The ‘Ins’ and ‘Outs’ of IBS


Do you fit the criteria?


By Karlene Georgiadis – Biomedical Naturopath


Being a Poo Queen and biomedical naturopath, I am not squeamish about talking ‘ins’ and ‘outs.’ It’s what I do and I actually have these conversations several times a day.


Helpful tools I use in my clinic.

One of my trusty clinic tools is the Bristol Stool Chart. I love how people get all serious and reflective when comparing their daily stool to the matching number and description on the chart.

But, there are always those clients who say: “I am all of them – every day!”

It’s a little bit like the weather here in Victoria; you never know what you are going to get – often it’s everything!

These clients are frequently diagnosed with Irritable Bowel Syndrome, or IBS, which does little to explain the situation beyond priming them to ‘expect the unexpected.’


This is where the Rome Criteria comes in.

These criteria are used to diagnose functional gastrointestinal (GI) disorders, such as IBS.

It is such a relief that the debilitating symptoms of functional GI disorders, including IBS, are now widely recognised by doctors.


With this wider recognition, it is now also well acknowledged that problem GI symptoms can vary widely!

This means that changes can occur in many different body processes. In particular, a person may experience problems with:

• The movement of food and waste through the GI tract (motility disturbance)
• Heightened experience of pain in the internal organs (visceral hypersensitivity)
• Gut-immune defences (altered mucosal and immune function)
• Bacteria imbalances in the gut (altered gut microbiota)
• Brain and gut communication (altered central nervous system processing)

The Rome Criteria also emphasise that the best management for functional GI disorders requires a ‘biopsychosocial approach.’ This means also taking into consideration:

• Early life influences
• Genetics
• Culture
• Environment
• Stress
• Personality
• Psychological state
• Social support
• Food
• Diet

Of course, I have been working from this premise for such a long time, as gut function runs deep in the foundation of naturopathic practice.



Now, we are all speaking the same language!

The Rome Criteria providing a standard definition and description of the functional GI changes associated with a diagnosis of IBS.

This is an important area for ongoing research, which I seriously geek out about!

In actual practice, some people who do not exactly meet the Rome Criteria might still benefit from treatment. For these individuals, the Rome Criteria are most useful for describing a particular condition.

This is also especially important for me because I regularly converse with Doctors and Specialists in the shared care of many patients.


But wait, there is more!

There are now subtypes. There is a “constipation” subtype, a “diarrhoea” subtype, and of course a “mixed” subtype, but also, if you are particularly mixed, that is considered “unclassified.”

New additions to the Rome Criteria also include: “Intestinal Microenvironment and the Functional GI Disorders.”

This is cause for celebration for me as science is now validating the space I have been working in for years.

Stay tuned for further details of my upcoming book, which is all about gut health, including information about the role of our microbiota, food, and nutrition in healthy GI function.


Functional testing is such an important part of what I do.

A common question I am asked is: “What functional testing is right for me?”

The answer is this depends entirely upon the unique presentation of each client during an appointment.

Anyone who knows about how I practice in my clinic as a biomedical naturopath and Poo Queen will know I absolutely love functional testing. This is because the evidence it generates is vital to providing the most personalised details to your healing plan going forward.

If you asked me: ‘What is my favourite test?’ I would have to say – your poo!


Of course, I am the Poo Queen so I can help you the most through this specific testing!

Honestly, I sometimes feel like I am reading your tea leaves when I am reading your stool report in a Full Microbial Analysis. I love the details it provides!

What is really great about my process is that there are often things I don’t need to test. This is because I either already know the answer to the question I am asking, or other types of test results are not going to be bringing in new information vital to your healing path right now.

I like to ask the questions where the answer is vital and is going to help me take you the greatest leaps forward in your health.

It is an investment on many levels including your energy, effort, and time – so I want it to really mean something.

Some people do a lot of leg work before they even step foot into my office and they have researched the hilt out of functional testing – wanting to get the latest and greatest, biggest, and most expensive test. The question I always ask is will it be bringing in new information that we don’t already know through other means?

I help clients take the stress out of what test to do. I tell my clients to give that task over to me to worry about. After all, I have been working in this space for some time.


The Poo Queen – Karlene xx


Karlene Georgiadis

Biomedical Naturopath and upcoming author of Your Poo Matters!

Further reading

For those readers, like me, who also love to ‘geek out’ here is a link to further reading on this topic: Lacy, BE, et al. Bowel Disorders. Gastroenterology. 2016; 150:1393-1407; Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders. Accessed 8/10/16: