It is the opinion of this interviewer, Celeste Cooper, RN,
that irritable bowel syndrome is a comorbid condition to many immune disorders.
In my interview with Dr. Wangen, I found what he had to say very interesting,
and I think you will too.
Dr. Stephen Wangen, ND and the IBS Treatment Center have a
mission to provide the best care possible for irritable bowel syndrome. He
says, “You not only look at symptoms, you have to look for the cause of the
problem and, most drugs are only designed to treat symptoms.”
So Dr. Wangen:
How do you determine need?
Anyone suffering from a digestive problem needs to seek help
from someone who is focused on solving IBS. Digestive problems should not be
unpredictable. In fact, they shouldn't happen at all except on rare occasions.
Can you share a few of the causes you have found in IBS?
There are so many causes. One of the advantages of
specializing in this area is the ability to sort through those and determine
which are relevant for each patient. The digestive tract is a fascinating
ecosystem that contains 100 trillion bacteria and a majority of our immune
system. The health of this environment plays a role in the development of food
intolerances, food allergies, and food sensitivities, all of which must be
assessed. It also is impacted by everything we ingest, and it has the potential
to be affected by yeast overgrowth (Candida), parasites, and even stress. All of these play a role in leaky gut
syndrome, which is another aspect of digestive health. I have seen patients
with food allergies that they never even imagined possible, such as to cane
sugar, and people with yeast or parasites that had been completely missed. But
most patients have several factors negatively affecting their digestion all at
the same time. That is why it is often challenging to figure out by yourself.
Why did you decide to start a center based solely on
treatment of IBS?
I once suffered from IBS. When I saw doctors, they had no
idea why I had my symptoms. They made guesses and nothing helped. I was told that
it was stress and labeled it as IBS. That didn't leave me with any more
knowledge than when I first started. I already knew that my bowel irritated me.
As I began to see patients, I became more focused on finding the cause of
digestive problems, and then I became more successful at helping patients.
Ironically, it usually isn’t stress that causes the problem, but IBS that
causes the stress!
How many patients do you see with IBS?
I've seen around 4,000 IBS patients.
What is your most difficult type of IBS to treat?
There are many different types of IBS, but they all involve
one or more of the following symptoms: diarrhea, constipation, abdominal pain,
gas, or bloating. I can't say that one is more complicated than the other. The
symptoms only tell me that something is wrong.
As a naturopathic doctor, do you use integrative therapies
such as, manual therapies, acupuncture, trigger point therapies, meditation, or
nutritional changes?
My goal has always been to solve IBS, not adhere to a
medical philosophy. All of the things that you mentioned have value, sometimes
even prescription medications. However, all of these treatment modalities are a
lot more effective when used in the right ways for right person by assessing
each patient individually.
At the IBS Treatment Center, we focus on trying to find the
cause of the problem. There are many assessment tools including unique labs for
testing the environment of the bowel and its effect on the body. They are not
all created equal. We test the labs, use different labs in different
situations, and we apply various treatments based on what works best for each
individual.
Can you tell us a bit more about what you are looking for
with lab results?
Lab results help us develop our priorities. A good lab will
properly identify the correct food intolerance, for example. And a highly
specialized parasite lab will find parasites that other labs miss. However,
even lab work has its limitations. Many aspects of what we do have come from
years of clinical experience. Sometimes experience and listening to your
patient is more valuable than lab work. We combine both to get the best results
possible.
What can the patient expect as an active participant in the
treatment protocol?
Anyone who thinks that health can be handed to you from
someone else is gravely mistaken. Patients often need to make dietary changes,
but these are targeted changes based on each patient’s lab results. If patients
are willing to participate in their plan, they have a very good chance of
getting better.
Do you consider gluten to be an irritant to the bowel and do
you feel this is true for ALL IBS patients?
Gluten intolerance is just one of many possible irritants
involved in IBS. It may or may not be a
factor for an individual. Determination is based on what we find with the
patient’s lab results.
An anti-inflammatory diet is suggested for arthritis and
autoimmune disorders. What are your thoughts on suggesting it for IBS patients?
Inflammation is produced by the immune system and the immune
system must be triggered to turn it on. Different foods will turn on
inflammation in different people. A successful anti-inflammatory diet is about
identifying the specific triggers in each individual. There is no one size fits
all anti-inflammatory diet, but there is an anti-inflammatory diet for each
patient.
In general, what is the easiest to overcome and what is the
most difficult? (ie. infrequent attacks vs IBS and bowel disease).
Inflammatory bowel disease (IBD), which is very different
from IBS, is often the most difficult, but even then we have good success.
You don’t feel patients with IBS and bowel diseases such as
Crohn’s disease or diverticulosis have more difficulty controlling incontinence
or increased bowel motility?
All of these diagnoses -- IBS, Crohn's disease, and even
diverticulosis, include a wide spectrum when it comes to the severity of the
symptoms that can be experienced. Even though each diagnosis is different with
regard to the underlying damage that has occurred, some people have relatively
mild symptoms, and others are in the hospital. This is even true for IBS.
Therefore, I don't like to underestimate one person's problems just because
they don't have a diagnosis that the medical community considers as serious as
another. I try not to judge my patients
or predetermine who can get better. Everyone should have hope that they can
heal, because they usually can.
How long does it take for your protocol to work?
Every patient has different components that we are treating,
so it varies. Healing is like putting together a puzzle. There is usually more
than one piece to the puzzle, and every puzzle is different. In general we
should be seeing improvement within about a month after implementing treatment
and continuing over the next several weeks. Some patients heal quickly, and
others take longer, but the goal is to get them moving in the right direction
and then keep them on that path.
I understand that treatment is individualized, but what are
your general thoughts on probiotics?
The good bacteria in your digestive ecosystem are critical
to digestive health. But not everyone needs probiotics, and probiotics are
certainly not all created equal. I like to assess the bacterial environment
before I even recommend probiotics, because there are some people who feel
worse when they take probiotics and others who are just wasting money taking
them. However, when I do recommend probiotics I usually use a full spectrum
probiotic that contains as many different species as possible.
What can the patients, who are proactive in their role, hope
to achieve?
Patients should expect a significant improvement in their
health. I think that people often let the medical system off the hook too
easily. If you take your car into the mechanic and they tell you that they
can't fix it, then you find someone who can.
Our goal is to help people get better. Sometimes the most difficult
aspect is getting the patient to believe that improvement is possible. If every
other highly respected expert is telling you that there is nothing that you can
do, then you start to believe it. Unfortunately we're not perfect, but we have
a great deal more to offer than most people are getting elsewhere. It's what
makes my job so rewarding!
About Dr Stphen Wangen
Dr Stephen Wangen is the co-founder and Medical Director of
the IBS Treatment Center. He is a board certified and licensed physician with a
doctoral degree in naturopathic medicine from Bastyr University. Dr. Wangen is
the author of two books, “The Irritable Bowel Syndrome Solution,” and
“Healthier Without Wheat: A New Understanding of Wheat Allergies, Celiac
Disease, and Non-Celiac Gluten Intolerance.” Dr. Wangen is also a clinical
faculty member of Bastyr University and the Research Director of the Food
Allergy and Intolerance Foundation. He may be reached in the Seattle office or
by email at info@ibstreatmentcenter.com
and on Facebook at www.facebook.com/ibstreatmentcenter
If you live in the Seattle, Washington or Santa Monica, California areas you can call them at:
206-264-1111 (Seattle) or 310-319-1500 (Santa Monica).
You can learn more about Dr. Wangen and the IBS Treatment Center and the individual care they provide at www.IBSTreatmentCenter.com
Post interview remark
It was a pleasure to do this interview with Dr. Wangen and
inspiring to know there are doctors who treat IBS patients comprehensively.
Naturopathic doctors are not all created equal, and this one had me at “our
goal is to improve patient outcome, based on the individual patient.” There is no cookie cutter answer to managing
IBS, and it is refreshing to speak with a healthcare provider that understands
how IBS affects a patient’s quality of life, then sets about improving it.
Related articles:
What is Irritable Bowel Syndrome? By Celeste Cooper, here.
Coming Clean on a Dirty Secret, Irritable Bowel Syndrome by
Celeste Cooper, here.
As Fibromyalgia Expert on Sharecare, here.
SIBO, Yeast & Leaky Gut and YOU! here
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