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About 60 million people——that’s 20 percent of Americans — have irritable bowel syndrome (IBS). These people struggle with miserable, often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain. 目前在美国大约有6000万人患有肠易激综合症（IBS），这几乎占到总人口的20%，常年与这些症状抗争——腹胀、痉挛、腹泻、便秘和疼痛。
Numerous culprits contribute to IBS. Your gut lining can break down from stress; too many antibiotics or anti-inflammatory drugs like aspirin or Advil; steroids; intestinal infections; a low-fiber, high-sugar diet; alcohol and even C-sections (which we have seen a dramatic increase in recent years).
These and other things trigger and activate an immune response, sparking food allergies and aggravating your second brain (the enteric nervous system), creating havoc that leads to IBS. It isn’t just your bowel that can become affected; so can your mood, your energy levels, and a host of other problems.
In medical school, professors told us IBS was a psychological condition. Science proves that’s completely wrong. Unfortunately, conventional doctors often tell patients there is no cure, it’s all in their head, or they prescribe them with antidepressants, sedatives, and other drugs that could potentially make the problem worse.
导致IBS的原因有很多，你的肠道防御系统可能因为以下各种原因分崩离析——压力、过多抗生素或抗炎药（阿司匹林、布洛芬等）、类固醇、肠道感染、纤维素不足、高糖饮食、酒精，甚至剖腹产（近年来大幅增加）。
这些诱因触发了身体的免疫反应，导致食物过敏，加重第二大脑（肠道神经系统）的破坏程度，进一步引发肠易激综合症。这并不意味着只有肠道受到影响，同时受损的还会有情绪、能量等很多其他的方面。
以前在医学院时，教授们告诉我们IBS是一个心理原因导致的状况，但科学证明这个说法完全是错误的。非常不幸的是，传统的医生一般都会告诉患者这个病症是无法治疗的，这种根深蒂固的观念使得他们只会给患者开一些抗抑郁药、镇静剂或其他反而会使病情加重的药物。
This is not the answer. To treat IBS, you need to address the underlying causes of why your digestion is not working. That’s where Functional Medicine comes in.
In Functional Medicine, we know one disease can have many causes (or that one cause can create many diseases, such as with gluten). If you have five people with IBS, the causes may be quite different for each person, so for each individual we focus on getting to the root cause of disease.
Research tells us that two of the biggest causes of irritable bowel are food allergies and overgrowth of bacteria in the small intestine. There may be others, including a lack of digestive enzymes, parasites living in the gut, zinc ormagnesium deficiency, and heavy metal toxicity.
That’s why it becomes so critically important to personalize treatment based on the unique circumstances that exist for each person who suffers from IBS. The solution is most certainly not one-size-fits-all, but solutions can be found if we look carefully at the underlying causes and treat them.
Let’s briefly look at the two primary causes of IBS and then discuss how to treat them.
这并不是我们想要的答案! 要治疗IBS，我们需要找出并解决消化系统为什么不工作的根本原因，这也是功能医学解决的范畴。
在功能医学的概念里，我们都知道一种病症可能是由很多原因导致的（或是一种原因可以诱发多种疾病，如谷蛋白）。比如五个IBS的患者，他们的诱因可能都是不同的，我们应该根据个体差异找出每个人的病因所在。
研究表明IBS两个最常见的诱因是食物过敏和小肠坏菌的过度增长，还有其他一些诱因，比如消化酶的缺乏、肠道寄生虫、锌或镁不足、重金属蓄积等等。
这就是为什么个性化医疗变得至关重要的原因——基于个体的独特性，绝非是一种治疗方案放之四海而皆准，而是我们要找到致病的根本原因，并有针对性的加以治疗。
我们快速回顾一下引起IBS的两大诱因，之后再讨论如何干预。
Food allergens or sensitivities
A landmark paper, published in the prestigious British medical journal Gut, found that eliminating foods which were identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms. Another article, an editorial in the American Journal of Gastroenterology, stated clearly that we must respect and recognize the role of food allergies and inflammation in IBS.
What these and other studies clearly reveal is that certain foods can irritate your bowel and digestive system. These food sensitivities aren’t a true allergy, like a peanut allergy or shellfish allergy, but rather a more mild food sensitivity that can cause terrible symptoms.
食物过敏or 食物敏感
一篇发表在《英国医学杂志<内脏>》上的的文献具有里程碑式的意义，论述了限制摄入迟发过敏反应的食物可在很大程度上缓解IBS症状。另一篇发表在《美国胃肠病学杂志》上的社论则清晰的陈述了我们应该尊重和认识到食物过敏和炎症在IBS中起到的作用。
这些研究都表明特定的食物可刺激肠道和消化系统，这些所谓的食物敏感其实并非是真正的“过敏”，像是对花生或贝类的过敏，而是一种更加温和的“食物敏感”，但可以引发严重的症状。
Of the many common food sensitivities, gluten perhaps is most prevalent. Even if your doctor tells you that your tests for gluten antibodies or celiac are normal, you can still have a severe reaction.
Dairy, which contains proteins like casein and whey that can irritate and inflame your gut, is another common culprit.
There are others, including soy, corn, and eggs. Reactions to these foods can cause more than just gut problems. They can also create obesity, depression, and acne.
在众多的食物敏感中，谷蛋白应是最为普遍的，即使你的医生告诉你对于谷蛋白抗体和腹部检查的结果都是正常的，你还是有可能存在严重的反应。
奶制品是另一个罪魁祸首，其中含有的酪蛋白和乳清蛋白可刺激肠道并致炎。
还有一些其他食物，比如豆类、小麦和鸡蛋等，不仅引起肠道的问题，还可能导致肥胖、抑郁和痤疮等。
Your Functional Medicine doctor can run tests to assess food sensitivities and gluten reactions. Or you could do my Blood Sugar Solution 10-Day Detox Diet, which along with sugary and junky foods, eliminates the most common food sensitivities.
功能医学医生可为你检测食物敏感和对谷蛋白的反应，或者做10天排毒饮食调整，剔除垃圾食品的同时可避开常见的一些过敏食物。
Gut Imbalances
The surface area of your small intestine, where food is absorbed, is about the size of a tennis court. That area also houses about 60 percent of your immune system.
This sophisticated gut-immune system is just one cell layer away from a toxic sewer: All of the bacteria and undigested food particles in your gut.
If that lining breaks down, your immune system will be exposed to foreign particles from food, bacteria, and other microbes.
肠道失衡
小肠表面的面积很大，几乎是一个网球场大小，而且起到全身免疫系统作用的60%。
复杂的肠道免疫系统是从细胞层面远离毒素（囊括所有的肠道细菌和未消化的食物残渣）的屏障。
如果这道防线崩塌，你的免疫系统将会曝露于来自外界的各种物质中——食物、坏菌和其他微生物等。
Simply put, your gut microbial ecosystem must be healthy for you to be healthy. When your gut bacteria are out of balance — when you have too many pathogenic bacteria and not enough healthy bacteria —you get sick.
Stop and think about this for a minute: You’ve got about three pounds of bacteria — 500 species — in your gut. In fact, there is more bacterial DNA in your body than there is human DNA! Among all that gut bacteria, there are good guys, bad guys, and VERY bad guys.
If the bad guys take over, or if they move into areas that they shouldn’t be (like the small intestine which is normally sterile), they can start fermenting the food you digest, particularly sugary or starchy foods.
Imbalances in your gut ecosystem that can trigger or exacerbate IBS include leaky gut, small intestinal bacterial overgrowth (SIBO), and yeast overgrowth. While approaches to fixing these and other gut issues usually becomes issue-specific, the key to reversing them all becomes rebooting your gut by getting rid of the bad stuff and putting in the good stuff.
简言之，你的健康必须建立于肠道微生物环境的健康，当你的肠道菌群失衡（坏菌过多，好菌不足）时，就会生病了。
下面我们思考一下——你的身体内有大约3磅、500多种的细菌在肠道内，这意味着细菌DNA比人类的DNA要多得多！有好菌，有坏菌，还有非常坏的菌群，如果坏菌占了上风，或者是到了不应该出现的地方（比如应该是无菌的小肠部分），就会开始发酵你所吃进去的食物，尤其是甜食和淀粉类食物。
肠道菌群失衡可诱发或加重IBS，包括肠漏症、小肠菌群过度增长（SIBO）、霉菌过多。所以通常解决这些或其他肠道问题的关键，就在于如何摆脱坏菌并以好菌替代。
The Biggest Change You Can Make to Treat IBS
If you suffer from IBS, you understandably want relief fast. The biggest change you can make to get impressive, almost-immediate results involves changing your diet.
To do that, you’ll want to go on an ultra-simple, anti-inflammatory diet low in allergens, refined carbohydrates, sugars, and processed foods. Keep it really simple and keep a journal to record how you feel after each meal. You might also want to consider removing foods that are difficult on the gut, such as grains and beans.
治疗IBS你可以做出最大的改变
如果你患有IBS，你一定希望被快速治愈。最大的改变你可以做出的，并且是迅速有效的，就是改变饮食。
要做到这一点，你需要采用一种极简、抗炎饮食来限制过敏源、精制碳水化合物、糖和加工食品的摄入。使用简单的食谱并坚持饮食日记来记录每一餐的感受，并且还需要祛除对肠道有影响的食物，如谷物和豆类。
10 Strategies to Eliminate IBS
Because numerous underlying issues can contribute to IBS, testing and working with a Functional Medicine practitioner probably becomes your most effective option. That said, simply applying the following dietary tools and other strategies can help reverse or prevent IBS and create good gut health.
消除IBS的十大策略
因为太多潜在的问题都可以导致IBS，所以功能医学检测和干预可能是你最有效的选择，就是说，简单的应用下列饮食工具和其他策略就可以帮助你预防或扭转IBS，建立良好的肠道健康。
1. Eat protein. To avoid the blood sugar imbalances that feed bad gut bacteria, eat protein with every meal, even at breakfast. This will help you to avoid sudden increases in your blood sugar. Have a good protein-based breakfast every day. I’ve provided some delicious recipes here. Eat clean and sustainably raised animal protein, like fish, turkey, chicken, and lean cuts of lamb, and plenty of vegetable protein such as nuts, beans, seeds, and tofu.
1. 摄取蛋白。为了避免血糖控制失衡造成肠道坏菌增加，应该每一餐（甚至是早餐）摄取蛋白，这可以帮助避免血糖的突然升高，应该每天要有以优质蛋白为基础的早餐。我在这里提供一些好的饮食建议——清洁和可持续饲养的动物蛋白，如鱼、火鸡、鸡肉、羊肉（瘦肉），大量植物蛋白如坚果、豆类、种籽和豆腐。
2. Eat high-fiber foods. Whole grains, vegetables, nuts, seeds, and fruit all contain beneficial fiber.
2. 摄取高纤维食物。全麦、蔬菜、坚果、种籽和水果等富含有益纤维的食物。
3. Don’t be afraid of healthy fat. Increase omega-3 fatty acids by eating cold-water wild salmon, sardines, herring, flaxseeds, and even seaweed. Use more grass-fed or organic animal products. Eliminate all hydrogenated fat, found in margarine, shortening, and processed oils, as well as many baked goods and processed foods. Instead use healthy oils, such as coconut oil, olive (especially extra virgin olive oil), cold pressed sesame, and other nut oils.
3. 不要对健康的脂肪有恐惧。通过进食冷水野生鲑鱼、沙丁鱼、鲱鱼、亚麻籽甚至是海藻等增加omega-3脂肪酸的摄入，食用更多的食草或有机动物制品，限制所有的氢化脂肪、人造奶油、起酥油、地沟油，以及烘焙食品和加工食品等，使用健康的油脂代替，如椰子油、橄榄油（尤其是特级初榨橄榄油），冷轧芝麻油和其他坚果油。
4. Eat at least 8 to 10 servings of colorful fruits and vegetables a day, which contain disease fighting vitamins, minerals, fiber, phytonutrients, antioxidants, and anti-inflammatory molecules.
4. 每天至少吃8-10种彩色蔬果，其中富含对抗疾病的维生素、微量元素、纤维、复合营养素、抗氧化剂和抗发炎物质。
5. Avoid all processed junk food, including sodas, juices, and diet drinks, which impact sugar and lipid metabolism. Liquid sugar calories are the biggest contributor to obesity, diabetes, and heart disease.
5. 限制所有垃圾食品，包括汽水、果汁等各种饮料，这些都会影响糖脂代谢。液体糖分是引起肥胖、糖尿病和心脏病的一个很大的诱因。
6. Add in the good stuff.Eliminating IBS demands that you get rid of the bad stuff, but also replace it with good stuff. Zinc, vitamin A, glutamine, omega-3 fats (fish oil), and evening primrose oil are among the nutrients that help repair the gut lining. We also use herbs like quercetin and turmeric to reduce inflammation and heal a leaky gut. You can find these and other nutrients in my store.
6. 添加对抗IBS的有益物质。祛除不良因素并用有益因素替代，锌、维生素A、谷氨酰胺、omega-3脂肪酸（鱼油）和月见草油等都是可以帮助修复肠道的营养物质，使用草药比如槲皮素和姜黄可以降低炎症、修复肠漏。
7. Reduce stress. Meditation, deep breathing, and yoga are all great ways to reduce stress. You might also consider trying my relaxing UltraCalm CD.
7. 减压。冥想、深呼吸和瑜伽都是非常好的减压手段，你也可以尝试听一听放松的CD。
8. Sleep deprivation makes you fat and leads to depression, pain, heart disease, diabetes, and so many other problems. Check out this blog to get 19 tips for a better night’s sleep.
8. 睡眠不足可导致肥胖、抑郁、疼痛、心脏疾病、糖尿病等很多症状。
9. Exercise regularly. Even 30 minutes of vigorous walking can help, and if you want something more intense, try high-intensity interval training or weight resistance. Regardless of your current condition, I’ve provided a simple but comprehensive exercise plan here.
9. 规律运动。甚至30分钟的步行都是有帮助的，如果你想运动度更强烈一些，可以尝试高强度间隔训练或重量对抗训练。
10. Repopulate your digestive tract with good bacteria.Take very high-potency probiotics (look for at least 25 billion live CFU’s from diversified strains of Lactobacillus, Bifidobacterium, and Saccharomyces boulardii), twice a day for one to two months. Start slowly and observe how the probiotics affect your gut. In some cases, certain individuals may need to delay probiotics until their gut is more intact. Eating fermented foods like kimchi are also great ways to repopulate healthy gut flora.
10. 重建肠道菌群。服用高效益生菌（包含至少250亿CFU的多样化乳酸菌、双歧菌、酵母菌）一天两次一到两个月，慢慢开始观察菌群对肠道造成的影响。在有些案例中，有的人需要延长益生菌的服用直到肠道更加完整。食用发酵食物比如泡菜也是一种建立健康肠道菌群的好方法
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