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the irritable bowel syndrome solution
by Dr Stephen Wangen
This book explain how Dr Wangen uses food intolerance testing and comprehensive digestive stool analysis (CDSA) to tackle the symptoms of IBS at his treatment center in Seattle.
an interview with dr stephen wangen
Thanks for talking to us Dr Wangen. Can I ask you when you first became involved in the treatment of IBS?
I've been treating IBS for over six years. As a medical student, I suffered from IBS. It was then that I began to gain an appreciation for the impact that food has on our health. I thought that stress was the cause of my symptoms, but I later discovered that for me it was gluten, a protein found in wheat, barley, and rye, among other grains.
As I began to practice medicine I found that I was having a great deal of success helping my IBS patients resolve their problem. They were extremely grateful and continued to refer patients to me. I began to see more and more people with IBS and the symptoms of constipation, diarrhea, abdominal pain, gas, and bloating. Almost invariably we were able to sort out their problem's cause and lead them to an IBS-free life.
How did that develop into opening your own IBS treatment center?
As my confidence and patient base grew, I realized that I was developing a whole new specialty in treating IBS, and that there are many more people out there who need help and could benefit from my approach. That led to my new book on the topic, The Irritable Bowel Syndrome Solution, and the creation of the IBS Treatment Center.
What in your view are the main causes of IBS - and are the causes all treatable?
IBS, as we all suspect, is triggered by food. But of course, we need to eat, so how can we eat without triggering IBS? There are really two key issues at play, the immune system and the bacterial environment in the digestive tract.
The immune system is incredibly complex, but the short story is that it is designed to protect us against foreign invaders. The surprising part is that sometimes what we consider healthy food is considered by our immune system to be a foreign invader. However, once you consider that we are a product of hundreds of thousands of years of evolution, and didn't necessarily evolve eating the things that we eat now, it shouldn't be too surprising that not all food is viewed by our immune system as nutrition. This is fundamentally known as a food allergy and is a primary cause of IBS.
The other key factor is the bacterial environment within our digestive tract. We are designed to have bacteria there. In fact, we can't live without them. But some bacteria are more beneficial than others. This environment is susceptible to being thrown off-balance by antibiotics, chemicals, bad bacteria, yeast (candida), parasites, and viruses such as the stomach flu. This can wreak havoc with your digestion, causing IBS, and in some cases even mimic a food allergy. This issue really isn't any different than the outside world around you. If we alter the ecosystem, then there will be negative consequences.
Can you tell me about the treatments you use, and how you decide what treatments are right for different patients?
It's impossible for me to know what is causing a person's IBS until I run some tests. Everyone is different, but most people who suffer from IBS need to have both their immune response to food and their digestive environment evaluated, and often there are problems in both areas.
We can determine if the immune system is attacking food by running a blood test to determine if someone is creating antibodies against a specific food. This may sound complicated, but antibodies are simply an indicator that something is being attacked. I always measure both IgG and IgE antibodies to a complete panel of about 100 foods. Everyone is unique, so it's impossible to know what (if any) food or foods are triggering the immune system to attack until the results are in.
We can evaluate the bacterial environment through stool testing. Proper stool testing will include cultures of both good and bad bacteria, as well as yeast (candida), and parasites if necessary. It is just as important to evaluate whether or not you have adequate acidophilus and bifidobacterium (both good bacteria), as it is to measure the presence of the multitude of potential bad bacteria. Most stool tests do neither and only evaluate for parasites and deadly bacteria such as salmonella.
After we get the test results back, only then can we appropriately address your IBS. Allergenic foods will need to be eliminated from the diet. This is often more complicated than it sounds. Many people don't have success until they understand the various places a food or food group can be hidden in your diet. This is why I generally spend at least a half an hour reviewing these results with patients. I also review and provide with them many handouts about how to avoid those foods and educate them on what alternatives will be good for them.
Imbalances in the digestive ecosystem will be evident on the stool test results and are usually readily treatable. They may require treating yeast, bad bacteria, or parasites with an appropriate pharmaceutical or natural agent. Deficiencies in good bacteria can be corrected by taking quality probiotics in adequate dosages.
I rarely use fiber, digestive enzymes, or stress reduction techniques because although they can be helpful, in my experience they generally don't address the cause of the problem or cure IBS.
What kind of success rates have your seen with your patients?
Once we've run the appropriate tests and implemented the treatment plan, I expect all of my patients to experience major improvement in their IBS. About 95% experience complete resolution of their IBS. The cases that don't vastly improve usually turn out not to be IBS at all, but something else that can cause similar problems, such as gallstones, ulcers, endometriosis, and the like, which of course also need to be ruled out.
Do you find that certain types of IBS, eg: IBS with diarrhea or IBS with constipation, are easier to treat than others?
Diarrhea, constipation, abdominal pain, gas, and bloating are merely symptoms of a deeper problem. The cause can even be identical. For example, one patient can have diarrhea triggered by dairy products, and another can have constipation triggered by dairy products. I haven't seen any difference in the success rate between patients with different symptoms. I expect them all to get better.
Mainstream treatment of IBS can be inadequate at best - do you think that in the future more doctors will start to use treatment methods similar to your own? Is the future bright for IBS sufferers?
Eventually this will become more common in medicine, but it will take a very long time. Conventional medicine doesn't have much appreciation for food or good bacteria having much to do with health, even though it is extremely logical. Medicine is a big business, and you won't see much attention or money being focused on this area because there isn't lots of money to be made. Selling a drug or surgery is much more profitable.
Having said that, I don't see any reason why people can't take charge of their own health and demand better health care. That's how changes come about. And that's my goal. I want to educate the public, and I want everyone to be healthier.
REVIEWS OF A NEW IBS SOLUTION
Review by Steve 
Dr Wangen is founder of the IBS Treatment Center in Seattle. He suffered from IBS when he was studying. This book is clear and well-written. It certainly provides a compelling argument. He believes and states that there is a cause to IBS and that IBS can be cured. He recommends stool testing for parasites, bacteria and yeast etc and blood testing for food intolerances. Once the results are known then the problem can be eradicated and hence the IBS will be cured.
I live in the UK, but if I were in the US I would definitely want to go to see this doctor. In the meantime I had the stool test done by Metametrix in the US which is the same lab that Dr Wangen uses. I also had a blood test for food intolerances carried out. The test came back as essentially normal and because the book doesn't provide any information what to do when this happens I do not know what to do next. So I have to say that I found this omission from the book very annoying. Other than that it is definitely worth a look.
Have you read The Irritable Bowel Syndrome Solution? Please contact Sophie to send in your review.