IBS Demystified
What’s Really Going On in the Gut (and How to Heal It)
Dr. Tracy Tranchitella, ND | Sunrise Functional Medicine
If you’ve ever felt like your digestive system has a mind of its own, you’re not alone. Irritable bowel syndrome (IBS) is one of the most common gut conditions worldwide, affecting millions of people every day. It’s frustrating, uncomfortable, and often confusing because unlike other digestive conditions, IBS doesn’t have a single clear cause you can point to. Instead, it falls into a category of disorders called “disorders of gut-brain interaction” (DGBIs), formerly known as functional gastrointestinal disorders.
That term functional is important—it means that even though symptoms are very real and sometimes quite severe, standard lab work or imaging usually doesn’t turn up anything conclusive. IBS has long been called a “disease of exclusion,” meaning the diagnosis often comes after other conditions such as celiac disease or inflammatory bowel diseases have been ruled out. This can leave patients in limbo. Conventional medicine offers a few prescription options for symptom management, but those don’t get to the underlying “why” behind IBS. That’s where functional and naturopathic medicine can shine—by taking a broader look at root causes, patterns, and the interplay between digestion, lifestyle, and overall health.
The Many Faces of IBS
IBS isn’t one-size-fits-all. It shows up differently for different people, with several subtypes recognized:
- IBS-D: diarrhea-predominant
- IBS-C: constipation-predominant
- IBS-M: a mix of diarrhea and constipation
- IBS-U: unspecified
Symptoms can range from mild inconvenience to life-disrupting. Abdominal pain, bloating, unpredictable bowel habits, and fatigue can make even everyday routines—like going to work or sharing a meal with friends—a source of stress. It’s also worth noting that IBS is often linked with other conditions, like anxiety, depression, and migraines, pointing again to the importance of the gut-brain connection.
What Triggers IBS?
IBS doesn’t have one single cause—it’s more like a perfect storm of influences. Here are some of the big players:
Food sensitivities and intolerances: Many people with IBS notice a direct connection between what they eat and how they feel. Food sensitivities can inflame the gut lining and trigger symptoms.
Dysbiosis: The gut microbiome—our community of bacteria, viruses, and fungi—plays a huge role in digestion. People with IBS often have reduced diversity in their microbiome, which can leave the digestive system vulnerable.
Stress: The gut-brain connection runs both ways. Emotional stress, and especially traumatic life events, can set IBS into motion or make it worse.
Hormones: Women are more likely to develop IBS, and research shows estrogen fluctuations can influence immune responses in the gut.
Root Causes from a Functional Medicine Lens
When Dr. Tracy Tranchitella and her colleagues at Sunrise Functional Medicine look at IBS, they aren’t just trying to quiet symptoms. They’re asking: What’s going on beneath the surface? A few patterns come up often:
Post-infection IBS: An acute GI infection, like food poisoning, can disrupt the gut long-term. Certain pathogens—like protozoa or bacteria—are more strongly associated with triggering IBS than others.
Pathobiont overgrowth: Sometimes the problem isn’t foreign invaders but our own “friendly” microbes behaving badly. Under stress, commensal bacteria can become opportunistic troublemakers.
Digestive imbalances: Bile acid malabsorption, enzyme insufficiencies, or poor nutrient absorption can all feed into IBS. For example, abnormal bile acid metabolism has been linked to loose stools and diarrhea-predominant IBS.
Gut permeability: Sometimes called “leaky gut,” this happens when the intestinal barrier becomes compromised, allowing unwanted substances to pass into circulation and stoke inflammation.
The big takeaway? IBS is rarely about just one thing. It’s about how food, stress, microbiome shifts, hormones, and immune responses interact in each unique person.
Lifestyle and Functional Medicine Approaches
The good news is that IBS doesn’t have to run your life. Functional medicine offers a range of strategies that can be personalized depending on what’s driving the symptoms:
Nutrition: Identifying and removing food triggers is often the first step. This might include trialing an elimination diet or reducing fermentable carbs (FODMAPs) to see if symptoms improve.
Rebuilding the microbiome: Probiotics, prebiotics, and sometimes antimicrobial herbs can help repopulate and balance gut bacteria.
Repairing the gut lining: Nutrients like L-glutamine, zinc, and omega-3s can help strengthen the intestinal barrier.
Stress management: Mind-body practices such as yoga, meditation, and breathwork can calm the nervous system, improving the gut-brain connection.
Movement: Regular exercise supports healthy bowel motility and reduces stress—two wins for IBS management.
In functional medicine, clinicians often use frameworks like IFM’s 5R program—Remove, Replace, Repopulate, Repair, and Rebalance—to address digestive dysfunction systematically. Tools like the DIGIN model and Functional Medicine Matrix help map out how digestion, inflammation, and lifestyle factors intersect.
Why Personalization Matters
One of the biggest frustrations with IBS is that what works for one person doesn’t necessarily work for another. That’s why a personalized plan matters so much. For some, the focus might be rebalancing gut bacteria. For others, it may be about calming stress responses, adjusting diet, or supporting hormone balance. Dr. Tranchitella emphasizes that IBS isn’t something you “just have to live with.” By exploring root causes, patients can find long-lasting relief instead of cycling endlessly through symptom management.
Moving Forward
IBS is a reminder of how interconnected the body really is—digestion, hormones, stress, and immune function are all woven together. While conventional medicine often stops at symptom relief, functional and naturopathic approaches open the door to healing by addressing the deeper “why.” If you’re struggling with IBS, you don’t have to navigate it alone. Working with a clinician trained in functional medicine, like Dr. Tracy Tranchitella at Sunrise Functional Medicine, can help you uncover what’s driving your symptoms and create a plan tailored to your needs.
Because at the end of the day, your gut doesn’t just want to be quiet—it wants to be heard, understood, and supported. And with the right approach, relief and resilience are absolutely possible. You don’t have to settle for living at the mercy of your digestion. By working with a functional medicine practitioner like Dr. Tracy Tranchitella at Sunrise Functional Medicine, you can uncover the root causes of your IBS and build a plan that restores comfort and confidence. Relief is possible, and so is getting your life back.