IBS-M case study: 10 years of alternating constipation and diarrhoea – how Helen rebuilt trust in her digestion

If you have IBS-M one of the worst parts is never knowing which way the day will go. The uncertainty about constipation or diarrhoea can take up a lot of headspace. This is Helen’s story, a real client who came to me after years of alternating gut symptoms, and finished the Gut Reset with a much clearer idea of which meals suited her.

(This case study reflects one individual client’s experience of working with me, with identifying details changed to protect her privacy. Results vary from person to person, and this is not a guarantee of similar results for any other individual.)

Living with IBS-M: Helen’s Story

A client in her mid to late 50s came to me after a decade of bowel habits that swung between constipation and loose stools, often with a strong sense of urgency. She wanted to stop the yo-yoing and feel able to trust her digestion again. Her symptoms began around ten years earlier, after a getting food poisoning whilst on holiday.

She felt nothing had been right since then. A few years ago she was diagnosed with small intestinal bacterial overgrowth (SIBO) and treated with rifaximin. When she was retested about three years later, the result was negative. Her blood tests were healthy, a bile acid diarrhoea test was normal, and several colonoscopies had all come back clear. (This ‘all clear’ is quite common with many of my IBS clients – there are no biomarkers to indicate medication is needed or to show disease processing)

What I noticed in the first session

Helen had been following a low FODMAP diet for some time and had also been advised by a doctor to eat little and often. Her diet was pretty healthy and varied, but the snacks tended to be bread, cheese and fruit through the day. She felt hungry quite often, and after a small meal the hunger would return quite quickly. She also had regular nausea and occasional mild heartburn. She also mentioned that her flare-ups often seemed to follow meals that were higher in fat. That gave us somewhere to start.

Setting a goal: Regulating the bowel movements

Helen’s goal was simple. She wanted to stop the swings between loose bowels and constipation and feel able to trust her digestion again.

A personalised approach to managing IBS-M

Because Helen kept noticing that richer meals were followed by an increase in symptoms, I suggested she reduce the fat in her diet. We agreed a pattern that kept her intake to roughly 40 grams a day, and I suggested she try a digestive enzyme containing lipase with meals that included higher fat foods. I also suggested a few other supplements to go alongside this. Early on, she noticed that a richer restaurant meal was often followed by a worse day, which helped her see the pattern for herself.

I encouraged her to eat three good sized meals a day and two set snacks, on a mostly low FODMAP diet. We worked on bringing more variety into it so meals felt less limited.

Over the three months, we met weekly. I also encouraged Helen to work through a structured FODMAP reintroduction to test each FODMAP group. After ten years of limiting a lot of foods, this was a mental shift in her relationship to food.

Along the way, Helen worried about losing too much weight as she cut back on fat. We talked through how to increase her protein and keep her calories up while still eating in a lower fat way, so she felt nourished as well as comfortable.

How things changed for Helen

By the end of the three months, Helen told me she felt much more confident around food. She had learned how to choose meals that suited her digestion, and she felt she was no longer guessing. She was really pleased to be experiencing less urgency and bloating, and to be able to trust her digestion again.

Life after the Gut Reset: Helen’s feedback

Helen described how, over the three months, she went back to eating a range of foods she had been avoiding or limiting for around ten years, and how that had changed her outlook on food. She also enjoyed watching the Gut Reset portal education videos that I share with all my clients.

She valued the weekly sessions for the practical advice, and told me she had begun unsure whether it would help after so many other attempts but was pleased with the progress.

Ready to take control of your IBS symptoms?

If you’re living with unpredictable diarrhoea, bloating or cramping, and feel like you’ve tried everything without a clear answer, you’re not alone, and you don’t have to keep guessing. The 3 Month Gut Reset is my personalised, step by step programme designed to help you understand your own triggers and build a sustainable way of eating that works for your life.

Book a discovery call to find out how I can help you feel more like yourself again.