Get off the toilet! 

IBS

• What's it like to live with IBS?

  Irritable Bowel Syndrome can be anything from mild to severe, and it can severely negatively impact your life.

  Many people with IBS find they are very tired. This could be down to lack of essential nutrients through a restricted diet, or down to the worry of what to eat next. There is also an overlap between mental health conditions like anxiety or depression which can also cause fatigue.

  The worry about what to eat next takes up a lot of the headspace in my clients. It’s difficult to maintain social engagements when so much socialising revolves around meals out or drinks, and these can cause your symptoms to flare up. Some of my IBS clients worry about leaving the house in case they have an accident.

  Depending on your personality type a noisy digestion and smelly gas can be excruciatingly embarrassing. This can cause people to withdraw in relationships, or avoid staying over night with a partner.

  IBS isn’t just a bit of bloating, it can really affect the quality of your life.

• What to eat when you have IBS

  There are different approaches to the best IBS diet, and it might be different for everyone. A common diet that has been tried and tested for IBS is the low FODMAP diet. This diet restricts fermentable carbohydrates for a few weeks and then carefully reintroduces them to identify triggers. FODMAP is an acronym standing for:

  • fermentable,
  • Oligosaccharides,
  • Disaccharides,
  • Monosaccharides,
  • And
  • Polyols.

  Read a Beginners guide to the low FODMAP diet to read about how to get started.

• What are the treatment options for IBS?

  Depending on the type of symptoms you have with your IBS will dictate possible options for diet, supplements, lifestyle, or medication use.

  Diet changes can include

  • the low FODMAP diet – most helpful for IBS diarrhoea predominant or IBS Mixed type.
  • low histamine diet – often helpful for reflux, abdominal pain and allergic symptoms such as itchy skin, hives, rhinitis or sneezing and wheezing
  • low sulphur diet – if very smelly odorous gas, joint pains along side loose stools, and bloating.
  • increasing your fibre content – especially for people with constipation

  Lifestyle changes include getting enough sleep, regular exercise, managing stress, finding some joy back in your life. Medication could include laxatives, drugs to firm up your bowel movements, antispasmodics for cramps and gas as well as other things your doctor could recommend.

  Supplements include vitamins and minerals essential for gut health, probiotics, anti-microbial herbs, prebiotics or support for the immune system.

• Is IBS affected by your menstrual cycle?

  Many women find their menstrual cycle changes their digestion. It can be normal to feel a little more constipated before your period, and then experience looser stools as the bleeding kick in.

  Women with IBS tend to have more painful periods, and it’s been shown rectal sensitivity increases around your period as well.

  You may also find during the perimenopause phase when your hormones are fluctuation that digestive symptoms can increase.  This might all feel very unfair as you’re already struggling with bad digestion, painful periods and bloating, but you can get relief from both together when you identify your digestive triggers, and eat in a way that suits your body.

  You can read more about IBS and Periods in my longer blog post.

• How to get an IBS diagnosis

  There isn’t a clear medical test for IBS, and so it can take a while to get a diagnosis from a doctor. If you suspect you might have IBS it’s important you visit a doctor so they can confirm this.

  There are lots of more serious conditions, such as colon cancer, inflammatory bowel disease or coeliac disease that have similar symptoms to IBS, so you don’t want to miss your doctor ruling these out first. IBS is sometimes called a diagnosis of exclusion, because we have to rule out other conditions before it’s confirmed you’ve got irritable bowel syndrome.

  Typical tests your doctor might run depend on your symptoms, they could include:

  • Blood test – looking for inflammation markers such as CRP, or ESR
  • Stool test – looking for a bacterial or parasite infection, or traces of blood in the stool which could indicate a more serious condition
  • Endoscopy – looking at the health of your upper digestive system with a small camera
  • Colonoscopy – looking at the health of your colon with a small camera
  • Feeling your stomach – physical examination can check for lumps, adhesions and your pain
  • Scans – CT or MRI scans to look inside your body and check for adhesions, tumours or blockages.

  Once you have an IBS diagnosis, there is no automatic treatment path as with some medical diagnoses, but there is lots of help in terms of diet and lifestyle, as well as some medication to ease symptoms.

• How to calm an IBS flare up

  Calming an IBS flare is normally a mix of diet and lifestyle actions. It can take a few days, or a few hours, but some of the things I recommend include

  • gentle movement like walking, to shift trapped gas
  • Wearing a loose fitting waistband because tight clothes can make cramps and pain worse
  • warmth such as a hot water bottle or a warm bath to sooth
  • eating a lower FODMAP diet for a few days to remove fermentable carbs
  • going easy on yourself, take time to recover

  You can read more about how to calm an IBS flare in my blog post.