As a registered dietitian with irritable bowel syndrome (IBS), there have been many moments where I have felt completely lost about what to eat to feel better, too. Although Dr. Google will have you believe that following a simple set of rules will make you feel better in no time, we know that it’s rarely that simple.
IBS is a complex condition that requires personalized medical treatment. Further, there are three different sub-classifications of IBS. Some people lean more toward constipation, others experience mostly diarrhea, and another set of people experience both without much predictability.
Because of the complexity, it’s so important to seek medical attention so that you have the right diagnosis and proper treatment. Although my treatment may look different from yours, there are foundational habits that almost everyone can follow to start feeling better. We talked to a handful of dietitians who personally have IBS to give us their expert advice on where to begin.
I eat regular, balanced meals.
“Be careful not to over-restrict your diet,” says Kim Kulp, RDN, owner of the Gut Health Connection in Novato, Calif. “It’s easy to be afraid of eating when it hurts, but skipping meals, not eating enough nutrients, or the right balance of fiber, can often make symptoms worse.”
Oftentimes, we must go back to the basics before we add in fancy treatments. Eating regular balanced meals is about as basic as it gets. However, if you suffer from tummy trouble, it’s not as easy as it sounds. Many folks find that they have a lot of stress around food due to not knowing what’s going to set off a cascade of symptoms.
One dietitian highlights how important it is to meet your nutrition needs with IBS. It’s very possible that by restricting your diet or not absorbing nutrients after bowel distress you may be left with big nutrition gaps in your diet.
Kerry Conlon, MS, RDN who is trained in FODMAPs by Monash University says, “as someone who struggles with IBS, and as an IBS dietitian, I have found that many IBS sufferers are often undernourished. Because of this, I often don’t jump to nutritional interventions that could be unnecessarily restrictive. Oftentimes, correcting nutritional deficiencies can greatly improve symptoms!”
I identified my triggers.
While I am not a fan of unnecessary diet restrictions, it is important to understand foods that tend to set off your symptoms. I spent months keeping food journals to identify specific patterns that kept coming up for me.
IBS nutrition experts strongly recommend against eliminating foods as much as possible. “With IBS and any other gut health issues, we know it’s highly contributed by the emotions of the brain/gut,” says Jenny Gherau, RD. “Start with a healthy gut health journal to record your food, beverages, emotions/stress, activity, sleep, and symptoms/bowel movements. Work with your dietitian to find triggers and other patterns. Spending time cultivating self-awareness is key to minimizing symptoms.”
Common triggers of IBS may include:
- Artificial sugars
- Excessive raw vegetables
- Acidic foods
This is not an exhaustive list, and many people do not need long-term restrictions to manage their symptoms. “Most people turn to diet management of IBS through FODMAPs,” says Tok-hui Yeap, RD, CSP, LD. “While a low-FODMAP diet could help with short-term symptomatic relief, it’s not meant for long term and certainly cannot address the underlying issues, microbiome, GI tract infections, use of antibiotics, and chronic stress.”
I filled in any nutrition gaps.
For me, it was important to supplement gaps in my nutritional needs. After experiencing a severe flare-up that lasted months, I knew that my body wasn’t getting enough of the nutrients I needed. I could feel the difference; I had low energy, extreme hunger swings, and heart palpitations on bad symptoms days.
In the case of IBS-D, which leans more towards the diarrhea side of the spectrum, you may be losing significant amounts of water, electrolytes, and water-soluble vitamins that impact how well you feel. Blood work with your doctor will tell you if there are any major nutrition deficits you need to work on like iron levels, vitamin D, and electrolytes.
A multivitamin and electrolytes in my morning water helped reduce my symptoms and improve my lab work within a few months.
I managed my stress.
Stress management means something different to everybody, and we all have different stress tolerance levels. New research on stress and gut health shows that there is a strong connection between high-stress lifestyles or events and disruption to the gastrointestinal tract.
Proven stress management techniques can help reduce symptoms of stress and may indirectly influence your IBS symptoms. Stress tips like getting enough sleep, going for a walk, and having a regular exercise routine are all great habits to focus on first.
“Find a stress management technique that works for you,” says Cassie Madsen, MS, RD of Gut Health and Nutrition. “Then practice it regularly, even when you do not feel stressed. Walking or yoga are great forms of gentle movement for your daily routine. Avoid strenuous exercise if it makes your symptoms worse.”
I found support.
Lastly, it took a long time before I decided things were “bad enough” to seek medical support. Don’t make my mistake and wait until things worsen to get the help you need. Start building a care team now so that you have support when you really need it.
A primary care doctor, gastrointestinal specialist, dietitian, counselor, and even pelvic floor therapist can all be integral parts of your support system. “A gastroenterologist and dietitian are definite musts, but I personally have found the most help from a pelvic physiotherapist, osteopath, and massage therapist,” says Bri Bell, RD of Frugal Minimalist Kitchen. “They can help identify and treat imbalances in the soft tissue of the abdomen and pelvic floor, release tension, and suggest exercises you can do at home to help yourself get things moving.”
This article originally appeared on Clean Plates, January 22, 2023.