Did you know the second leading cause of missed workdays, after the common cold, is Irritable Bowel Syndrome (IBS)? Neither did I!
Through my professional experience, I know many people are embarrassed when it comes to talking about their digestion. Most people answer “fine” or “okay” when I ask about their “ins and outs,” but after some detective work, they open up about abdominal and gas pain they frequently experience, or balloon-sized bloating after meals. Constipation one minute and extreme diarrhea the next.
Men are less likely than women to disclose these issues, mostly rationalizing they just ate a little too much or too fast. That’s not to say that doesn’t happen, but the fact remains, 10-15% of the population walks around with IBS symptoms. Who knows how many more people are out there, too stubborn or embarrassed to see their doctor? That’s why I’m going to take you through some symptoms so you can determine if you should call a health professional such as myself for help.
Additional IBS symptoms include:
- Excessive belching
- Emotional stress
- Pain after meals
- Incomplete bowel movements, irregular bowel movements (less than one per day), and too frequent bowel movements (more than three per day).
Many factors can lead to IBS, including an overgrowth of “bad” gut bacteria, food sensitivities, compromised digestive secretions, lack of exercise, stress, and certain medications.
Increasing dietary fiber – The best fiber sources are fruit and vegetables, but you can also find it in grains, providing no sensitivities exist. Psyllium and partially hydrolyzed guar gum can also be used, as they are bulking agents. Fiber is a prebiotic, which we’ll touch on later. For those transitioning from very little daily fiber consumption, please ease into increasing fiber. Too much too soon can cause additional pain, discomfort, and trips to the bathroom.
Eliminate refined sugars – Excessive consumption of refined sugar in a single sitting slows down the mechanical aspects of digestion, called peristalsis. It also hinders the early parts of the small intestine, the duodenum, which is considered the hub of digestion because it houses the secretion outlets to the liver and gallbladder, as well as the pancreas.
Probiotics – A probiotic supplement containing numerous strains of “good” bacteria, especially lactobacillus and bifidobacterium, is a great way to rebalance your gut – for as long as you continue to take them. However, it would be ideal to include actual fermented foods each day such as tempeh, miso, sauerkraut, kimchi, kavassa, pickles, and olives.
Prebiotics – Prebiotics feed the “good” gut bacteria and mitigate the “bad” bacteria in the microbiome.
“Resistant starch” is a type that resists digestion, it does not provide a large insulin spike (not that insulin is bad), and it supplies the body with half the number of calories as regular carbohydrates. Put another way, rather than the 4 calories you would receive from one gram of carbohydrate, you would only receive two calories. Resistant starch is a form of prebiotic and, according to Dr. Michael Ruscio, it comes in 4 different types listed below. Keep in mind it’s best to vary the following rather than rely on just one.
Type 1- Found in the fibrous cell walls of plants, such as grains, legumes and seeds.
Type 2 – Either a dietary supplement made from corn/potato/tapioca starch or from green (unripe) banana flour or in the aforementioned foods themselves.
Type 3 – Retrogradation is a process in which starchy foods like potatoes and rice are turned into resistant starch by cooking and then letting them cool.
Type 4 – Is a byproduct of chemical manufacturing. In other words, it’s man-made.
FODMAPs and SIBO – FODMAPs stands for Fermentable Oligosaccharide, Disaccharide, Monosaccharide and Polyols. These are sugars that hang around fermenting in the gut and feeding the “bad” bacteria. FODMAPs can feed Small Intestinal Bacterial Overgrowth (SIBO), which occurs when there is an increase or change in bacteria, such as when bacteria from the large intestine creeps into the small intestine. SIBO decreases the function of the small intestine, disrupts digestion and nutrient absorption, and can make the cells of the intestinal wall permeable, allowing larger food proteins to pass through into the bloodstream. Therefore, if FODMAPs are consumed with SIBO present, it is very difficult to reverse symptoms; but if FODMAPs are eliminated, there is a chance to rid the gut of SIBO.
Image taken from http://www.med.monash.edu/cecs/gastro/fodmap/low-high.html
Psychological components – Stress , anxiety, poor sleep, depression all factor into IBS. Here’s a personal story that hopefully my High school and University girlfriends never read. As a young guy, I was very nervous around girls which led to a lot of stress and anxiety. Inevitably, while a girlfriend and I watched a movie, my stomach would immediately make uncontrollable and embarrassing noises. I know now that I wasn’t helping myself with a poor diet at the time heavy in processed foods, especially Coffee Crisp.
Symptom Journal The next time your symptoms are present, write down what you ate and drank before they occurred, what your mood was, and whether you were under any stress. Also write down what medications you may be consuming. Keep a dedicated notebook for this and you’re one-step ahead of the game when you visit a professional.
Water – I usually suggest women consume 2-2.2L of water and 2.5-3L for men, but ultimately proper hydration comes down to excreting pale yellow urine. Water will help with the elimination of urine and feces. For maximal nutritional absorption, avoid all liquids 20 minutes before, during, and after meals. Otherwise, you’re washing away digestive enzymes.
Other difficult foods – Other foods some may find difficult to digest are beans, legumes and lentils, cabbage, broccoli, onions, corn, peas, carrots, citrus fruits, and carbonated drinks.
Stress – Managing stress and anxiety are key. Sixty percent of those with IBS also report physiological issues. This isn’t to say that IBS causes these issues, but knowing this fact may make us more aware of feelings of stress, anxiety, and depression, etc.
My favourite stress busters are to go for a walk (also great for weight loss) and practice deep breathing, You could try those, or perhaps meditation and yoga. Before you roll your eyes and dismiss meditation give this great app a try.
Sleep – I talk about the importance of sleep in just about every post, so if you are new to my blog then please read this post Sleep: A Deadly Game Of Russian Roulette
Eliminate food sensitivities – Sensitivities to food or symptoms of a compromised intestinal wall, will cause digestive distress. The most accurate way of finding out what, if any, food sensitivities you may have is to go through a proper elimination diet. If you’d like to get to the bottom of what foods agree with you, either visit me in Toronto at The Dempster Clinic or via my Online Coaching Programs. I’ll save you a “bloat” load of time and money figuring out which foods are best for you.