Functional Nutrition Intervention Protocols
IRRITABLE BOWEL SYNDROME
SSESSMENT
Anthropometrics
Biomarkers/Labs
Conventional
Height, weight, BMI
Waist circumference, hip circumference, waist-to-hip ratio
% body fat, % lean body mass
R/O gastrointestinal tract cancer
R/O celiac disease
Iron status, folate/B12 status, protein status, vitamin D
Functional
Comprehensive stool analysis, intestinal permeability
RBC essential fatty acids
Food sensitivity testing (IgG or Mediator Release Testing)
Nutrigenetic
As appropriate, such as inflammation profile, Phase I/Phase
II detoxification profile
Clinical Indicators
Nutrition-focused physical exam
Diet/Lifestyle Histories
Comprehensive intake form
Include Medical Symptom Questionnaire
IAGNOSIS
NTERVENTION
Irritable bowel syndrome
IFM 5R Program for Gastrointestinal Dysfunction
Core Food Plan
Balanced core food plan
Food Plan Modifications
21-day Comprehensive Elimination Diet + anti-inflammatory
foods + elimination of any foods promoting GI reactions
Functional Foods/Medical Foods
Soluble fiber foods, such as oatmeal/oat bran, cooked or
canned fruits and vegetables
Anti-inflammatory medical food
Dietary Supplements
Vitamins
High quality daily multivitamin with chelated minerals
If using antacid or proton pump inhibitor, replenish vitamin
B12, folate
Minerals
Replace if patient using antacids or protein pump inhibitors
or labs indicate need: Ca, Cr, Fe, I, Mg, Mn, Se, Zn
75 mg Zn short-term may help with intestinal permeability
Nutritionals
L-glutamine, 10-40 g/day, taken between meals, increase
gradually, caution with individuals with bipolar disorder
Irritable Bowel Syndrome
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Functional Nutrition Intervention Protocols
Dairy-free probiotics, 30-100 billion colony-forming units of
Lactobacillus and Bifidobacter bacteria in divided doses
daily; increase gradually; accompany with soluble fiber
Omega-3 fatty acids, 2-4 g/day
Bovine colostrum may be helpful, from herds certified to be
free of bovine spongiform encephalopathy (BSE)
Botanicals
Anti-inflammatory herbs: boswellia, 400 mg tid; ginger
(root), 1-4 g/d; turmeric (root), 500 mg/d standardized to
95% curcuminoids, willow (bark), 60-240 mg salicin/d
Carminative herbs: peppermint tea; enteric-coated
peppermint oil, 180-200 mg tid between meals
Promote healing: Aloe vera juice (aloes-free), 50 ml (~6 oz)
tid; DGL (deglycyrrhizinated licorice), 200 mg standardized
extract (1-2% glycyrrhizin) tid
Food/Medication/Dietary
Supplement Interactions
Lifestyle Recommendations
Physical Activity
Aloe vera may cause hypoglycemia
Daily activity, as tolerated, preferably outdoors (sunshine)
Yoga and other mindfulness activities
Sleep
Full complement, as determined for individual patient
Psycho-social
Stress assessment, management program
Encourage social connections, activities that are meaningful
and pleasurable for the individual
ONITORING and
Follow-up Plan
VALUATING
Periodic contact by functional nutrition practitioner
Return to clinic in 3 weeks to begin food reintroduction
Primary source of dietary supplement information: Natural Standard Database
Drisko J, Bischoff B, Hall M, McCallum R. Treating irritable bowel syndrome with a food elimination diet
followed by food challenge and probiotics. J Am Coll Nutr. 2006;25:514-22.
Irritable Bowel Syndrome
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