IBS can be a royal pain in the ass...or for most people, the stomach!
It typically causes severe bloating, stomach extension, diarrhoea, constipation, indigestion and pain to name but a few. It can seriously impact on a persons daily life causing the need for sudden and frequent trips to the toilet, stress and depression. So figuring out what causes symptoms is key managing your health.
A common approach to treating such symptoms is by eliminating a certain group of foods known as "FODMAPs". Its full title stands for Fermentable Oligosaccharhides, Disaccharides, Monosaccharides and Polyols and relates to a pretty random list of foods, many of which are deemed healthy and often encouraged in everyones daily diet. These foods are a carbohydrate which contain sugars that are easily fermentable in the gut when improperly digested and so cause bloating, flatulence and diarrhoea etc.
What foods can cause IBS symptoms?
Some of the frequent irritants are lactose, from dairy products, fructose, from certain fruit and honey, and polyols from foods like mushrooms and sugar alcohols. Broccoli, cabbage and other fibrous vegetables are also on the list containing fructans, and though we are advised to have a diet rich in green vegetable, this can be detrimental for some peoples health.
But all is not lost! The amount of these foods you consume can also be a factor. So it may mean that after an elimination diet, you can reintroduce certain foods be it in a smaller quantity. And this can be the hard part as many foods people are intolerant to are often their favourite foods they crave every day.
How do I test for FODMAP intolerance?
Clients will often appear having been diagnosed with IBS after going through a colonoscopy or other medical procedure from a doctor. It is a very generic term used for gut inflammation or gut issues and patients are often left bewildered not knowing where to go from there. But it is often an option to do further testing such as a SIBO breath test or stool test. SIBO stands for small intestinal bacterial overgrowth and may show that there is an overgrowth of unfriendly bacteria in the small intestine, instead of in the colon where it should be. People with a FODMAP intolerance can lack the appropriate digestive enzymes to break down these fermentable sugars before they are able to reach the colon, so they sit in the intestines fermenting and causing discomfort, pain and bloating etc.
Stress...is it a factor?
Most certainly! People often know that their symptoms increase during times of stress, whether thats in work, at home or anywhere else. But it can often be the hardest thing to admit. Making appropriate life changes and choosing health over everything else can be a struggle but most often, worth it!
It is believed that stress alters the gut microbiota and therefore not only can be a primary factor of ibs, but also in fodmap intolerance and digestive issues. The vagus nerve connects our guts to our brains, and contains more nerve endings than the actual brain itself! Thats a lot of nerves! So how you feel emotionally, not just physically, can dramatically effect your digestion and your bodies ability to absorb nutrients from foods. Eating in a calm, quiet and relaxed environment and managing stress through exercise, yoga and even meditation can all help improve symptoms.
So what should I do?
Give it a go! Of course symptoms differ greatly for everyone but strictly eliminating FODMAPs for at least 30-60 days and slowly reintroducing them can be the first place to start. Yes it takes work, commitment, time and for the first few week, lots of persistence. But after 2 weeks you should be well equipped and in good supply with the "allowed" foods...of which there are plenty!
Think of it as detective work. Aim to arrest the offending foods and take charge! The outcome will be worth it!