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Ep.61 – Forcing your body – The IBS struggle
13 Aug, 2024

Episode Intro

Client Abby first started working with me. She was stuck on the toilet for about an hour each day. She felt she had to force herself to go every morning because she was very anxious about needing a poo out of the house. She was trying to make her digestion fit to her schedule, but it just wasn't playing ball. In this episode of The Inside Knowledge, I'll share five different experiences of how separate clients have been trying to force their body to do something that ultimately it just couldn't do all for different reasons. Maybe this is something that could be relevant to you too, if you've got IBS and you're trying to manage it yourself.

Podcast transcript

Welcome to episode 61 of the Inside Knowledge Podcast for people with IBS. I’m Anna Mapson.

I’ve picked this topic about forcing your body to do things that you don’t want it to do because it’s something I’ve seen more and more.

Or maybe I’ve just noticed it more, over the last year with a couple of different clients.

Are you forcing your body into your life?

I’ve picked five really different examples of how sometimes our body wishes or our desires for our lives just don’t really align with our normal human physiology.

Or the current health conditions that you have, which could include IBS among other health conditions as well.

What I mean by that is you have desires and things that you want to do in your life and sometimes you feel like you’re being held back by your digestive conditions. Or other health conditions. I think there are three main reasons why people with IBS experience this more.

IBS can be erratic and uncertain

Firstly is that IBS is a kind of chronic flaring type condition, so you never really know when it’s going to be bad, and that can be really challenging. It’s hard to plan.

With some conditions, you might have more of a sense of, it’s every time you have your period, or it’s every time you get exposed to a certain deodorant, you get a rash, or something like that, which you can know the results will be such a way.

But with IBS, you don’t always know what will set off your trigger or when it will occur. So it’s very hard to plan.

IBS can be embarrassing

The second thing is that it’s quite embarrassing and people don’t really want to share much about how they need to spend hours on the toilet. Or they’re going to need to go to the toilet every 20 minutes because they’ve got diarrhea. Or they’re in work and they’re farting a lot and they’re just embarrassed about the smell or the sounds.

We have a lot of shame about using the toilet and all of these different conversations. So that again, makes it very difficult for you to navigate having IBS and moving through the rest of your life.

Life can be stressful – making IBS worse

And then the third thing is just that our lives are quite stressful and, you know, you have your work, social lives, travel, and all of these kinds of expectations that you will partake in life and do all of these, you know, often very fun things and great.

But. There can be quite difficult when you have IBS and it can be quite difficult to explain that to friends and family. There are three kind of push and pulls on our lives and sometimes we just want it all to go away. We want all the IBS to just not be there.

Creating routines & habits that work for a while…

You try to put in place either a lot of routines, tricks and scaffoldings and supplements and all of these things to hold you in place and keep you going. Or you try and put in various habits that are quite excessive, like I was mentioning sitting on the toilet for up to an hour every day just to get a bowel movement.

So those are the kind of things I’m going to explore a bit today.

1. Taking the pill despite side effects

The first example that I wanted to talk about today is somebody I worked with. A young woman who was running her contraception pills month after month without a break. Which is easily possible to do and I think doctors will say it’s okay to do that. So she wouldn’t be having a period because when she did have a period it was inconvenient.

She didn’t really enjoy it. She just started one pill pack straight after the other.

Natural processes can be inconvenient

But, throughout working with me, what we noticed is that certain types of digestive symptoms would get worse around that time that the end of her pill packet would be coming along. She was trying to kind of avoid having periods by running the pill packets one after the other, but the digestive symptoms would build up.

Her bloating would get worse, her water retention would get worse. And to some extent mood symptoms would also worsen.

Throughout working together, I was encouraging her to try to allow time for your body to do what it needs to do.

Now, I fully understand that when you have a break in your pill packet, it is not normal period. It’s not your body’s natural menstrual cycle.

However, it does release some of the hormones. In your womb lining, so as you release them, it can change the levels of hormones in your body. Not for everybody, but for some people, they feel better having a break in their pill packets.

Although, there is a little bit of research, I think, that means that it could be a little bit less effective.

So actually, taking it every single day for three months, in terms of contraceptive value, may be more effective. But, for this particular client, her problems that she was noticing was that she was getting a build up of bloating. A build up of water retention around her middle and hips, and also changes in her mood.

And actually by changing that and by doing the inconvenient thing, it helped her to get better control of her digestive symptoms. By doing something that was actually more inconvenient.

The next two examples they’ve both got an angle of trying to force your body to have a bowel movement first thing in the morning in order not to have one later on.

2. Forcing your body to poo in the morning

The next example is somebody who worked in a school and it was very difficult for her to go to the toilet during the day. Because she was face to face with a lot of children and just couldn’t nip out of the classroom in order to have a long time sitting on the toilet.

She was somebody who had more constipation predominant symptoms and was really struggling to try and go first thing in the morning so that she wouldn’t have to face, having to go later in the day.

Avoiding needing a poo at work

She just kept saying it’s not convenient to go at work. I can’t go at work. It’s not convenient.  This happens to quite a few of my clients because of the types of jobs. Whether they’re in a medical setting in a school or educational setting.

A lot of frontline jobs where you are dealing with the public, maybe you’re on a cash desk and you just can’t keep nipping off to go to the toilet. This makes it really, really difficult to properly respond to your body.

With this example, this client that I worked with, she was really loathe to try and eat the way I was suggesting or guiding her towards. Which was increasing fibre. And actually increasing the amounts of foods that she had to eat because she was worried that it would lead to more trips to the toilet later on during the day.

So this is where we have one of the conundrums. Where the challenge is really is trying to force your body to do something that is not biologically normal can lead to more problems.

Not responding to your body can reduce the urge to go

For example, not responding to your body and not going to the toilet when you need to can actually lead you to lose touch over time with that nervous system impulse that says, actually I need to go to the toilet, we need to go to the bathroom now.

You lose that connection if you keep ignoring it. In a way, it can kind of hold you back from implementing the things that logically you know will help. So with this client I worked with, she understood that she needed to eat more, she needed to eat more fibre and to regulate her bowels better, but the fear of having this additional, inconvenience during the day was very real.

We had to talk through quite a lot around. In order to get an easier normal bowel movement that didn’t take 20 minutes sitting on the toilet.

Regulating bowel movements to save time on the loo

That you could just go quickly get it out and then go back to the job. That was going to make life much, much easier in the long run. Although there was a period of adjustment and a period of working out like how effective the dietary changes are going to be in order to normalize bowel movements.

She needed to eat more fibre more food, to regulate her digestion. She needed to eat three meals a day instead of just like one and a half or two. And these things did help, but there was a big transition period where it was kind of getting easier in the morning but still a fear that eating, pushing it too far, like maybe eating too much might be quite challenging.

3. Ignoring the urge to go to the toilet outside the house

The other example that I have which is pretty similar is somebody who was just petrified about having to go to the toilet outside of her house. She wouldn’t even go to the toilet at her mum’s house where she’d grown up. Just really concerned about anybody hearing, anybody smelling. Just the thought of anybody knowing anything about her bathroom habits was just completely overwhelming.

This person was also spending about half an hour on the toilet every morning and having to leave a lot of time in her morning routine in order to just sit there and wait for something to happen.

Switching the focus from macros to fibre

Now she also wasn’t eating enough fiber and that was more down to the fact that she’d really prioritized quite a heavy protein diet in order to meet training macros from the gym.

Really trying to bulk up and lose weight, but in order to do that had really deprioritized vegetables and fruit and much more focused on muscle building protein and protein shakes, but over time that had probably led to, slightly slow transit time and not enough bulk to form a better bowel movement.

The things that she needed to sort of work on and accept was, again, like trying to cope with the thought of maybe going to the toilet outside of the home, but also making it a lot easier so that if that eventuality ever did occur, it wouldn’t be such a nightmare because It wouldn’t take half an hour to go every time.

So the root of those two was quite similar, that it was needing to force your body to get it out in the morning, even though it didn’t really actually need to go. They weren’t having an urge to go, but they were doing it both for different reasons, but in order to avoid the potential to go to the toilet later in the day.

4. Needing a set amount of poos per day

Now, my next client was almost the opposite of this, who also wanted to control his bowel movement timing, but was working from the opposite direction, and actually wanted to have a second bowel movement every day. And almost needed to do that in order to feel better. He felt that if he didn’t have a second bowel movement during the day, then he would become more bloated and it would ruin his enjoyment of his evening meal.

Which felt really stressful because then he felt he had to restrict foods for his evening meal in terms of variety. So he had to eat very boring food and so it was like, Oh, if I can’t get this poo out in the afternoon, then it means I’m going to need a really boring dinner again. So I’ve really got to get it out now.

And so he was. Sort of scheduling this time and again spending about half an hour sometimes just sitting there waiting for it to happen When actually his body wasn’t really Needing to pass another stool. There wasn’t really enough or it just wasn’t always the right time. This urge to want to go twice a day, and if you’re not going twice a day, then it’s not healthy, came from another nutrition program that he had done, where they told him that it was good to have more bowel movements, and so he’d really taken that to heart and really tried to work on it, feeling that unless he was doing that, it wasn’t normal.

If you haven’t listened to my very first episode of this podcast, I would urge you to go back and do that, it talks about what is a normal poo, what is normal digestion, and the reason I started with that episode is often when I’m working with my clients, We’re trying to get to some level of normality with bowel movements, that’s just the nature of working with people who’ve got IBS.

But, what’s normal is not only just to have a normal bowel movement once a day, it is often to have a day where you don’t go, or a day where you go three times a day, or something that’s out of the normal for you. That’s also normal. Like, it’s okay to have some range of flexibility with different types of stools, different frequencies, different timings, and yes, some people do go on the dot of 7.30 every morning and it’s the same shape and they pass it easily, but I would also say that’s quite rare.

It’s quite normal for people to want to go twice a day, or not to go twice a day. If that’s the case, that’s also okay. So go back and listen to that, What’s Normal, if you want a little overview of my thoughts what you can aim for.

I think the reason I’ve chosen both of those two examples, though, is that they’re both examples of people wanting to control their physical, biological processes in their body in order to meet either Something that’s come externally, that’s telling you this is how your body should be behaving, or trying to fit in with a kind of schedule, like a work routine or, you know, social anxiety about using bathrooms outside of the home.

5. Drinking alcohol every day to relax

The final example that I wanted to bring up in this episode is a little bit different. It’s somebody I worked with a few years ago who lived on her own. She had a history of like childhood trauma., had had quite a lot of anxiety in her life. We worked a lot on her digestive symptoms, which were coming and going. Typical IBS symptoms like bloating and constipation and gas. As well as abdominal pain.

But he sort of routine that she was trying to mould her body into was about drinking alcohol every night. So she loved to have a glass of wine as she was cooking her dinner, relaxing, she just found it soothing at the end of the day. And she said it helped her sleep, particularly when she was on her own.

Drinking alone and socially

She did have a partner, when they were together they would often, have a few drinks and then when she was on her own she would also have a few drinks and she felt like it helped her get to sleep.

Although her sleep was also very bad and she would wake up very early. Alcohol can sort of almost help you feel like you’re having a good night’s sleep because you might drop off to sleep a little bit easier. But it’s a bit of a sedative and it doesn’t actually put you into a deep sleep.

Anyway, that’s a whole separate thing. Go back and listen to my sleep episode, episode 60, if you want an overview of sleep. Anyway, so this client that I was talking about with alcohol, she found it very difficult to adjust to a new routine of not drinking alcohol under my guidance. Because she felt that the alcohol was kind of keeping her going.

Hard to reduce alcohol reliance

And she didn’t want to believe that the alcohol was in some way contributing to her digestive symptoms because she also felt it was relaxing.

This example is a bit different in that she wasn’t scheduling her body to do it in the same way, but She had the same, kind of, expectations that her body should be able to cope with a glass of wine every night. Because, for some of her friends, they could. They can have a glass of wine and they don’t have IBS.

So why shouldn’t she be able to cope with it? That was what she kept coming back to. It’s unfair. That sensation that it’s unfair. Why should you have to deal with all this stuff? is also very common with anybody with chronic health conditions. It does feel unfair. Like, why should you have to put up with this stuff when somebody else doesn’t?

Learning to accept your body

But the situation is that, that is what your body is like at the moment. This is how your body is. This is your physiology, your genetics. And to get to a point where you accept that to begin with, then you can work from where you are. So I’m not saying give up and everything should just be accepted and you should learn to live with your symptoms.

I don’t mean that, I just mean there’s a level of accepting that This digestive condition that you’ve got right now is affecting your life. It’s probably stopping you socializing as much. Because a lot of socializing is done around meals and drinks and stuff.

You might be avoiding seeing people, maybe you’re avoiding going on holiday. Maybe you’re avoiding going for promotion because you know it involves travel to a different city for example.

When you get to a place where you can accept that you have got IBS and what you need to do in order to get on top of it, then you can start to make some changes.

And sometimes it does involve making some compromises with either expectations about what your body should and shouldn’t be able to achieve, and starting with the reality of where it is, and maybe involves some compromises in terms of your wants as well.

What you want to be able to do, you might not be able to do all of that for a short time while you try and get on top of your diet, your digestive regularity. Supplements, anything that you can throw at it. 

Accepting where you are with your health

It’s a little bit like when you’re starting an exercise program and you just say, well, I should be able to run a mile. So therefore I’m just going to go and run a mile.

Actually it might not be the case that you can. Maybe you’ve got a knee injury or maybe you just haven’t even walked a mile for quite a long time, so there’s no way you can start running a mile.

That’s what I mean by just being a bit conscious of where you are now and where you want to get to and what compromises you might have to make in order to get to a better place.

Sometimes you have to make a choice. I’m talking about how to make small kinds of compromises in order to improve your digestion.

And I guess that is what I’m aiming this episode at. Anybody who is struggling with how their digestion, and what they need to do to improve their IBS is not fitting into their current lifestyle. There’s no easy answers, I’m afraid, and there’s no simple way. I just wanted to talk about it, I suppose, with a few examples, because maybe some of those will hit home for you.

And if you want someone to help you through all of that, I can do that, in my three month gut reset, which is where I work with people online, over three months. From anywhere around the world. And we have loads of coaching calls where we explore all of those kind of challenges. There’s no one size fits all solution.

Whatever works for you might not work for somebody else. And that is why individualizing it and personalizing it is really the only way to get on top of your IBS. Hopefully that has given you a few things to think about for this week.

I’ll leave it there. Thank you very much for listening to this episode of the Inside Knowledge.

Better digestion for everyone.

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