The Basics of IBS
Have you ever wondered what IBS actually was? How it was diagnosed and whether or not there was a cure?
WELL…
Here is the quickest of quickest explanation of what it is, how its diagnosed and what we can potentially do about it. I say potentially because unless I can properly asses someone ( a client) I can’t guarantee that these methods would work for you.
Our bodies are different and we react to different things. While someone who has IBS may be able to tolerate chickpeas doesn’t mean the next person can.
This isn’t a blanketed approach.
What is IBS and what causes it?
Well for starters we know that Irritable Bowel is diagnosed by its symptoms and not by medical test. These symptoms can range from abdominal pain lasting longer than 3 months, to mucus in the stool to a bloated or distended feeling in the abdomen. Other related symptoms can be migraines, urinary problems, fatigue, heartburn, painful sexual intercourse and even fibromyalgia.
So, what causes IBS? Unfortunately, we still don’t have an answer to this one yet. Yes, we know it affects twice as many women as it does men and that its symptoms are often triggered and worsened by dietary factors & stress…but we still aren’t able to pinpoint it to one theory.
But in the spirit of this blog, let’s talk chat briefly about those theories.
Some theories suggest it has to do with SIBO ( small intestinal bacterial overgrowth), abnormal motility (contractions of the gut that move poorly digested food and gas through the intestines), chronic antibiotic use, the “ brain to gut” connection and some have even suggested it could be inherited.Regardless of these studies (because remember, we still don’t have a definitive answer) what we do know is that it is a sensitivity that can be incredibly painful and uncomfortable.
Can it cause other problems?
In short, sometimes. Some people urinate more often, sex can be uncomfortable, the esophagus can be affected (aka heartburn) and most commonly, you may feel tired more often. The list varies from person to person.
So, where do we start?
One thing we can do to help manage IBS is with our diet and lifestyle. When you have irritable bowel there is a strong relationship between what you eat and how you feel. You know the saying “you are what you eat” now’s the time to switch that to “you feel what you eat”.
While there is more to just removing foods from your diet (think hormone imbalance, stress, deficiencies, etc) let’s just focus on the diet aspect for now because that’s my territory and the lane in which I swim in.
Now in order to manage some people’s symptoms of IBS we have to change the way in which we eat. This means, adjusting certain lifestyle habits. What you may have been able to eat before in large quantities might have to change to smaller meals throughout the day. It could also mean chewing slowly, avoiding certain food (through elimination, not sensitivity tests) and supplementation.
The first step in identifying what foods may be causing you issues, is to first understand how certain foods affect your gut. This is where the FODMAP diet comes into play.
FODMAP- what is it?
In short, FODMAP is based on food components consisting of short-chain carbohydrates and sugar alcohols believed to contribute to digestive distress.
Digestive stress is usually caused by foods that are poorly absorbed in the small intestine (SI). This means when they don’t get absorbed in the SI they travel to the large intestine carrying with them more water than normal- hence why some people get watery diarrhea and others abdominal pain from the pressure the water puts on the nerve cells.
Now the reason why I choose to incorporate the FODMAP method into my practice is because it is based on scientific evidence. It’s a diet that has been tried and tested for many years and continues to prove to be effective for those who suffer from IBS.
If you are detailed oriented like me here’s a deep dive into the science behind it but if this doesn’t seem like your cup of tea that’s ok! I just hope I was able to answer some of your questions J
F O D M A P
Fermentation
Oligosaccharides (GOS)
Disaccharides (Lactose)
Monosaccharides (Fructose)
Polyols
FERMENTATION - this is the result of how gut bacteria interacts with carbohydrates, a process that releases a variety of gasses. Only two things can happen during this process. (1) they get absorbed into the blood stream or (2) you get gassy and bloated due to malabsorption
OLIGOSACCHARIDES – most people can’t digest these types of carbohydrates as humans actually lack the essential enzymes to break down their components into our bloodstream. Typical foods include legumes, nuts, garlic, onions, rye & wheat.
DISACCHARIDE – lactose (milk) is a disaccharide and again you’ll find that most people are intolerant to this as they lack the enzyme lactase. However, not all milk products are created equal which is why you may be ok with some dairy products as opposed to others. Hard cheeses tend to be better on the gut as they contain less lactose than soft cheeses.
MONOSACCHARIDES- is when the body cannot absorb the fructose found in many fruits. Now this one is probably the most confusing to explain but simply put- if there is an imbalance between the level of fructose and glucose in a food it will cause someone with IBS issues. For example: foods that are high in fructose but low in glucose (apples) it can cause digestive distress. BUT if the playing field are equal (think pure sugar/candy) your body will most likely tolerate it because there’s an equal amount of both fructose and glucose that the body is able to pass through ( you can thank GLUT-2 for that).
POLYOLS- these are sugar alcohols found predominately in artificial sweetners. The only thing you need to remember here is to avoid any processed food labels that end in “ol” like xylitol, sorbitol, mannitol, etc etc.
***It’s important to know that FODMAPS aren’t “bad”, in fact these foods provide a variety of benefits to the body!. The problem however is the issue with the muscle contractions in the digestive tract (motility) that cause issues. Fast motility produces diarrhea and slow motility produces constipation. Foods high in FODMAP just unfortunately aggravate this.***
FODMAP DIET
While the list is extensive and can feel intimidating, I can assure you that not everything on the FODMAP diet will be an issue for you. There are certain foods on this kind of diet that you will be completely fine with and others not so much. This is why we do an elimination phase to pinpoint where your sensitivities are.
Now I know what you’re thinking……”this didn’t help me at all!” and while I wish I could help diagnose exactly what is causing your digestive upset in one paragraph, the reality is, there are multiple causes and reasons as to why you might be experiencing IBS. So what I’m trying to tell you today is (1) there is a cause and (2) there is a way to manage its symptoms, we just have to figure out where yours is steaming from and what the best course of action is.