“Irritable Bowel Syndrome” and other Functional Gastrointestinal Disorders: A New Paradigm

Referred to a gastroenterologist and still searching for answers?

The most common reasons patients are referred to a gastroenterologist are chronic diarrhea or constipation, bloating, and abdominal pain. Gastroenterologists typically rule out cancer, inflammatory bowel diseases such as Crohn’s Disease and Ulcerative Colitis, and celiac disease. When patients do not fall into one of these categories, they are often labeled with the diagnosis of “Irritable Bowel Syndrome,” or IBS.


What is IBS?

IBS and other functional gastrointestinal disorders (FIGD) were previously defined by specific symptoms and the absence of structural or biochemical abnormalities. However, this definition is now considered to be outdated. With more advanced and specific testing now available, structural and biochemical abnormalities that explain or cause the symptoms of IBS and other FIGD are often found.


Is it all in my head?

The short answer? No. Due to the high prevalence of psychiatric comorbidities found with IBS, such as depression and anxiety, it was previously proposed that mood disorders “cause” gastrointestinal symptoms. Alternatively, it was hypothesized that individuals with mood disorders were more sensitive to their physical gastrointestinal system. To the contrary, epidemiological data now provide strong evidence that in many patients, gastrointestinal symptoms arise first and mood disorders occur later. Various mechanisms for gut-brain dysfunction have been identified, with mild systemic inflammation as a causal factor in some cases. Other causative factors that play a role in functional gastrointestinal disorders and IBS include chronic infections, imbalanced intestinal microbiota, low-grade mucosal inflammation including increased eosinophils (the immune cells that fight parasites and cause allergies), systemic immune activation, altered intestinal permeability (i.e. “leaky gut”), altered bile salt metabolism (compounds that come from the liver to digest and absorb fats and fat-soluble vitamins), abnormalities in serotonin metabolism (your “feel good” neurotransmitter), and genetic factors.


Make sure to get the right testing done.

The key to treating IBS and FGIDs is identifying the root underlying causative factors. The doctors at Holistique run highly comprehensive and sensitive tests to look at the problematic pathogens in the gut, as well as functional markers including levels of inflammation, digestive function, and permeability. These tests provide the answers needed to identify and treat the root cause of digestive concerns.


How do doctors at Holistique treat IBS?

Depending on various factors identified with specialized gastrointestinal testing, Holistique doctors may prescribe an herbal or nutraceutical protocol to help eradicate problematic infections, heal the gut lining and reduce inflammation. In other cases, Holistique doctors may work with patients on removing problematic food triggers. Because stress and chronic “fight or flight” or sympathetic nervous system activity can lead to slower gut motility, stress-reduction practices may be a part of a comprehensive treatment plan.


What other therapies can be helpful for IBS?

Intravenous nutrient therapy is highly valuable in patients with gastrointestinal disorders because the gut is compromised and therefore frequently does not absorb nutrients from food optimally. Bypassing the gut by utilizing intravenous therapy can get necessary vitamins and other nutrients to the cells that need them to support healing, including the gastrointestinal cells themselves.


I am interested in working with a Holistique doc, what do I do?

Call or text to schedule a new patient appointment at 425-451-0404. We look forward to developing a personalized care plan for you, and help lead you closer to complete symptom recovery.



Borghini, Raffaele et al. “New insights in IBS-like disorders: Pandora’s box has been opened; a review.” Gastroenterology and hepatology from bed to bench vol. 10,2 (2017): 79-89.

Holtmann, Gerald et al. “Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview.” Digestive diseases (Basel, Switzerland) vol. 35 Suppl 1 (2017): 5-13.

Dr. Marian is Holistique Medical Center’s associate naturopathic physician. She is passionate about identifying and treating the root cause of complex chronic illnesses. She believes everyone deserves to live each day as the most vibrant and authentic version of themselves, and only by addressing the root cause of illness can true symptom relief be obtained. Dr. Marian received her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, Washington. In addition to the core naturopathic curriculum, she completed advanced training in pediatrics, gynecology, cardiovascular disease, diabetes, detoxification, genomic medicine, IV therapy, and neural therapy. Prior to her doctoral studies at Bastyr University, Dr. Marian received a Bachelor of Science in Chemical Engineering as well as a Master of Science in Environmental Engineering from the University of Washington. Maria also has five years of experience in biomedical and engineering research. She enjoys attending conferences and seminars regularly to stay absolutely current in her areas of specialty. As a research technician at Benaroya Research Institute at Virginia Mason, a non-profit international leader in immune system and autoimmune disease research, Dr. Marian contributed to important research in characterizing the underlying pathology of a rare condition of accelerated aging in children. Dr. Marian’s passion for understanding the human body fuels her clinical work, and in turn, her clinical work inspires her dedication to lifelong learning.