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Is IBS an issue with the Gut Microbiome or mainly related to mental stress ?

I have been suffering with IBS-C since 5-6 years. If I actually look back and think correctly the initial symptoms probably were noticeable 10 years ago, but I did not pay much attention to it thinking that it was probably constipation.

I have tried all types of treatment, Allopathy, Ayurveda & Homeopathy, but nothing works. Have consulted various doctors and they usually prescribe Rifaximin & some pro-biotics. They also advise change in diet and moderate exercise, yoga etc. Maintaining a strict diet is a bit difficult since I have to travel overseas at times for my business. And moreover I sometimes cannot resist sweets and cakes etc.

I have been having a good amount of mental stress since last few years owing to issues in my business and career. But, I'm also active and walk about 4kms everyday. All my medical reports are normal, expect the Endoscopy shows a mild barrettes esophagus and some mild ulcer like redness inside my stomach. The colonoscopy is also normal, and blood reports are also fine.

I learnt about a gut Microbiome Test at AIG Hospital at Hyderabad, and I personally got it (Not recommended by doc's) done to see if it showed any irregularities, seems like they are the only ones in India who have a Gut Microbiome test. The gut microbiome report shows a mild gut dysbiosis. Also, surprisingly the only treatment suggested to me was to maintain a good diet and some anti - acidity pills. Other things suggested were active lifestyle, moderate activity, exercise, yoga, walking etc. And yes, the report also mentions that one needs to manage mental stress and tensions, and try some breathing exercises.

My symptoms are gas, bloating, passing wind especially during evenings. Slight pain and sometimes moderate pain in abdomen, pain in abdomen reduces after passing wind. Motions usually twice a day, morning and at night before sleep. The thickness of stool is surprisingly thinner. Also noticed that whenever I take Rifaximin all these symptoms reduce and the stool is also better but much harder and have to apply a lot of pressure to pass it.

I definitely have an anxiety issue, and cannot sleep well, without sleeping tablets. I'm very confused about how to handle these problems, please suggest what could be the best treatment.


  1. So sorry you are going through these symptoms and not getting any relief. IBS- C can be so frustrating. As far as suggesting a treatment, that would not be a possibility as we are not medical professionals, and we care about your safety.

    What I can offer is talking about my personal experience dealing with IBS-C. At the time what helped me overcome it was a probiotic daily. And I had to try various ones, until I found the one that offered me relief. We all require different strands of bacteria for our individual gut flora so it may take a couple of tries until you see improvement. In addition, a totally change of my diet was crucial. No sugar, no wheat were the big ones for me. Lots of fish and steamed/cooked veggies. No rice either. That is when I saw an immediate improvement. Slowly I got into adding fiber via smoothies etc.

    I hope this helps some.

    -Elizabeth (team member)

    1. Hi Elizabeth,

      Thanks for your quick reply, and very much appreciate your suggestions.
      I have been advised to have a low food map diet by one particular gastroenterologist, whereas a dietician suggested that a variety of different foods would be good for helping improve the gut microbiome. So its confusing, and I'm a bit reluctant to experiment since I have had some bad experiences as my digestion goes for a toss.

      I'm taking the Healthy Hey Probiotics daily one tablet, and ayurvedic tablet for acidity and digestion called Acideem. I try to avoid veggies such as Cauliflower, Broccoli, Onions and Potatoes since they are the main culprits. It would have been great if there were tests to identify the correct strands of beneficial bacteria that is needed by my body, and the ones that are the culprits causing flatulence.

      However, IBS is still not well understood by most of the Doctors and Gastroenterologist, and they seem to point it to mental stress. Moreover, I had one more bad experience when a senior experienced Gastroenterologist refused to see my Gut Microbiome test. My main question is - what causes IBS, is it mental stress or is it an imbalance in the gut flora ?


      1. I personally think that the cause might be different for different people. For me, it’s definitely mental stress. I’ve dealt with anxiety for most of my life and it’s the worst and at times only trigger for my IBS. My safe foods change tremendously depending on my stress levels. Sometimes, when I’m on vacation and feel very calm, I can eat almost anything, although I do have some actual food triggers.
        I’m not quite sure how true this is, but I’ve also heard that the gut microbiome can be impacted by stress.
        However, I have also heard from other community members that their issues seem unrelated to stress. So it’s probably very individual…
        Regarding the diet, I have found that listening to my body rather than following a strict diet works best for me. Veggies aren’t the safest for me, so I always do small portions of cooked veggies and change up my protein sources as much as possible to add variety into my diet. However, I do eat gluten-free (gluten causes me lots of bloating, discomfort and skin issues), so eating out is very hard…
        Karina (team member)

      2. I sympathize. My symptoms have been so bad for the last four years I had to retire. I have post-infectious ibs-c. We are lucky enough to have a local team of gastroenterologists who do know how to deal with it, and I just recently came under their care during a hospital stay. They are completely opposed to the low fodmap diet, and I now agree with them. There are a few foods I can't eat comfortably, but only a few. Everyone's trigger foods will be different. They use Miralax first, along with a fiber supplement, and if that doesn't work, Linzess. Supplements that help me are: GABA (Nature's Way), MSM (NOW brand), and NOW peppermint oil capsules (enteric coated and much cheaper than IBgard). Good luck. I hope you find a good GI doc.

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