IBS
Irritable bowel syndrome (IBS) is one of the most commonly diagnosed digestive conditions.
Across the world, it impacts between 9% and 23% of the global population. It has also been indicated that up 12% of those seeking healthcare are due to symptoms of IBS.
The exact causes of IBS are not fully understood. However, a combination of factors is often responsible for the onset of IBS symptoms. These factors can vary between individuals.
The diagnosis is referred to as one of exclusion. This means that once other reasons for the symptoms of IBS have been excluded, for example, inflammatory bowel disease (IBD), the diagnosis of IBS may then be given to the patient. [Source: Pubmed]
It’s also not uncommon for digestive issues or imbalance in the gut to contribute to skin issues such as:
- Skin rashes [Source: Pubmed]
- Eczema [Source: Pubmed]
- Acne Rosacea [Source: Pubmed]
- Psoriasis [Source: Pubmed]
Causes of IBS
There are several factors that can be responsible for IBS symptoms. It is also possible that a combination of these may lead to IBS symptoms.
These causes include:
- Altered gastrointestinal motility
- Visceral hypersensitivity
- Post-infectious reactivity
- Brain-gut interactions
- Alterations gut bacteria
- Food sensitivities
- Carbohydrate malabsorption
- Intestinal inflammation [Source: Pubmed]
Also Read: How Do I Know If I Have IBS?
Symptoms of IBS
The symptoms of IBS can vary in severity and frequency of onset. However, the symptoms that are reported to be the most distressing are:
- Abdominal pain
- Straining
- Urgency
- Bloating
It’s also common for those with digestive issues to be experiencing symptoms elsewhere in the body.
These include:
- Myalgias (muscle pain)
- Headaches
- Depression
- Skin issues [Source: Hopkins Medicine]
IBS and Skin Health – Is there a connection?
A recent study indicated that people with acne were more likely to experience digestive symptoms.
These symptoms include constipation, bad breath, and reflux. Bloating, in particular, was highly associated with skin conditions. [Source: Pubmed]
There is growing research into how the health of the digestive system and the balance of the bacteria with it can impact the health of the skin.
The communication between the gut and the skin is termed the gut-skin axis.
This can be attributed to alterations in the microflora leading to localised and then system inflammation, which can potentially contribute to skin symptoms. [Source: Pubmed]
IBS and Acne
A key study indicated that up to 40% of individuals with acne may have low stomach acid. This was then theorised to impact the bacterial balance of the small intestine and contribute to SIBO and skin issues.
Additionally, emotional stress has the potential to contribute to microflora changes which may then impact the integrity of the gut lining. This may then set the stage for a localised and systemic inflammatory response.
[Source: Pubmed]Skin Health and SIBO
A low level of stomach acid is considered a significant risk factor for developing SIBO. SIBO has been detected in 50% of patients on long-term proton pump inhibitor therapy. [Source: Pubmed]
SIBO is associated with digestive symptoms such as bloating, abdominal pain, and changes in bowel patterns.
It’s also reported in other syndromes such as fibromyalgia and chronic fatigue syndrome [Source: Pubmed]
There is also a close link between SIBO and acne rosacea.
IBS and Acne Rosacea
A recent report indicated that SIBO is 10 times more likely in those with acne rosacea than in healthy controls. It has also been noted that treatment of SIBO leads to a clinical improvement in symptoms of rosacea.
This can be due to changes in the balance of the microorganisms in the gut, alterations along the gut lining as well as low-level inflammation.
A central component of this may be the increase in specific inflammatory compounds from bacteria, called endotoxins, entering circulation. [Source: Pubmed]
IBS and Eczema
Eczema is a chronic inflammatory skin disorder that is understood to develop due to multiple factors.
These include:
- Immune dysregulation
- Genetic susceptibility
- Environmental factors
- Impaired barrier function
It has also been reported that those with eczema have gut microbiome differences and inflammation in their gut. [Source: Pubmed]
Notably, infants with eczema appear to have reduced diversity in their gut microbiome and elevated levels or organisms such as clostridia species. Additionally, a Dutch study reports that early life colonisation of organisms such as Clostridium difficile and Escherichia coli is associated with an increased risk of eczema. [Source: Pubmed]
Key strains of bacteria such as Bifidobacteria lactis Bb-12 or Lactobacillus GG have benefits in modifying the changes in the gut, which are associated with the allergic inflammation seen in eczema. [Source: Pubmed]
Gut Health and Psoriasis
Changes in the gut microbiome have been associated with skin conditions such as psoriasis.
One key change is a reduction in Akkermansia Muciniphilia. This beneficial bacteria is understood to strengthen the gut lining and protect against systemic inflammatory conditions. It has also been found that those with psoriasis have a reduction in the diversity of organisms within their gut microbiome. This can lead to a less stable bacterial ecosystem [Source: Pubmed]
How to Balance the Gut
Imbalances in the gut microbiome can lead to the common symptoms of IBS. However, even without bloating or changes in bowel patterns, these imbalances have the potential to lead to symptoms elsewhere in the body, such as on the skin.
The food we eat plays a central role in the balance of bacteria in the gut microbiome. As mentioned in this article, microbiome diversity is a key metric used to support gut health and skin health. This refers to the wider range of bacteria leading to increased resilience and stability in the gut ecosystem.
To support the stability of the gut microbiome, it can be helpful to think about each food we eat supporting the growth of different bacteria within the gut. Therefore, the wider the range of foods we at, the wider the range of organisms we support.
Another area of concern is agricultural practices such as antibiotics and pesticides. While not used at levels that are present in human blood samples, they may lead to changes in the gut microbiome, specifically in the reduction of diversity. [Source: Pubmed]
Additionally, the regular intake of fermented food over a 10-week period has been shown to increase microbiome diversity and improve immune responses.
Examples of fermented foods are:
- Kefir
- Kimchi
- Sauerkraut [Source: Pubmed]
Conclusion
Whether there are digestive issues present alongside skin issues or not, supporting the diversity of the microbiome is a central approach.
This may also be challenging due to many following an increasingly restrictive diet to attempt to identify the specific triggers.
Working to address the underlying issue is central to diversifying the diet and supporting the gut microbiome.
