Last Updated on May 1, 2026
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Key Takeaways
- Irritable Bowel Syndrome (aka. IBS) is common, but symptoms like bloating, abdominal pain, diarrhea, and constipation are not normal signs of healthy digestion.
- An IBS diagnosis often describes symptoms without identifying the deeper root causes driving them.
- Root causes of IBS may include SIBO, parasites, dysbiosis, enzyme deficiencies, food sensitivities, celiac disease, or low stomach acid.
- Increasing food sensitivities over time can be a red flag that something deeper is disrupting gut health.
- Red flags like blood in the stool, unexplained weight loss, or new symptoms after age 50 should be evaluated by a gastroenterologist promptly.
Bloating after meals, constipation, or rushing to the bathroom out of nowhere are all signs of irritable bowel syndrome.
And the truth that no doctor will tell you is that irritable bowel syndrome (aka IBS) isn’t normal.
Even if you’ve been diagnosed with IBS, there’s so much more going on under the surface that conventional medicine doesn’t bother to see.
That’s because irritable bowel syndrome becomes a label to explain symptoms and prescribe medication. An IBS diagnosis was never meant to explain WHY you have these symptoms.
If you’re reading this, I’m guessing that you feel frustrated, and that many of the random fixes you’ve tried haven’t worked.
I’ve seen this pattern over and over again. You try elimination diets, probiotics, or “gut healing” supplements or protocols — only to end up more confused, more restricted, and still symptomatic.
And here’s the kicker. Research clearly shows us that these IBS gut symptoms often don’t stop, but instead evolve with time into skin problems, hormone imbalances, or even autoimmune conditions.
So what’s really going on?
In this episode, Dr. Izabella Wentz and I are breaking down the hidden root causes of IBS so you can finally start connecting the dots.
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 with Hashimoto's thyroiditis in 2009, following a decade of debilitating symptoms. As an accomplished author, Dr. Wentz has written several best-selling books, including her new book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome.
While irritable bowel syndrome (IBS) is often treated as a standalone diagnosis, it is often a sign of deeper, unaddressed imbalances for those with autoimmune conditions like Hashimoto’s.
Let’s talk about the truth behind IBS, what it really means that your doctor won’t tell you, IBS management, and what you should consider, especially if you’re struggling to tolerate different foods.
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
In This Episode:
- Why IBS is often called a “trash can diagnosis” (and what that really means)
- The surprising link between IBS causes and autoimmune conditions
- Are bloating, acid reflux, and stomach pain normal? (How to decipher them)
- Avoid THIS biggest mistake trying to “heal” irritable bowel syndrome
- How food sensitivities can spiral out of control (and why that’s a red flag)
- Can fasting stop Irritable Bowel Syndrome (IBS)?
- The role of infections like SIBO or parasites in IBS root causes
- Key signs your IBS symptoms need deeper investigation ASAP
Quotes
“When we eat food, we're not supposed to have stomach aches or bloating, and we should be passing bowel movements once or twice a day.”
“Dark red, tarry stools, or even bright red blood in your stools could indicate more serious things, potentially bowel cancer.”
Links
Find and Follow Dr. Wentz online | Instagram | Facebook | TikTok
Get your copy of Dr. Wentz's newest book — IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome
Healthy Skin Show ep. 023: How Low Thyroid Plays A Role In Skin Rashes w/ Dr. Izabella Wentz
415: What Causes Irritable Bowel Syndrome (IBS)? (And Sneaky Food Sensitivity Triggers) w/ Dr. Izabella Wentz {FULL TRANSCRIPT}
Jennifer Fugo (00:59.207)
Dr. Izabella Wentz, it is so wonderful to have you back here on the show. This is your third time, and today we are gonna dive into the broad topic, but important because so many people struggle with it, of IBS, or irritable bowel syndrome. It's a little bit of a mouthful. So thank you for being here, we really appreciate you spending this time with us.
Izabella Wentz (01:21.646)
Jennifer, thank you so much for having me. I love your work, and I so appreciate how you show up in the world.
Jennifer Fugo (01:27.717)
I appreciate you as well. And I love, too, that you have been so willing to talk about health topics that I think so many women, but men too, are really struggling with. And sometimes we struggle in silence. Sometimes we struggle because it's become normalized, right? I think that's one thing I've realized, especially with a lot of gut issues.
When I was younger and I did not know what was going on with my gut, this is back in like 2005, 2006, I had so many IBS issues, but I was like, oh, I just have like, you know, bathroom issues, it's normal. And the truth is, it's not. So can you share with us, what is IBS (irritable bowel syndrome)? And then we'll talk a little bit about how you came to find this topic to be so important that you wanted to share about it in a more in-depth way, because you have so much to say about this topic.
Izabella Wentz (02:27.406)
Yeah, absolutely. So IBS is very, very common, right? So you can have, probably 25 to 45 million people in the US have IBS that are affected by it, it accounts for 12% of visits to primary care physicians, but it's definitely not normal. So IBS (irritable bowel syndrome) is typically diagnosed by symptoms. This is going to be diarrhea, constipation, or both. People might have abdominal pain, bloating. A lot of times people will say when they have diarrhea, it's like explosive diarrhea, their stomachs really hurt, or they have constipation and they just can't go, and their stools look like tiny little rocks. When they do go, they might have a lot of gas. And it is something that again, it's very, very common, but this is not how our digestive system is supposed to work. When we eat food, we're supposed to properly digest it. We're not supposed to have stomach aches, we're not supposed to have bloating, and we should be passing bowel movements once or twice a day. And they should be sausage-like and easy to pass, relatively soft, not too soft, not too mushy, and not too hard.
The reason why I'm so passionate about this topic, Jennifer, is I was personally diagnosed with irritable bowel syndrome when I was a young woman myself, when I was actually a first-year pharmacy student, and I didn't really get a lot of help from conventional medicine. So I ended up getting a prescription from my physician. He said this is caused by stress, you are in grad school, you're in class 40 hours a week, you are taking two exams a week, of course you're going to be stressed out. I have no doubt that you are living in a very high-stress situation, but I'm not going to tell you to quit school and go live on a beach somewhere. And so to get through it, he gave me some medications that slowed down my digestive secretions, I happen to have really awful diarrhea all the time. And I ended up with essentially blurry vision and brain fog from the medication. So it's an anticholinergic medication that was used back in the day, and salivation, lacrimation, urination, and defecation gets slowed down by this pathway.
Jennifer Fugo (05:08.432)
Oh my gosh!
Izabella Wentz (05:14.314)
And so beyond just having the IBS symptoms and having really awful stomach cramping, having to run out of my lectures to the bathroom, having to carry a SHIT kit with me everywhere with like extra pants, and extra underwear, and wipes, and Imodium. Eventually, I started to get more and more symptoms. So it started with IBS. Later on, I started to have anxiety, panic attacks, I then began to lose my hair and have pain throughout my body. And I eventually ended up with a Hashimoto's diagnosis.
People, I feel like, on the internet know me as the thyroid pharmacist. And my journey with Hashimoto's was, how do I get myself into remission? A lot of it had to do with, actually, gut health. When I trained in functional medicine, I learned that IBS oftentimes precedes an autoimmune diagnosis, sometimes by five, sometimes by 10 or 15 years. In my case, it was about six years. So I got diagnosed with IBS initially, and then six years down the road, I end up with an autoimmune condition. And for me, I really want to educate young women, old women, children, everybody, you know, men, who are willing to listen, to understand that there's this huge connection between gut health and our overall health. And listen, it's not just like bone broth and probiotics that are going to solve your body issues.
Jennifer Fugo (06:20.28)
No, it is not. That is so true, because I think most people have this belief that if they just drink bone broth every day and take probiotics, their irritable bowel syndrome is magically going to be healed. There is a little bit of that magical thinking. And listen, all of us have moments in life when we think, oh, well, this is going to solve it. It's the simplest explanation, I just need probiotics and bone broth. But the truth is that there are other things going on under the surface.
I did want to ask you a quick question, just while we're on the topic, about IBS being a diagnosis because it wasn't a diagnosis for like all of eternity. In fact, I would argue that it's only become a diagnosis in our lifetime. Like, probably what, in maybe the last 20 years? It wasn't a thing before, so much, it was just like, oh, you have gut issues, you have bowel issues. But it's not actually, like there's more of a, well, you don't have these things, like exclusionary criteria. It's not necessarily with some diseases, like you were saying with Hashimoto's, oh, well, you have XYZ, if you have these things, you have Hashimoto's. Whereas with irritable bowel syndrome, it's a little bit almost backwards, in a sense.
Izabella Wentz (07:37.647)
Yeah, I like to call it a trash can diagnosis. My husband's like, that's my favorite thing about your book is that you talk about a trash can diagnosis. It used to be for a while a diagnosis of exclusion, where doctors were like, OK, well, what is causing this, do you have some kind of infection, so on and so forth, where the modern diagnosis now relies on a six-month history of self-reported bowel issues. And really, I feel like it's a label that's given to people when they have specific symptoms, but the label doesn't educate us about what's causing those symptoms. And the results are quite poor with conventional medicine, less than 25% of people get symptom relief.
And here's the thing, IBS can be caused by a whole bunch of different things. It can be caused by L-glutamine deficiency, and potentially bone broth could help with that. It could be caused by dysbiosis, and probiotics might help with that. It could be caused by SIBO, in that case, you would want to do a SIBO protocol. It could be caused by protozoal infections. It could be caused, 25% of the time, a person that gets the IBS label actually has celiac disease, and then there's all kinds of food sensitivities, enzyme deficiencies. And yet most people are not worked up for those things, they're just kind of like, oh, well, here's a medication, or be less stressed, right? You're stressed out, stop that!
Jennifer Fugo (08:59.974)
Just stop your stress, as if it's a choice all the time, you're just being stressed. But why do you think, this was one interesting stat that I saw in your book, that only about 13% of IBS patients ever end up getting to a gastroenterologist. So, why do you think that is? It feels like, you don't know what's causing it, but if you don't ever investigate some of the deeper issues, like, yeah, it is a trash can diagnosis because it's basically like, we don't know. We know you have these problems, but we don't actually know what it is.
Izabella Wentz (09:37.455)
I don't know why that is. Most people are diagnosed by their primary care doctors. I would really advocate for them to actually go to a gastroenterologist. Dr. Habba, a gastroenterologist who had seen a lot of people with IBS diarrhea, in 2011 he published a study of 303 people and found that 98% of them had a treatable cause. And so that meant there's always going to be a cause, I mean, in his case, 98% of the time. And he was able to categorize it into five different major things, and then addressing those things would help a person become not symptomatic.
So I would definitely advocate for everybody to go to a gastroenterologist if they have gotten the IBS label from their primary care doctor. There are things that are, I guess, red flags that would especially make me advocate for that happening like ASAP. And this would be like, if you're over 50, if you're having weight loss, if you have any blood with your bowel movements. So dark red, tarry stools, or even bright red blood in your stools, these could indicate more serious things, potentially bowel cancer. Also inflammatory bowel disease is something that many people are misdiagnosed with for quite some time. They might have inflammatory bowel disease, but they're giving the IBS label. And I feel like my hope is everybody would get a workup with gastroenterologist. They're not going to necessarily get all the answers at some point, I do think functional medicine might have some of the answers that gastroenterologists might not. And so my hope for people is that they really educate themselves if they have this condition so that they can actually achieve resolution, and remission, and live their best lives.
Jennifer Fugo (11:29.988)
Yeah, I agree with you. It's been interesting, having my own clinic, and while, yes, I work with skin issues, a lot of my clients also have IBS-type issues and gut issues, et cetera. And I think it's always interesting when sometimes a client does go to their gastroenterologist, because maybe also we sometimes find stuff where we're like, I think you need to see your doctor about this.
It's interesting, like Dr. Ken Brown, whom we both know, he's so interested in figuring out what's going on. And yet you have other gastroenterologists that are like, oh, take some Miralax, take some Metamucil. You're like, but that doesn't solve the problem. I will never forget, I started to get a lot of gut issues, did a stool test, and ended up with some type of, I don't remember the exact strain of Citrobacter, but it was on the stool test and it was very high. And so I went to a gastro, one locally, who I had no idea if he was functional or not, but he was open-minded enough. He was like, okay, I'll treat you. And so similarly to your story about how you got the, what type of drug was it again? It was more of like an antidepressant?
Izabella Wentz (12:44.173)
It was an anticholinergic, so Levsin was the name of the drug I got, it's an old school drug.
Jennifer Fugo (12:49.626)
That’s right. Yeah, so they tried to prescribe rifaximin. My health insurance said, nope, she has to try either an antidepressant, an anticholinergic, or something else first, before we'll approve this. And I was like, that's dumb, because I have an infection, why would you treat me with medication that's not proven to clear that infection? So anyway, I ended up on a different type of antibiotic that was approved by my insurance. I do know that rifaximin is expensive, but this goes to show sometimes why, I think sometimes we do, there is frustration with conventional medicine, but there are issues sometimes beyond what the doctor can do because it's like an insurance concern or an insurance issue.
So medicine is complicated, unfortunately, but I do appreciate the fact that you're encouraging everyone to take this seriously, to not just settle for a diagnosis because we are not a diagnosis, it is simply just pointing to possible problems. And speaking of problems, I wanted to ask you, you mentioned in your story about how you started with this IBS issue, which sounded way more diarrhea dominant, but then you developed Hashimoto's. Why do you think that so many people can start off with more of these like, even maybe explosive diarrhea incidences, or maybe you have soft stools that oscillate between really soft, explosive, to just kind of soft, maybe occasionally constipated, and then all of a sudden, you start developing things like Hashimoto's and other conditions?
Izabella Wentz (14:30.551)
Well, it's interesting because I feel like the body's constantly in a feedback loop and it's not necessarily like a one-way street, I feel like it's always connected. So, thyroid function can impact the digestive tract. A small study done on a group of people with IBS found that 18.5% of them had some thyroid dysfunction. In the early stages of Hashimoto's, people might have an overactive thyroid and this can actually cause diarrhea.
Jennifer Fugo (14:58.852)
Oh, wow.
Izabella Wentz (15:00.289)
Yeah, and the other thing is hypothyroidism can suppress stomach acid, and then you can end up with things like SIBO and slowed motility, or you can essentially be eating foods that you become sensitive to. So you can develop more food sensitivities when you have hypothyroidism. You can actually be at more risk for getting various infections when you have low stomach acid, which comes along with hypothyroidism. And then there's also, when you have malabsorption in your small intestine or any kind of malabsorption in your gut, then you can become nutrient depleted, which then can lead to thyroid issues. So you can become selenium deficient, selenium is super important for thyroid health. You can become zinc deficient, that's important for thyroid health. Selenium and zinc are very important for thyroid health.
And then there's also, sometimes, and I think this was maybe in my case, but there are certain infections that can really impact the immune system that can cause IBS and Hashimoto's. In my case, I feel like my big root cause was a protozoal infection that can be associated with IBS. 72% of people with IBS in one study were found to have it. It can also cause chronic hives, which I had, and also it can cause Hashimoto's. So potentially that could be one root cause that connects all of the different things. With all the people that I've seen over the last 13 plus years with Hashimoto's and people's stories that I've heard, I feel like there's so many different pathways where having an IBS issue can impact your autoimmunity and your thyroid function.
The other one that I feel like has probably the most science behind it is the connection between autoimmunity and intestinal permeability. Dr. Alessio Fasano has called it the three-legged stool of autoimmunity, where you have to have three things in order for autoimmunity to manifest, and that's the genetic predisposition, some kind of a trigger, and intestinal permeability. And so all three things need to be present for autoimmunity to manifest. And intestinal permeability, also called leaky gut, there's a lot of different symptoms that have been associated with it. It can also be asymptomatic. But interestingly, the symptoms are very much like IBS symptoms. So it could be like constipation, diarrhea, abdominal pain, so on and so forth. So a lot of people who have an IBS diagnosis, they actually have intestinal permeability as well.
Jennifer Fugo (17:48.231)
Do you think that there are any, because we've talked a lot about diarrhea, constipation, obviously sometimes people can have bloating, gas. Are there any contributors or symptoms that somebody might not necessarily think point to IBS, or that they're not as concerned about but maybe they should be?
Izabella Wentz (18:10.915)
Gosh, you know, for me, I can speak from my personal experience,. I thought it was normal to have stomach pains after eating. Like I thought that was just part of the digestive process, like you eat your food and then your stomach hurts for a few hours. So that's definitely not normal.
Jennifer Fugo (18:27.527)
The things we learn in life.
Izabella Wentz (18:29.409)
Yeah, yeah, definitely like being bloated all the time. So I used to work out like every single day and I was always trying to get my abs to be flat and they just never were. And then when I cut out some foods, I was like, wow, I have abs, where did that come from? So bloating is going to be an issue that most people might not recognize. I feel like acid reflux, if you have that more than once a month, that's going to be an indication that something is off. Really, I feel like most people should have bowel movements on a daily basis. I know I've talked to some people that say they go every two weeks, and that's normal for them. And I'm like, no, that is not normal.
Jennifer Fugo (19:08.583)
Gosh. No.
Izabella Wentz (19:13.837)
And also people that have diarrhea six times a day, that's not normal either.
Jennifer Fugo (19:16.487)
Yeah. If somebody felt better if, say, they fasted, because I've heard that before, why do I feel better? And better can also look like, and for people who don't know, like yes, your gut symptoms can also improve, but their skin sometimes feels better, they may feel less itchy, et cetera. Why do you think fasting could possibly make someone feel better? And, with the caveat, do you have any thoughts on why that might not necessarily, it could be a red flag. I kind of think of it as a little bit of a red flag, but it's also not a fix. I worry that people go, well, I'm just gonna fast all the time. And I'm like, that's not exactly practical. So what are your thoughts on that?
Izabella Wentz (20:02.093)
Definitely. So, digestive rest can help your symptoms if you have some kind of impaired digestion, whether that is a lack of digestive enzymes or some kind of like, let's say you have SIBO or some kind of an infection happening in your system, or a food sensitivity. Every time you're eating a food, that's going to cause you to be symptomatic. Let's say, if you have low stomach acid and you're eating protein, you're going to feel really, really tired after that because your digestion takes up a lot of energy, and so that could be a reason why you feel better. If you have SIBO, for example, and you're eating food, the bacteria in your small intestine are going to be fermenting that food and then releasing different kind of gases that can cause symptoms. Food sensitivity is like, OK, so we're just not eating anything and therefore we're not reacting to the foods.
Jennifer Fugo (20:56.454)
Exactly.
Izabella Wentz (21:00.879)
And so that food sensitivity can cause so many different symptoms. Other types of infections too, they can be associated with symptoms once they ferment fiber or whatnot; they can kind of cause you to be very reactive. And I feel like fasting does have a time and place and can be helpful, a lot of people with IBS are like, I just feel so much better. And there is bowel rest that can be helpful with especially inflammatory bowel disease, that could be part of the healing strategy, but like you said, it's not like a permanent solution to just like not eat.
Jennifer Fugo (21:33.381)
Yeah, it's not. I think what we forget is that sometimes we can maybe feel better, but on the flip side, we have to consider where we, like women are more complex. I don't know, I have mixed feelings about fasting for women. I think for some women it works great, and for other women like myself, it just caused lots of blood sugar imbalances that ultimately were unsustainable. And I mean, you've written a book about adrenal issues, really caused a ton of adrenal issues for me, was not helpful.
But I also worry about the physiology of the GI tract. We start to degrade our mucosal membrane, we start to see depletion of certain organisms. So I think we have to balance some of the advice. And that's what I love about what you share, especially in your books, and especially this new book on IBS, that there's a balanced approach to it that is measured. It's not like, do this cleanse and don't eat for like three to seven days, and then you're fixed. There's none of that gimmickiness in your advice to people, which I very much appreciate in this day and age.
So for people that are listening to this and saying, you just mentioned food sensitivities. Do you have any thoughts on why someone might notice that over the course of time they have these IBS-like symptoms? Maybe they were diagnosed with IBS. And if it's getting worse and now they're like, okay, well, I kind of can't tolerate gluten, and then suddenly I just like can't seem to tolerate dairy, and now I had to cut out like corn and all these other things. Do you find that that can also be a trend, where people will notice an increasing number of food reactions as maybe their issues progress?
Izabella Wentz (23:28.887)
Yeah, I definitely think that's a red flag. I know I'm a big proponent of elimination diets to figure out your food sensitivities, but a true food sensitivity should be maybe one to three foods, right? And so maybe you might be sensitive to gluten, or dairy, or soy, or some of the common reactive foods. And when you eliminate those foods, if that's your true root cause, then your health should bounce back. You might have some temporary food sensitivities just because your gut was leaky and you're going to be sensitive to whatever you were eating, but really a solid elimination diet for a few months, if that was like the only thing that was going on, you should be able to reintroduce a lot of foods back and you should be asymptomatic.
So for me, that is a red flag that you've got something going on in your digestive tract. Oftentimes it could be an infection. So a protozoal infection, for example, it can really essentially eat at your digestive lining and make you sensitive to whatever foods you're eating. Blastocystis hominis, the biggest one studied in IBS, can cause issues with grain intolerance, gluten intolerance, dairy intolerance, a sparkling water intolerance, sugar intolerance.
Jennifer Fugo (24:46.373)
Wow.
Izabella Wentz (24:51.373)
All of these different interesting things can cause a lot of food intolerances that are living in your digestive tract. Same with like, when you have SIBO, then you're going to be constantly having intestinal permeability and there are certain foods that you can react to that are fermented by these bacteria. So again, for me, it's like elimination diet is a great place to start. But if you've done that for three months and you're still not a hundred percent well, there's a chance there's something else going on there.
And I will say for me, that was also the case. So I've been there where I was like, foods must be the answer, so I just need to eliminate more foods. And that can be a very slippery slope where you're left with not eating that many foods, still symptomatic, and like really losing that intuitive feedback from your body.
Jennifer Fugo (25:33.062)
Yeah.
Izabella Wentz (25:48.527)
I got to a point where gluten and dairy elimination worked so well initially, but then I kept eliminating more and more foods and I lost too much weight. My skin was kind of gray, like the collagen in my face started degrading, and it was not a good place to be for sure. So I'm very, I really want to get that message out to people too, that elimination diets are not the be-all-end-all, they can become very restrictive and we can get ourselves into eating disorder territory with that.
Jennifer Fugo (26:08.995)
Absolutely. I also wanted to ask you about coffee, because I always thought it was interesting that you talked about coffee and constipation. I just thought I would ask you this because I have my own strong feelings about coffee. I'm not against coffee, but I do worry, when it comes to constipation and coffee, it's a whole different matter. So what are your thoughts if somebody is, and maybe you can qualify, are we talking about drinking coffee, are we doing coffee enemas? Coffee and constipation, what are your thoughts?
Izabella Wentz (26:39.639)
Yeah. So some people find that coffee really helps to move their bowels, and that's expected, right, it can kind of have some stimulating effects on our nervous system. But if you absolutely need coffee to go number two, that could be a red flag. Sometimes something is going on with your digestive tract and your parasympathetic system. You might have a choline deficiency, so that's another thing to consider.
Jennifer Fugo (27:10.501)
See, all of these things are clues. I always tell people that. It's like, if we do something and it makes a change, it doesn't matter what, whether it's good, bad, what have you, it's feedback. And then we should ask why, what could be causing that specific response? So I always think that's so fascinating when you dig into that a little bit more. So one thing I did want to ask, because you brought this up in the beginning, your doctor told you that the reason you likely had all of these issues was because you were stressed. I feel like that seems to become a catchall for many health complaints these days. I would bet the number of women and men who have Hashimoto's, for example, is it pretty common that the doctor is also gonna say you're just stressed? That's why you feel tired and whatnot?
Izabella Wentz (28:03.311)
Certainly, that's a very common, and I mean, they're not wrong.
Jennifer Fugo (28:06.691)
No, no, they're not wrong.
Izabella Wentz (28:16.087)
Stress doesn't really help anything, does it? Like, it can really make us sick, right? Whenever I work with people, I always ask them, what was going on in your life before you got sick? And it's like, I was under a lot of stress.
Jennifer Fugo (28:23.844)
Of course.
Izabella Wentz (28:46.001)
And stress can really impact our gut, it can deplete our secretory IgA and make us more susceptible to food sensitivities, infections. Having a lot of adrenaline released actually like supercharges our opportunistic bacteria, and they're like, oh, it's time to go to war against the gut, I know that it's time to overpower. And definitely stress isn't super, super helpful for anything. So I do think that is a big contributor to IBS, Hashimoto's, autoimmunity, pretty much every condition in the world. But I think people are doing patients a disservice.
Jennifer Fugo (29:09.592)
Agreed.
Izabella Wentz (29:10.743)
By saying like, you're stressed out, be less stressed. Like, what does that actually mean? Like, okay, I'm just gonna stop being stressed. So there are things we can do, for sure.
Jennifer Fugo (29:20.526)
Right.
Izabella Wentz (29:48.509)
We can do cognitive behavioral therapy, yoga, meditation, prayer. A lot of them have actually been found to improve IBS symptoms. And there's not like one perfect one, you can just choose what resonates with you, and that can be part of your healing journey. But there's oftentimes other systems that get broken when we've been under a lot of stress. For example, we might be depleted in L-glutamine, zinc, and B vitamins when we're very stressed out, that's kind of how the body fuels the stress response. Or you might actually have gotten yourself in a situation where you have now a gut infection because your intestinal secretory IgA was so weakened under stress, and just being less stressed isn't going to solve the infection. And so I feel like yes, and we do need to do more work oftentimes.
Jennifer Fugo (30:10.137)
Yeah, to look and dig deeper. I think part of the reason I'm asking that question is because a lot of people feel like they're being told, well, this is just in your head, this is, you're just depressed, you're just stressed. I feel like there's a weird catchall bucket that has, that a lot of doctors will say. And if you fall into that bucket of things, then it's just, and they always say just before the descriptor, you're just this. So do you think that there is maybe a more psychological possible trigger as well, or relationship, that might be more than just stress as an explanation for IBS? Or do you think it's a yes-and as well, like that can happen in addition to all these other more physiologic problems?
Izabella Wentz (31:07.929)
I mean, the head is connected to the body, right?
Jennifer Fugo (31:10.649)
True.
Izabella Wentz (31:14.825)
So definitely for many people, there is a psychological component. They can be under a lot of stress, or maybe they had a period of being very stressed, and maybe they're more chill now, but they're still having some of these digestive issues. So I feel like it can definitely be that component, but it's not the be-all-end-all for many people. I think the trendy things right now are nervous system regulation, and stress, and SIBO, as far as the conversation goes for IBS, maybe the low FODMAP diet, but like, listen, not everybody with IBS has SIBO as a root cause. And for some people they might have SIBO, but that's not the primary driver. They need to fix other things in order to get symptom resolution.
And yes, there are people who are very stressed and that is exacerbating or causing their IBS, but that's not the truth for everybody, right? Or that might be a part of what they need to work on. They might be stressed and they might also have SIBO, and they might also have enzyme deficiencies, and so on and so forth. So it's never, I wish, it's never that simple as to say like, well, everybody has this.
Jennifer Fugo (32:21.765)
So what you're saying is there's not just the one thing that everyone, I feel like everyone's like, but what's the one thing that I have? And it's like, it might not just be one thing.
Izabella Wentz (32:35.949)
You have a body, right? That's the one thing you do have.
Jennifer Fugo (32:37.647)
That is true.
Izabella Wentz (32:44.398)
Yeah. There's just, there's a lot of different things that could go wrong and that could cause those symptoms, right?
Jennifer Fugo (32:47.737)
Yeah, so many things. Well, I wanted to ask you as we kind of round out this conversation because you do have such, like this is, first of all, this book is huge. It is huge. Your brand new, well, one of your brand new babies, one of them. This book is beautiful and it is so filled with really helpful information.
If somebody is struggling with IBS, so this could be someone who, like if you're listening to the Healthy Skin Show and you have skin issues, great, it's not uncommon to have gut issues, but maybe you're listening to this for yourself and you know somebody else in your life who is struggling with IBS, or your child is struggling with IBS. Is there one or two things that someone could do, or where they could start, that could be, aside from getting your book, really helpful for them where they are right now in the beginning stages of figuring this out?
Izabella Wentz (33:50.659)
Definitely. So, looking at how foods impact your digestion would be a great place to start, and that can give us some clues as to what might be going on behind our symptoms. So some of the common dietary triggers, we already talked about gluten, dairy, and soy, these are potential things you might wish to eliminate to see if they make an impact on your digestion. Up to 25% of people who have the IBS label might actually have celiac disease. And then there's also like this whole world of gluten intolerance, wheat intolerance, nickel hypersensitivity, which wheat is a high nickel food, so on and so forth that you might wish to consider. Also, for some people, it's fatty foods that might be a trigger. And that usually informs us that you have some kind of an enzyme deficiency, potentially a pancreatic enzyme deficiency or ox bile. Also, there are gut parasite infections like Giardia, for example, that can cause fat malabsorption.
Looking at other foods, high fiber foods and raw veggies for some people, I know I have seen people where salad and blueberries are like the biggest triggers. And in that case it's like, okay, there's you've got some kind of a dysbiosis going on because it's really your microbiome that helps you digest your foods. If you tend to react to high FODMAP foods like onions, and crucifers, and so on and so forth, then there's a chance you might have SIBO. So kind of figuring out which foods are your friends and which foods are setting you off.
Another set of things that I'm a big proponent of is figuring out if processed foods are an issue for you. There are a lot of food additives, and especially non-caloric sweeteners, that have been implicated in IBS and inflammatory bowel disease as well. Some of them work as osmotic laxatives, others work as irritants. So they can really, really irritate your gut. I would look at the medications that you're taking. There are certain medications that can be causative of diarrhea, like metformin. One example, I know a lot of people in the anti-aging community.
Jennifer Fugo (36:09.03)
That's interesting. Wow.
Izabella Wentz (36:26.801)
Yeah, PCOS. That can cause bile acid malabsorption diarrhea. Also certain birth control pills, like the Yasmin birth control that contains drospirenone, that's been found to be an IBS trigger, it can act as a gut irritant. So that would be something that I would consider with most people. Utilizing really good digestive lifestyle habits, so eating in a calm environment can really go a long way because our digestion starts in the brain. We want to shift ourselves into like that rest and digest, not fight or flight, chewing your food properly, potentially using herbal bitters or digestive enzymes can be helpful with that process.
Doing any kind of stress reduction, again, like yoga, cognitive behavioral therapy, that's gonna help everything. And you know, you and I, I'm sure you work with people who eat much better than you do, even as a nutritionist, right? I know I get that all the time where I work with people and they're like eating the perfect diet, but they're still symptomatic.
Jennifer Fugo (37:15.675)
Yeah.
Izabella Wentz (37:28.655)
And so if you've been that person, if you're like really taking care of yourself and drinking your bone broth, and your fermented foods, and eating this amazing diet, and you're de-stressing, but you're still not having symptom resolution, I would really advocate for functional medicine testing to see what is happening. I found so many different weird things like inflammatory markers, dysbiosis, pancreatic enzyme deficiencies, various types of bacterial, protozoal, viral infections in people with residual symptoms that are, you know, living a perfect lifestyle.
Jennifer Fugo (37:59.003)
Yep, and I think one way to also look at it, if you're not dealing, I think sometimes people will say, well, but my symptoms aren't that bad. I would say this, like, Izabella, your story, Dr. Izabella, your story is really important because you underscore this idea that we start in one place, we start having these symptoms that show up. And then with time, they end up in a totally opposite direction that you're like, I didn't even see this coming. And so I oftentimes think about this investment of time, energy, and even financial investment in your health as something that it's easier to address when things aren't the train wreck or the five alarm fire, right? It usually is.
And just knowing your journey, if you could go back now to where you were, struggling in college, when you went to the doctor, you're asking for help. If you could have told yourself, try and deal with this now, like is that something that you, if you could do, we can't do it, but would you have gone back? And what would you have said to yourself at that point in time?
Izabella Wentz (39:11.215)
Oh my goodness, so many different things. Do you want me to keep it to my digestive health?.
Jennifer Fugo (39:15.681)
Sure.
Izabella Wentz (39:40.335)
Okay. Yeah. I mean, I would have really encouraged myself to, probably back then there wasn't a lot of functional medicine doctors, but maybe like a naturopathic doctor to figure out what was the driving reason behind my symptoms. I actually had a good friend whose aunt was a naturopathic doctor and she had a lot of digestive issues and a lot of food sensitivities. And she did like this candida cleanse and some other kind of herbal cleanse and maybe medications for some infection. And she just was so healthy. And I remember we were about the same age when she said that. And I was kind of like, I don't know, so your aunt's a voodoo doctor?
Jennifer Fugo (40:04.294)
Sometimes, yeah, it doesn't make sense. We like tell a story in our head about like, well, this is what this seems like, but now you know better. Now you know better about why the value in that. And would you tell yourself that making the change to viewing your health issues as an important point in time to look deeper into it instead of accepting the anticholinergic medication and just moving on with your day? Do you think that that was, I mean, obviously that helps you now because you can see from experience, you learned. We learn so much from experience.
But we also, there's a part of it sometimes where you're like, I wish I could go back and just say, hey, this is a really important choice. It's like a point in time, a choice point where we could actually, there's two roads, right? I'm thinking of like that poem, can't think of who wrote it, but the two roads diverge, the path diverges. There's two options in the woods. You could go one way because it seems convenient, we take a pill every day and we'll get better. Or we go down the road that's unknown, we're not sure what we find down there, but there's the potential to unearth things. Do you think, which road do you think that you would choose now if you went back? Which would you tell yourself to take?
Izabella Wentz (41:30.969)
Gosh, it's kind of hard because I love my life right now and I have a wonderful husband and two beautiful children, and I'm like the butterfly effect, right?
Jennifer Fugo (41:34.15)
That's true.
Izabella Wentz (41:47.087)
Like if a butterfly flaps its wings, is it gonna? But if I could kind of end up at the same, and I have an amazing career, I've taken my pain to purpose. So I've gone through all of these health challenges, like I probably wouldn't be a thyroid pharmacist, I don't think I would have written five books. I probably would have become a psychiatrist and treated people with really high doses of medications, or maybe worked as a retail pharmacist or I don't know, maybe had a boring job and whatnot. But, yeah, I would have, if I could, then I would have said, hey, let's like actually really address this because this could make a really big difference. You know, gut health is very tied to intuition, which is something kind of like out in the left field and a little bit of woo-woo, but you say like you feel things in your gut.
Jennifer Fugo (42:18.695)
Sure.
Izabella Wentz (42:31.617)
And there is this like brain and gut pathway where I feel like I wouldn't have had a lot of health issues, and maybe I would have been a little bit more confident, or been better connected with my own self if I didn't have this gut issue and if I wasn't so disconnected from my body, right? Because I was like, oh, I've got my bowels are being irritable. I'm just going to shut them up,
Jennifer Fugo (42:54.351)
Yeah, yeah, it's a very interesting question. I have the same thought of like, uh oh, the butterfly effect of would I go back and tell myself to make all these changes? But then I think about the person who's sitting where I am today, and they're still struggling in it. But there's the story in their head that it's not that bad, and we have all the excuses to not do it. And I think it's helpful, just to know, like which would you choose? If you could go back, which would you choose? Like you said, if you ended up at the same point, which would you choose? Because it's helpful to know what somebody else would do. Not necessarily that we take our cues from other people, but I do think that it's helpful to kind of gauge like, would I have gone through the medication? Would I have done all of that if I knew that there was actually two roads? Because I think a lot of people don't realize that there are two paths, and they just go, well, I'll do what my insurance will cover, I'll do what the doctor tells me. And that's, like I said, that's why I love your book. I think it's such a great book. Thank you so much for writing this, and you've got two other or three other books as well.
Izabella Wentz (43:59.279)
I am a five-times published author as of a few days ago.
Jennifer Fugo (44:02.39)
Oh my gosh, wow. And you are, each of your books is, they're sizable. This is like, there is a lot of information in this and it's a worthwhile read. In fact, I still have, I have two of your books on my shelf. And I have your cookbook, the thyroid, I think, I forget which, was it for the thyroid?
Izabella Wentz (44:26.425)
Hashimoto's Pharmacology. So that was my third book.
Jennifer Fugo (44:29.38)
Yep, I have that book. I've got a bunch of your books on my bookshelf of books that I keep because they are all valuable, even for what I do. It's not like I just hand them out to a client and say, read this. I keep them for myself because they're, even as a practitioner, they're really helpful and valuable. So this new book is now available everywhere, and we can go to where to find it and get a copy of it?
Izabella Wentz (44:57.689)
Definitely Amazon and Barnes and Noble, it's available there. I have on my website, thyroidpharmacist.com/IBS, people can get some pre-order bonuses that we're keeping up a little bit longer if they wanted to submit their receipts there. And yeah, I write the books to be comprehensive but also approachable. So a lot of healthcare providers do use my books, and I'm hoping to really demystify all of the different triggers and causes and educate people so they can take charge of their own health.
And going back to like the two paths, like I am so glad that I did choose the road less traveled because had I not done that, I don't know what kind of a life I'd be living now. So I did eventually choose the path to healing myself, but it took a little bit longer. It took a lot longer. I feel like it took having an autoimmune diagnosis for me to finally wake up, and I don't want people to get a serious diagnosis before they start taking charge of their health.
Jennifer Fugo (45:52.634)
Yeah, absolutely. Well, thank you so much for joining us again to talk all about Ibs, including whether there’s a perfect diet for IBS. I will put all of your links into the show notes so people can find you and connect with you, especially on social media. I know you're very active on social media and you share a lot of great information. And thank you so much again for being here, writing this book, sharing your knowledge with us. And I always look forward to having you back in the future.
Izabella Wentz (46:18.585)
Thank you so much for having me. What a joy to be here with you.
Irritable Bowel Syndrome FAQs
What does an Irritable Bowel Syndrome (IBS) diagnosis really mean?
An IBS diagnosis usually means you have ongoing bowel symptoms like diarrhea, constipation, bloating, or abdominal pain, but it does not explain the root cause of those symptoms.
Can fasting help IBS symptoms?
Fasting may temporarily reduce symptoms by giving the digestive system a break, but it is not a long-term fix and may point to issues like food sensitivities, SIBO symptoms, low stomach acid, or infections.
Why do food sensitivities get worse with IBS?
Food sensitivities may increase when the gut lining is irritated or disrupted by issues like infections, SIBO, dysbiosis, or intestinal permeability.
