Navigating Irritable Bowel Syndrome (IBS) | Complete Guide

May 4, 2023

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Ahh, the feeling of gas building in your bowels, your pants growing tighter by the second, and a general feeling of fatigue settling in your entire body. Gas, bloating, abdominal discomfort, and fatigue didn’t come alone though; diarrhea and subtle nausea made a special appearance too. The old gang is back together. Yes, my friends, that’s what they call irritable bowel syndrome (IBS) coming for a visit.

Can you relate? If so, you’re not alone. IBS affects 11.2% of the world’s population, with the majority of sufferers being women. Symptoms can vary too; however, common ones include abdominal pain or discomfort, bloating, nausea, heartburn, drowsiness, gas, diarrhea, and/or constipation.

Unhealthy young woman with stomachache leaning on the bed at home

Unfortunately, the cause of IBS is unknown, which makes getting to the root cause tricky. Many researchers hypothesize that it’s a multi-factorial condition that may include mental health (trauma, stress, depression, etc.), a hypersensitive gut-brain axis, inflammation, overgrowth of bad bacteria, abnormal gut motility, gut mucosal permeability, and impaired immune function to name a few.

Regardless, your doctor may diagnose you with IBS if they’ve ruled out other diagnoses (Celiac, lactose intolerance, etc.) or if you’ve had recurrent abdominal pain or discomfort for at least three months and it’s accompanied by two or more of the following: improvement with a bowel movement, associated with a change in frequency of stool, and/or associated with a change in the appearance of stool.

Individuals are usually more specifically classified based on their stool appearance such as IBS-diarrhea (IBS-D), -constipation (IBS-C), -mixed (IBS-M), and -unsubtyped (IBS-U, doesn’t fit any of the other stool appearances).

 Personally, as someone who has dealt with IBS, it’s incredibly frustrating to be told IBS is your diagnosis without any further support. In reality, IBS is just a description of symptoms and doesn’t help with navigating the root cause.

So, let’s change this, shall we? Here are some tools to explore to alleviate symptoms, as well as discuss with your provider and dietitian to help navigate the root cause of IBS:

Woman with stomach pain staying home

  • Dietitian Directed Nutrition Therapy. The way we eat and what we eat can affect gut motility, permeability, stress hormones, and gut microbes.
  1. First, start with the basics: drink at least half your body weight (lbs.) in ounces of water daily, eat a variety of fiber-rich foods (vegetables, beans/lentils, nuts, seeds, fruit, and whole grains; 30-40 grams/day for adults), and take time to enjoy your meal (it’s hard to feel good, digestively speaking, if you’re inhaling your meal and not letting your GI tract do its job). A dietitian can help you build this foundation for lifelong health.
  2.  Pay attention to problematic foods and track symptoms. Some problematic foods include caffeine, sugar, alcohol, sugar alcohols, and fried, fatty, and spicy foods.
  3.  If you still aren’t feeling relief, then speak with a dietitian regarding nutrition therapy, such as an elimination diet to discover food intolerances or a low-FODMAP diet (specific groups of carbohydrates). These are short-term therapeutic diets that can improve intolerances and reduce symptoms.
  •    Is it Worse With Your Period? If you’re menstruating, track symptoms to see how they relate to your period. Hormones affect gut motility, visceral sensitivity, inflammation, and the like. If you also notice you have heavy and painful periods, contact your OB-GYN to rule out endometriosis.

 Gut-Brain Connection. Like butterflies in your stomach or nervous poos, your brain and gut communicate constantly. This communication takes place through the gut-brain axis via the vagus nerve, and some people, like me, have a more hypersensitive gut-brain axis than others, which can cause all sorts of digestive issues. Luckily, there are many tools you can practice to see if they help soothe symptoms: yoga, mindfulness, deep sleep, breathwork, meditation, vagus nerve stimulation (hum, sing, chant “om,” gargle, laugh, foot, and neck massage), and more.

  • Visceral and Pelvic Floor Work. Our bodies are beautifully complex—not only do our gut microbes and brain communicate, but our body can store stress and trauma, organs can shift out of place, muscles can get a little stuck or forget to function properly, and scar tissue can get in the way of your bowels moving smoothly. Tapping into the knowledge of a physical therapist who specializes in visceral and/or pelvic floor work is extremely helpful in discovering if any of these things are an issue for you.
  • Testing. Testing can take some guess work out of the root cause equation. Since IBS can be caused by inflammation, overgrowth of bad bacteria/viruses/fungi, and gut permeability, it’s good to look at the gut’s landscape, structure, and function. However, some of these tests are much more invasive than others, so speak with your doctor regarding stool analysis, small intestinal bacterial overgrowth (SIBO), pancreatic enzyme sufficiency, intolerances (lactose, fructose, etc.), food allergy testing, and more.

I’d love to hear from you. Please comment below with one thing you’ll implement today to navigate your IBS. Also, if you’d like to improve your IBS symptoms and gut health, schedule an appointment and let’s work together!

If you thought this blog post was helpful or know someone who would benefit from it, please like it and share it.

 With love, Steph

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