Welcome to episode 72 of the Inside Knowledge podcast for people with IBS. I’m Anna Mapson.
Living with IBS can be tough
The reason I picked this topic this week to focus on how IBS might be holding you back or the things it’s stopping you doing in life is not to go on about how bad it is. But just to bring out some of the key points that I see with my clients often, that maybe you don’t even realize how much this condition is affecting your life.
And I will talk a bit in each of the sections I want to cover about some of the things that make it easier and some of the things you can try at home. I suppose this episode is not going to be packed full of tips. But I also wanted to do it to reach out and just show you that I do understand how you feel because I work with people who have this condition all the time.
An IBS nutritionist with empathy
Everyone I work with has IBS and so I have these conversations day in, day out and I really understand the context of how IBS makes you feel. And I suppose I just wanted to let you know that you’re not completely alone. Because there are so many people with IBS all over the world who have the same issues as you. And these are the types of things I hear frequently in my clinic.
Living with IBS – relationships
I’m going to start with relationships. One of the biggest areas that I hear people talk about the most is not being able to go out with friends for dinner or go to a friend’s house because you are worried about what’s going to be served up. And about how that’s going to affect your digestion.
It can also affect things like not wanting to stay over at people’s houses. Or go away for the weekend. Especially if you’re going to have to share a bathroom with people you don’t particularly know very well. Maybe, you’re going to be going on a hen do and you’re just petrified at the thought of having to share a bathroom with somebody you don’t particularly know. Or to go and stay at a friend’s house overnight, you’d be worried about using their loo.
Making excuses not to socialise
So how this might translate is in the back of your mind, you’re thinking, Oh, I don’t really want to have to go through that experience. So instead, what I’ll do is think up reasons why I can’t really go. Or just not appear excited about the plans when you’re talking to your friends.
Romantic relationships with IBS
Staying over at romantic partner’s house as well can be really challenging when you have IBS. I remember someone I worked with a few years ago, who really wanted to stay at her boyfriend’s house, but she was just so worried about the excessive gas that happened overnight.
She was worried that she would fart in her sleep and he might hear or she was worried about it being really loud when she used the toilet in the morning. And so it was putting her off taking the relationship forward because she was so worried about him finding out. At that sort of stage in the relationship she didn’t really want to have to talk to him too much about her IBS.
So those two situations were, I suppose, for new people that you don’t really know so well and maybe just wanting to not engage or not take the relationship a bit further forward.
IBS can put a strain on your family ties
The other dynamic is when you have family members who’ve known you for years and years. You’re very comfortable together but maybe they always see you as, oh, the fussy one, or like, what can’t she eat now?
What’s in and out this week, you know, you have those kind of dynamics with your family who can be quite upfront. I mean, in some families anyway, and just quite open and that can be pretty challenging as well to navigate.
Sometimes people don’t really understand why certain foods are in or out and why you can sometimes tolerate foods. Actually you’ve had a flare up so you don’t necessarily want to have fish and chips this weekend. You actually don’t want to have any cake because you’re just avoiding those kind of foods for a while. It can be really challenging.
IBS can affect your social life
The way that IBS can affect your relationships is it either can hold you back from actually taking part in events and showing up to take part in relationships. Or it can also affect you just in a way that you are kind of holding something back from people that you spend time with. People that you love, and that love you, and you feel like there’s a little bit of a barrier in between you because of how you’re feeling physically.
Managing IBS at work
And actually that sort of brings me on to the next area that I wanted to talk about, which is when you are at work. Especially if you have to go into the office or your workplace, because there’s also a lot of things that can hold you back if you have IBS. Sometimes people don’t want to go for a different job where it means they would have to travel for a little bit longer each morning because traveling in the car or on a train can be very stressful.
Especially if you think you might need the toilet suddenly. Or you’re just struggling to organize yourself in the morning. With how long it takes you to go to the toilet, eating your breakfast, all of those things scheduling in feels difficult. So sometimes people avoid going for promotions at work or changing jobs because of the logistics and how IBS morning routine particularly is also going to be a problem.
Access to toilets at work with IBS
But the other thing at work that often holds people back from like fully showing up and presenting their best selves at their job is things like access to bathrooms or work. I did a survey about a year ago where I asked people what their experience was like with toilets locally in their workplace.
Freedom to take toilet breaks
And some people said they didn’t really have freely access to the toilet. Maybe you’re in a call centre or something where you are not free to just get up and move around whenever you want. That can be really anxiety inducing for people who have IBS. Then, even if you do have free access to the toilets, it can be really challenging if they’re open bathrooms. You’re worried about the smell, you’re worried about the noise. This is things that people I work with really struggle with when you have to go into the office and the worry of needing to use the toilet at work.
Avoiding work trips away
I know someone who has been invited on an overseas work trip flying halfway around the world. They were getting a promotion and part of the trip is to go and visit employees in a different part of the world. They’re very worried about a long haul flight, where they could get more constipation. Worried about access to safe foods whilst they’re away. And worried about the change in eating patterns, and what that might do to their bowel habits.
There’s a lot of anxiety that could be wrapped up in an overseas work trip particularly. Or even just going on a work away day. Anything like that where you’re with other people and you want to present your best self. You want to be showing up feeling professional.
Digestion distracting you at work
I have another client who’s also really worried about, rumbling stomach during a work away day. They were really concerned everybody would be able to hear their stomach during the meetings or sitting next to them. That was one of their biggest symptoms as the gurgling stomach. It really does affect the way you show up for work. Try to acknowledge that in your own mind.
So actually being conscious about how IBS is stopping you from progressing at work. Maybe it’s holding you back from getting a promotion. Maybe it’s stopping you from enjoying your time in the office, so you mostly work from home if you can.
These are all important considerations and maybe will feed into finding the right time for you to do something about it.
Living with IBS can affect your performance at work
You’ve also got the way how sometimes when you’re feeling under the weather it can just affect your performance. You’re not showing up with your best self, with your most shiny, happy, motivated face on. Because you’re feeling tired because you didn’t sleep last night, or maybe you’re undernourished because you’re not eating enough. All of these things can affect your performance at work.
Living with IBS – communicating
With both of those two areas, your social relationships and your workplace, the tips really are about communication. The way that you would talk with your friends and family about IBS would obviously be very different to how you might talk to your managers.
But it is really appropriate to discuss with your employers like how you’re feeling. It’s a physical health condition and although it’s not classed as a disability, it can be very disabling in terms of the pain, the fatigue. The constant need to be near a toilet for some people.
Tell people you’re not well
Despite the way that you would communicate would be very different, the best way to try and break down some of these barriers is to communicate how you’re feeling to your friends and family. And to your colleagues, if appropriate, or at least your manager. So that they understand you’re not just taking days off for the sake of it. Or you’re not just avoiding coming into the office because you don’t like people. It’s because you’re not well, and you need to have some adjustments made for you. A good employer will hopefully understand that. The communication really is very difficult, but it is the key to getting over these barriers.
Living with IBS can reduce your ability to exercise
The next area I wanted to bring up is exercise and how your IBS might be holding you back from fully engaging in exercise. Or just enjoying more physical activity. Often, people fear a flare up. That causes you to limit how much movement you’re getting in a day. It could be that you are worried about passing gas when you’re with other people. So that can happen when you’re out and you’re moving. I know I had a client who was really embarrassed. She loved running with other people, and was just worried about the noise of the farting as she was running.
And often people are worried about going to a yoga class for the same kind of reasons. Yoga or Pilates, particularly anything that’s calming. If you’re moving around, sometimes gas can come out and you can be very embarrassed about that or worried about it happening.
Exercise can help IBS
But the annoying thing is really that exercise actually can help reduce your IBS symptoms in the long run. Once you can find a good IBS friendly workout routine, something that suits you and whatever suits you is going to be the thing that you can maintain. It doesn’t really matter what kind of movement it is. Walking is great and I say this a lot but I really advise you to try and get in a 30 minute walk every day as a minimum. And if you can do more exercise, that’s great. But actually, we don’t need to do tons of exercise. Just starting from wherever you are and increasing your exercise a bit so that you are moving your body every day. It has a great impact on your mental health, your sleep, and your gut as well.
So there’s lots of reasons why exercise is good, but I really see this quite a lot in my clients that IBS is holding you back from engaging in exercise. Partly because you don’t have enough energy or you’re finding it hard to maintain the consistency to be able to go to the gym frequently or turn up to that class every week.
Living with IBS can affect your nutrition intake
Obviously a big one with IBS is how it can affect your nutrition. IBS definitely affects the way you eat and that is one of the biggest things that we see. But you might not know that IBS can lead you to have nutrient deficiencies or disordered eating patterns if you don’t take care of it.
And this is something I’m seeing more frequently with my clients. Actually by over restricting the types of foods that you eat, it’s leading you to miss out on key nutrients that are needed for maintaining your energy balance. For helping you with healthy skin, for helping with your mental health.
Key nutrients can be low in IBS
Key nutrients that people with IBS are often low in include iron, vitamin B12, vitamin D sometimes, could be zinc as well. So depending on what you’re eating and what you’re restricting, And also your own genetics and physiology.
You might be low in some of those things. There could also be a lot of other things, especially if you have other restrictions on your diet, like being vegetarian or vegan or gluten free or something like that.
There will be even less foods that are feeling safe and that you can eat on repeat. I’ve already talked about how anxiety about eating and what you’re eating can really affect social situations.
You often miss out on that from a social point of view, but also that people can skip meals because if you do want to go out you say, oh I’ll go out but I just won’t eat. Therefore you’re skipping meals, or you say, oh I’m going to go out later, So I don’t want to eat all day. I want to have a flat stomach, or I’m not massively bloated by the time I get to the restaurant.
Erratic eating patterns can worsen IBS
These kind of things can make your symptoms worse, so erratic eating patterns are not great for IBS. And really, until you know what your food triggers are, it is going to be guessing game and that is where it leads to more and more restrictions.
You cut the last foods out that caused you a problem. And if it was a mixed meal with lots of different foods in it you don’t really know which of the foods it was. You go therefore cutting more and more foods out until you don’t have a very varied diet anymore.
Anxiety about eating when you’re living with IBS
It can lead to like I said these nutrient deficiencies. What I also see quite a lot is anxiety about food, anxiety about eating. To the point where people feel very fearful for trying new foods and that in itself can cause IBS type symptoms.
So we know like when you’re really stressed and nervous you get this fight or flight response, it’s putting us into danger mode. Our body is not prioritizing digestion when you feel like that. it’s got a knock on effect as well. There’s some things to explore, perhaps for some people, is like how your food fear might be starting to rule your life more than you want it to.
Using the FODMAP diet for IBS
For anyone who hasn’t yet tried the low FODMAP diet, that is another solution that you can try. And I have a course that you can follow which guide you through how to do the FODMAP diet, what you can eat and what you should cut down on for the restriction phase. Then it walks you through exactly how to do the reintroduction so that you do not get stuck on a low FODMAP diet. It takes you back to eating as broad a diet as possible.
That is just one option or one way of managing your food intake. And it can help you around food fear, and anxiety about eating which can then lead to these problems of over restricting, constant worrying about your food, and also potential nutrient deficiencies.
Living with IBS can be mentally draining
And actually, worrying and the constant emotional stress is the last area that I wanted to focus on. So the mental and emotional toll of having IBS can be quite significant. It’s like a running commentary in your mind. Always thinking of the logistics of eating and what it would mean.
I was thinking the other day, it’s a little bit like, I remember when my kids were young. I used to think about their nap times and when everyone had to eat and you had to kind of work back from that time.
So it’s like, oh, if we want to go out to this group, then they need to have had a nap before then. And then, of course, before then they need to have had their dinner. So I need to get home by this time so I can prepare the meal. And, you know, you’re working backwards and like scheduling. The same kind of planning process goes on in the head of people with IBS quite a bit, I find.
Scheduling your day for IBS
For example, you might think, oh, tomorrow I need to go into the office, so I want to leave the house at 8 a. m. That means I need to get up, enough time to have my breakfast in order to sit on the toilet multiple times maybe in order to have a bowel movement before I go to work. Because you don’t want a chance having to have it at work, which means you need to get up at, say half past six. You also need to allow time to go on the toilet, but often to get a good bowel movement you need to, have a coffee before that. You need to do a little bit of exercise, you need to make sure you’ve done some mindfulness or whatever that helps you go.
Sometimes those kind of panics are like the running commentary in your head. It’s just like an extra area of organization that people do not realize that you’ve got. And that mental toll just adds up. Like I was saying, I remember with the kids when they’re young, like it’s constant thinking about, Oh, well, if I’ve got to do this first, then I need to do that next.
Running commentary of worry in your mind
And what happens if this happens, you’re just like worrying all the time about how things might pan out. It is logical that your brain has got that running commentary. Because if you think you’ve had some bad experiences in the past. That is why you have this ongoing anxiety about eating, about needing to use the toilet and where and when it will happen. Because it’s not worked out well in the past, that is why your brain is trying to keep you safe.
But it’s exhausting having that mental chatter in the background and people don’t really realize that you’re thinking all of these things. Which links into my first point about the impact on your social relationships. We also know that there’s a huge overlap between people who have anxiety, low mood, depression, and IBS.
Stress and the impact on IBS
There is a really strong gut brain connection that is linking up our mood and our thoughts to how we are digesting. But also it’s kind of more than that. There’s an ongoing cycle, so stress can trigger or worsen your symptoms. And then your symptoms can worsen and create more stress and anxiety and feelings of sadness because of the things that you’re missing out.
The part that IBS is holding you back from in terms of your mental health is feeling calm. It’s holding you back from pure relaxation and it’s holding you back from fully engaging and enjoying things. Because of the ongoing thoughts about how what you’ve eaten might be causing your symptoms. Constantly trying to get to the bottom of what your issues are. Which is very natural.
Struggling to be calm with IBS
You want to resolve it, but in this episode I’m trying to think about the ways that IBS is stopping you, or what it’s holding you back from doing, and I think what it’s holding you back from is living a life with peacefulness. You have got a layer of worry and anxiety about the next meal. Is it going to be the trigger? What else could you do? There’s a constant feelings of needing to do something to resolve it because it’s uncomfortable. It’s painful. It’s embarrassing.
Fear of normal life when you have IBS
Each of those areas I’ve talked about, social relationships, nutrition, exercising, work, and your mental health, all of those things are impacted by having IBS. Probably more things as well. I just kind of grouped them into those areas. Sometimes they’re held back by the fear of what might happen. You’re worried about being embarrassed if something did happen at the office about a noise or a smell, something might happen.
Worrying about future that hasn’t happened yet
Or, you can also be worried about things that are actually happening. It’s also quite good to separate those out. When we think about what is actually happening and what might happen. Trying to differentiate between those. Is the fear of something happening holding you back, or is the symptoms of IBS holding you back?
For example, fatigue, brain fog because you are not eating enough and you’re not sleeping well, or is it the pain that’s really keeping you in bed? Those things are actually happening right now. Maybe they’re holding you back right now.
Maybe you’re also worried about the fact that you might have a flare up if you did something. The fact is that IBS does affect all of these different aspects of your life. I hope this episode hasn’t been too depressing. I don’t want to just highlight all the things that are going wrong and that could be a problem in your life.
Maybe they don’t all affect you, and I hope they don’t. But I also want to try and highlight these things because people don’t necessarily always realize what the consequence is of living with IBS.
Working with me – 3 month Gut Reset
If you feel like you do want help though with your IBS then I work with people over three months. I guide you through how to find the right diet for you how to change The way that IBS impacts on your life. So that you can fully show up and you can start engaging properly with meals out with friends. With getting back into the office a few more days a week. Those kind of things really make a difference and help you to feel like you’re getting somewhere in your life rather than IBS is holding you back.
So if you want to talk to me about working with me, then I have this three month gut reset and you can apply to work with me via a link in the show notes or on my website.
Thanks very much for listening to this episode of the Inside Knowledge.
Better digestion for everyone.