triggers of IBS.
• Limit foods that you are sensitive to or do not tolerate well. Possibilites include dairy products, chocolate, eggs, and wheat products.
• Limit foods high in fat. If you know you will be having high-fat foods, eat a source of soluble fiber first – never eat high fat foods on an empty stomach.
• Eat green salads at the end of the meal (small portions with non-fat dressing) as bitter greens help stimulate HCL and enzymes needed to digest your food.
• Fibers are substances in plant foods that we do not digest and are useful in normalizing bowel function. The two main types of fiber are soluble and insoluble fiber.
• Soluble fibers are commonly found in fruits (especially pears, apples, and citrus), oats, barley and legumes. These water-soluble fibers form gels that provide beneficial effects.
• Insoluble fibers are commonly found in wheat bran, corn bran, whole grain breads and cereals, as well as vegetables. Insoluble fiber has the effect of preventing constipation.

Fiber acts like a sponge by attracting water into the digestive tract, softening stools and preventing constipation. On the flip side, fiber is also useful for adding bulk to the stool which is helpful when diarrhea is present.

Bitter foods can improve the whole upper digestive system’s function and enhance the absorption of nutrients. Try adding some bitters to meals, which include chicory, endive, radicchio, and dandelion greens.

Herbal and Nutritional Supplements have been shown in research studies to be helpful in the treatment of IBS.

• Enteric coated peppermint oil capsules are used to inhibit intestinal contractions and relieve abdominal pain and gas.
• Chamomile and valerian aid in decreasing gas.
• Slippery elm soothes the intestinal lining and decreases inflammation.
• Lemon balm decreases intestinal cramping and spasms.
• Nutritional supplements such as glutamine, beta-carotene, and zinc aid in the healing of the intestinal lining.

Food Allergies and Sensitivities have often been linked to the symptoms of IBS. Roughly two-thirds of patients have some type of food intolerance or allergy. I have never seen a patient in my practice that did not have some form of food sensitivity triggering their IBS. Therefore, it is imperative that patients address these causes and eliminate the offending agents. Talk to your Naturopathic Doctor about identifying potential food allergens through Food Sensitivity Testing.

Lifestyle Guidelines

• Exercise regularly – 30 to 60 minutes of moderate exercise every day. Contraction of skeletal muscles helps aid contraction of the smooth muscles lining the intestines and is vital for patients with IBS-C or the constipation variety.
• Daily practice of yoga, Tai Chi, or meditation can significantly reduce stress-related symptoms.
• Pay attention to your body’s signals. When you feel the urge to move your bowels, take the time to do so, don't hold it in. Ideally you shoul have a normal bowel movement each time after you eat.
• Make sleep a priority – inadequate sleep reduces the body’s ability to manage stress effectively.

Emotional Components such as depression, insomnia, fatigue, and anxiety are often associated with IBS sufferers. Increased contractions of the colon have been shown to occur in patients with IBS in response to stressful situations, which can lead to uncomfortable symptoms.

Various methods of treatment that may be helpful to reduce stress, anxiety, depression, and fatigue include biofeedback, individual counseling, guided imagery, and physical activity. If necessary, seek the help of a professional to manage stress or other emotional factors.

It is important to determine the cause of any intestinal complaint; therefore infectious or other causes of bowel symptoms must be ruled out prior to diagnosis of IBS. Once a diagnosis of IBS has been made, know that stress and emotional factors weigh heavily in the equation and should be addressed as part of treatment. Food Sensitivity Testing from a reputable lab company is mandatory for me to properly help IBS patients. Please make sure it is affordable to work with me as well as afford a Food Sensitivity Test as we will need a few visits together and the specialty test is not covered per insurance as the majority of the labs I order usually are such as Hormone Testing is covered per your insurance plan.

Thank you for your great Naturopathic questions! Please send them to me on a postcard to my address below as I love to get something in the mail that is not a bill. If your question cannot fit on a postcard that means you need to treat yourself to a Naturopathic visit with me. Pop over to my SCHEDULE page to get that set up!

Dr. Nicole Sundene, NMD

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, Perimenopause, Autoimmune, Postpartum Depression, Chronic Fatigue, Holistic Psychiatry,  Depression, Anxiety, Chronic Pain, Autoimmunity, Food Sensitivities, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!