I’ve been diagnosed with IBS, now what?
Irritable bowel syndrome, or IBS, is often given as a diagnosis with out any further guidance on how to manage it. IBS is more than just indigestion, it’s painful, can be unpredictable and leave you feeling afraid to eat certain foods.
If you experience regular gas and bloating, surprise loose stools or constipation, here is an outline of what causes IBS and some tools on how I recommend managing it.
THE GUT AND THE BRAIN ARE INTRICATELY CONNECTED...
IBS is part of a group of conditions known as disorders of gut-brain interaction DGBI (formerly known as functional gastro-intestinal disorders).
DGBI involve issues with the normal communication between the brain and the gut, the immune system, microbiome and one’s sensitivity to pain.
It’s more complex than just having irregular poops!
As a whole, this categorization does NOT include conditions such as celiac disease, inflammatory bowel disease (Crohn’s or Colitis), severe food allergies, acute infections, conditions or surgery that affect GI function.
In many cases we need to rule out these conditions prior to assuming it’s a functional cause, such as IBS or the things listed in the image above. So, speak with your doctor for further guidance.
Pathophysiological mechanisms in disorders of gut–brain interaction. Reference 1
IS IT TRULY IBS?
There is a set of guidelines known as the ROME IV criteria that help to diagnose if what you’re experiencing is IBS. There are 4 subtypes of IBS that your doctor or naturopathic doctor can use to determine if this is what you’re experiencing and how to begin treatment.
IRRITABLE BOWEL SYNDROME
Diagnostic criteria*
Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
Related to passing a bowel movement
Associated with a change in frequency of stool
Associated with a change in form (appearance) of stool
* Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
OKAY, SO YOU THINK YOU HAVE IBS, NOW WHAT?!
Treatment involves figured out the main trigger to your symptoms, and yes, it can be more than one. From here, a number of tools aimed at correcting the miscommunication, rebuilding the health of the digestive tract lining, a functional immune and microbiome.
If you want a personalized approach and you live in British Columbia, CA, book a free consult with me and I’ll walk you through it … here’s your spot
How I approach IBS
Visceral sensitivity scales to help you identify any fear or anxiety around food itself (food isn’t always the cause! but anxiety around it can make symptoms worse)
Tools to soothe this increased sensitivity to gas, bloating or other discomfort including carminative herbs (chamomile, peppermint or ginger) and the oils of these herbs such as peppermint oil.
Working to repair the communication between your gut and your brain
Discussing options for herbal, supplement or pharmaceuticals that have evidence to calm this gut-brain miswiring
And of course, your microbiome
In some cases, it is worth doing an antimicrobial approach to target microbiome overgrowth.
I look for possible risk factors to a microbiome cause: history of gastro-intestinal infections, antibiotic use, abdominal surgery or food poisoning are some examples
Supporting a healthy and robust ecosystem of microbiota with appropriate fiber.
What about food restriction?
Unless you are able to closely work with a qualified digestion-focused and qualified naturopathic doctor, holistic nutrition or dietician, it is recommended that you do not try food restriction on your own. Here’s why ..
1. Nutritional Imbalance: eliminating or reducing specific food groups, which can lead to nutritional imbalances. A lack of essential vitamins, minerals, and macro’s (carbs, fats and proteins) can result in deficiencies and other issues.
2. It’s not sustainable: many food restriction diets are challenging to sustain in the long term. The restrictive nature of these diets can lead to feelings of deprivation, cravings, and ultimately, difficulty sticking to the plan. This can create a cycle of restricting and then overindulging, which may negatively impact a person's relationship with food. It’s just not worth it.
The low FODMAP diet was shown to improve symptoms of gas, bloating and pain. However, it was the most successful when there were diet plans, shopping lists and a clear plan of coming out of this two-week trial period. Here’s a resource
About Dr. Whitney
Dr. Whitney is a gut-focused naturopathic doctor. She takes people from feeling limited by their IBS, bloating and food-related anxiety to feeling confident in their body and in control of their digestion.
She sees BC residents both virtually and in person in Victoria, BC.
She love running along the west coast oceanside, good coffee and spending time with her daughter and parter in Victoria!
Work with her 1:1, get started HERE
References
Vanuytsel T, Bercik P, Boeckxstaens G. Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders. Gut 2023;72:787-798.
Sultan N, Varney JE, Halmos EP, et al. How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice. J Neurogastroenterol Motil. 2022;28(3):343-356. doi:10.5056/jnm22035