Primary Causes & Action Plans

hs-CRP

Gut inflammation indicated by elevated CRP
IBS involves intestinal inflammation even without grossly visible pathology. hs-CRP elevation indicates active inflammation.
Target < 1.0 mg/L
Suggested Action Plan

Anti-inflammatory diet (elimination of trigger foods), probiotics, and potentially low-dose budesonide can reduce inflammation.

Fecal Calprotectin

Direct measure of intestinal inflammation
Calprotectin measures neutrophil infiltration in colon. Elevated calprotectin indicates active intestinal inflammation.
Target < 50 mcg/g
Suggested Action Plan

Lower calprotectin through anti-inflammatory diet, probiotics, and antimicrobial therapy (if dysbiosis is present). Retest in 2-3 months.

Microbiome Composition

Dysbiosis (abnormal bacterial ratios) drives IBS symptoms
IBS is associated with dysbiosis: low Firmicutes/Bacteroidetes ratio, reduced diversity, pathogenic overgrowth. Dysbiosis-targeted therapy improves IBS.
Target Healthy diversity; balanced ratios
Suggested Action Plan

Restore dysbiosis through probiotics (especially Lactobacillus and Bifidobacterium), prebiotic fiber, and diet modification. Antimicrobial therapy may be needed.

SIBO (Breath Testing)

Small intestinal bacterial overgrowth indicates functional disorder
SIBO is present in 60-80% of IBS patients. Breath test (lactulose or glucose) detects hydrogen/methane overproduc. SIBO-directed therapy resolves IBS in many.
Target Negative or <20 ppm increase
Suggested Action Plan

If positive, rifaxomicon (non-absorbed antibiotic) plus diet low in fermentable carbs often resolves SIBO and IBS. Retest after treatment.

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Getting Started

1
Get Comprehensive IBS Testing

Test hs-CRP, fecal calprotectin, microbiome (stool test), and SIBO breath test. Most IBS has identifiable cause.

2
Identify Your IBS Cause

SIBO? Dysbiosis? Food sensitivities? Inflammation? Your test results point to the specific problem and guide treatment.

3
Treat the Underlying Cause

SIBO: antimicrobial therapy. Dysbiosis: probiotics + prebiotics. Inflammation: elimination diet + anti-inflammatory supplements.

4
Eliminate Trigger Foods

Most IBS involves food sensitivities. Elimination diet (remove gluten, dairy, processed foods) for 4-6 weeks, then reintroduce to identify triggers.

5
Retest After Treatment

SIBO and dysbiosis should resolve with treatment. Retest breath test and microbiome 4-8 weeks after therapy.

Why I built this guide.

"IBS is often reversible when you find and fix the underlying cause."

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