Studies show that nearly 42 percent of women diagnosed with Polycystic Ovarian Syndrome (PCOS) also have a case of IBS, or Irritable Bowel Syndrome. Only about 10 percent of women with IBS don’t have PCOS. So I guess it’s safe to say that PCOS and IBS have a strong correlation and the link is worthy of some further research.
I have come across many women showing both,PCOS and IBS symptoms and they’re usually very confused if they have both conditions. That’s because both conditions come with an overlapping set of symptoms. For example, weight gain is a problem for both PCOS and IBS patients and it’s hard to tell what has triggered this effect.
So I thought about addressing this confounding issue in today’s post. I’ll be walking you through both conditions, their causes and symptoms in hopes to give you a better understanding of their relationship.
Make sure you read till the very end because I’ll also be helping you with some treatment options for your condition!
What Is PCOS?
PCOS is a hormonal imbalance condition that affects nearly 10 percent of all menstruating women. At its core, PCOS entails the production of excess androgens which are male sex hormones in a woman’s ovaries. I’ve discussed androgen excess in a previous article of mine, so you can look that up for more details. In summary, what it says is that the high levels of androgen lead to a whole score of symptoms that we now know as characteristic of PCOS. These include:
- An abnormally thick growth of facial and body hair
- New acne or worsening spots
- Irregular menstrual cycle or absence of menstruation for a prolonged time period
- Ovulary dysfunction
- Development of numerous tiny fluid-filled cysts on ovaries
In addition to the aforementioned symptoms, many women undergo life-threatening metabolic disorders such as insulin resistance, high blood pressure, Type-2 diabetes and heart disease. So what causes these debilitating symptoms for PCOS patients?
There’s been nearly half a century of scientific research on the matter but investigators still struggle to identify the root cause of PCOS. At this point, we only have a shortlist of some key factors, of which I’ve already told you about androgen excess. The main culprit under this umbrella is high testosterone levels.
But as research is progressing in this area, scientists and medical researchers are increasingly claiming the root cause of PCOS most likely begins in your gut.
And that’s probably where IBS comes in.
What is Irritable Bowel Syndrome?
IBS is probably one of the more vexing diagnoses because it’s usually considered the last gut condition after illnesses like inflammatory bowel disease, Crohn’s disease and Celiac disease have been crossed out.
Basically, IBS can only be diagnosed after it meets its ridiculously lengthy testing criteria, which includes pain in the abdomen for at least 3 days per month for at least 3 consecutive months. In addition to this, patients must exhibit any of the following symptoms:
- Abdominal pain that subsides following defecation.
- Change in the frequency of stool passing.
- Change in the consistency of stool.
If you happen to meet the criteria for an IBS diagnosis, you’re most likely going to be told by a doctor that there isn’t much that they can do for you and they’ll hand you a prescription for anti-diarrhea drugs. In my years of functional medicine practice, I can safely say that these medicines are only pain relievers and are set to manage your IBS symptoms. They do not address the root cause of the problem, unfortunately leaving you stuck with an illness for life.
What Is The Root Cause of IBS?
The reason why I consider IBS similar to PCOS is because both diseases are hard to identify in terms of a single, fixed cause. You should consider both these conditions as syndromes. That’s a better word to address them because they’re more of a collection of symptoms with multiple causes. If you’ve gone through my article of PCOS: The Big Picture then you probably know what I’m talking about. And in a similar vein, IBS has various symptomatic factors as well. Here are a few causes that I have personally seen in my patients.
Small Intestinal Bacterial Overgrowth (SIBO)
So we know that there are bacteria in our gut that is responsible for many metabolic and digestive processes that maintain gut health. But it’s important for our gut bacteria to stay within the large intestine. If and when bacteria move to the small intestine, that’s when health complications occur and give birth to SIBO.
A study involving 200 patients diagnosed with IBS illustrated that an overwhelming 84 percent of them also showed signs of SIBO. So we know that a SIBO condition is closely linked with IBS.
Our gut is home to hundreds of trillions of microorganisms. In fact, these numerable microorganisms make about 70 percent of our entire immune system and are responsible for the regulation of how we absorb nutrients from food. So, all your carbohydrates and calories are being handled by these tiny organisms. But problems occur when the number of harmful bacteria increases in comparison to healthy bacteria. Such a condition is known as gut dysbiosis. I’ve actually written and explained gut dysbiosis several times on my page. You can have a look at it here.
Studies show that over 70 percent of IBS patients have an intestinal dysbiosis condition.
Here’s another condition I’ve worked on and studied extensively. So the main function of your gut, or rather one of its main functions, is to absorb necessary nutrients from food. Other foreign objects are supposed to be discarded. This is made possible thanks to a tightly-packed wall of cells that only lets necessary object permeate through. If and when these cells loosen up and make the wall porous, so to speak, then they let in larger, potentially unsafe object pass through as well.
That’s where the term leaky gut originates from. And research indicates that IBS patients have a high risk of a leaky gut condition.
IBS is a common gastrointestinal issue that is multi-factorial in nature.
From abnormal central processing, disordered motility, visceral hypersensitivity, genetic and psychological factors, gut inflammation and dietary problems there’s so much that IBS patients have to be careful about.
I’ve personally witnessed patients who have a long list of adverse reactions to certain foods. The interesting thing is that many of these foods are the ones that also trigger PCOS in women! Take for example:
- High GI foods
- Dairy products
- Fried and processed foods
- Soy and corn
We’ve covered many of these in my previous article here.
Recent studies show that IBS and PCOS have a strong link with food hypersensitivity. But that’s not all. There are also many medications that can turn out to be problematic for PCOS and IBS patients. For example:
– Birth control pills for menstrual cycle regulation
– Anti-cholinergic and antispasmodic drugs for bowel movement regulation
– Antacids to neutralize gut acidity and cramps
-Antidepressants and antibiotics
These types of drugs are often taken by PCOS patients thinking that they will yield them some symptomatic relief. However, not only do these medications let their PCOS symptoms fester behind a mask, but they also worsen their IBS symptoms!
The good news is that the double trouble isn’t a cause of serious concern. A Low FODMAP diet can serve as a viable dietary solution to both PCOS and IBS. I’ll cover this below, but first let’s understand how the two conditions are linked.
How are PCOS and IBS Linked?
The answer to your question lies in your gut.
Scientific evidence confirms the relation between PCOS and a heightened risk of chronic metabolic illnesses. So low-grade inflammation, leaky gut and SIBO are all intrinsically linked.
PCOS and Leaky Gut
The main connection that PCOS has with a leaky gut is that the inner lining of your small intestine becomes increasingly permeable. Studies show that poor gut microbiota can cause changes to your estrous cycle and increase the biosynthesis of androgens in your system. This means the presence of leaky gut syndrome can hurt your menstrual cycle and exacerbate the risk of PCOS in you.
I’ve seen many patients take birth control pills to counter the disrupted menstrual cycle issue. I have since posted several in-depth videos on how taking the Pill only worsens your leaky gut and hence, your PCOS symptoms too.
PCOS and SIBO Low FODMAP diet
As explained above, SIBO occurs when foods that are not digested by the small intestine are transferred to the large intestine where they cause gas, bloating, water retention and other unpleasant symptoms. I have covered this topic in plenty of detail. You can watch my SIBO videos here.
I have used the Low FODMAP diet with my SIBO patients with quite a bit of success. I consider it a double-edged sword because this elimination based diet not only helps cure SIBO symptoms but also reduces the impact of PCOS on your body. If you’re interested in the FODMAP diet, have a look at my FREE dietary guide on FODMAPS.
PCOS and Gut Inflammation
PCOS, at its core, is an inflammatory process. Research studies are increasingly showing that PCOS is almost always matched by an inflamed gut. A recent meta-analytical study compiled data from 30 different studies. The result showed that women with PCOS are twice likely to suffer from inflammation than women who don’t have PCOS.
PCOS and Histamine Intolerance
Histamine is a chemical that’s stored in our immune cells, or better known as Mast cells. When triggered, they can activate the defense mechanism of our immune system, which often results in sneezing, coughing, itching, runny nose, etc. Histamine can also be found in gut bacteria and fermented foods. People with gut dysbiosis or a leaky gut syndrome usually have a high sensitivity to histamine.
This chemical is broken down via the DAO enzyme that lives in your gut and is supported by the progesterone hormone. I hope you’re slowly beginning to join the dots here. A hormonal imbalance issue like low progesterone levels—which is common among PCOS women—can reduce the function of DAO enzymes, which as a result, does not break down the histamine you get from your food. That’s how histamine intolerance can be a key sign of problems with ovulation and indicate the risk of PCOS. For more information, you can read my article on histamine intolerance here.
What to Do If You Have IBS and PCOS?
Understanding the main cause of your IBS will help explain the type of PCOS condition you’re struggling with and what needs to be done to properly treat it. So the first step is a proper workup for your IBS condition.
Essentially, IBS is a diagnosis of exclusion. Once the risk of cancer or inflammatory bowel disease has been ruled out, most patients are sent home with a diagnosis of IBS. Yet the big question is: what is causing diarrhea, constipation, gas, bloating, etc.?
This is where functional testing of the gut can shed light. Understanding and looking at the BIG picture is crucial. IBS can be rooted in gut dysbiosis, leaky gut, inflammation, hormone imbalances food sensitivities, histamine intolerance, medications and other health conditions such as Thyroid problems.
There are many causes that need exploration in order to fully understand and treat IBS properly. But once these areas of dysfunction are understood, the majority of people get well.
There are a couple of things worth considering when looking at the PCOS-IBS connection. Is your problem with your gut caused by gut dysbiosis, malabsorption, maldigestion, inflammation, infection, leaky gut, food sensitivity or is it caused by something else such as SIBO?
The first thing I can do is that I can administer my SIBO breath test with you.
Once the harmful bacteria move to your small intestine, they give off methane and hydrogen gases each time you consume sugar. It’s easy to detect this kind of breath pattern with my SIBO breath test.
You’ll have to follow a preparatory period that’s going to allow me to measure the actual level of bacteria present in your gut. Then you’ll be given a glucose or lactulose solution to drink. Your breath will be collected in a special bag and breath samples will be taken after every 20-30 minutes for three hours. Once completed, the collected samples will be sent to the lab for analysis.
If we’ve got a case of SIBO on our hands, then we’ll have to go through a special eradication procedure, as well as making dietary changes and adherence to a Low FODMAP diet.
One thing worth pointing out is that diet alone does not get rid of SIBO.
The second thing that I can do for you is that I can provide you with a leaky gut testing procedure. I think it’s important to address a condition like this since it affects millions of Americans each year and easily goes by unnoticed since it doesn’t have very specific symptoms.
Leaky gut affects your entire immune system. From your brain, skin, joints, thyroid, adrenals, colon and mouth—there are tons of problems emanating from a leaky gut syndrome and my special test is designed to contain this menace for good. Once we’ve screened your gut health and have received the results from the lab, I’ll go over your report in detail so we can work together on a personalized treatment plan.
However, there’s one more thing that you’ll have to do—on your part. Syndromes like PCOS and IBS don’t just go away overnight. They’re spread out in your body and that means you’re going to have to commit to healthier dietary and lifestyle changes. So what does that include?
- Stay away from foods rich in advanced glycation end-products such as canned foods, roasted peanuts and fried meats that have been cooked or sterilized on high heat.
- Consume a diet that’s low in fats and refined sugars because both of them can induce a leaky gut and dysbiosis. The type of fat you eat also makes a big difference and I would suggest you keep your fat intake to a minimum to keep your PCOS and metabolic issues at bay.
- Have a diet rich in fibrous foods. A good amount of fiber in your body can help reverse dysbiosis and even prevent it from happening in the first place.
- Make sure you exercise regularly. Light to moderate physical activity every day has been known to promote the growth of healthy bacteria inside your gut. So that’s one way to take care of your IBS for sure.
- You can take a probiotic to promote a healthy balance of good bacteria in your gut.
Want To Get In Touch?
If you’re looking to work with my office to help sort out both your PCOS and IBS dilemma, then I would recommend you get in touch with me at your earliest. Don’t waste time thinking that pain in your gut will subside on its own. It rarely does.
Please complete this health questionnaire and help me get to know your condition in detail. Make sure you check your email once you’ve submitted this form. I’ll be getting in touch with you to help devise a personalized treatment plan that relieves you of your metabolic condition!