Has your IBS diagnosis left you hanging? If you left your doctor's office with a shiny new diagnosis but no symptom management plan, you may be feeling a little lost right now. Don't panic! There are lots of ways to effectively manage your IBS symptoms. But, you need to find the right tools to put in your toolbox.
In this article, I'll outline common ways community members manage their IBS symptoms and help you decide if and when you should start the Low FODMAP Diet.
1. Find a FODMAP Trained Dietitian
If you have access to a FODMAP trained dietitian, I definitely recommend setting up a consultation as your first step. A properly trained dietitian can help you comb through your diet for common digestive triggers and may help you find some immediate relief (or at least lessen more aggressive symptoms).
A dietitian can also help you decide which plan of action will likely give you the best bang for your buck. This means you won't waste time trying symptom management plans that likely won't benefit you. A dietitian can also keep you from making changes that might actually make your symptoms worse (colon cleanse, anyone?).
Finally, if small changes don't significantly impact your symptoms, a dietitian can help you work through the Low FODMAP Diet quickly and efficiently.
2. Try Some Lifestyle Changes
The things that trigger each IBS patient are unique to them. This means odds are some of the things that trigger you will be fine for me and vise versa. Similarly, the way we react to triggers will be a little different. That being said, there are some common lifestyle changes that seem to help IBS patients across the board. Check out these common issues and see if there is an area where you can make changes today.
Improve Your Sleep Hygiene
Sleep hygiene isn't just about how much sleep you get. It's also about the quality. Making sure you get enough high-quality sleep for your body can keep your digestive system functioning at it's best. So, it's important to take time to make sure you're sleeping for the right amount of time and in the right environment for you. You can learn more about improving your sleep hygiene here.
Add Some Physical Activity
Have you ever noticed dogs always poop after a few minutes of walking? While your digestive system is a little bigger, the same principle applies. Exercises like walking, swimming, or yoga gently stimulate the muscles in your intestines, which can lead to easier bowel movements.
Water is the star of a ton of important bodily functions, including digestion. So, as much as you hate hearing it, it really is important to stay hydrated. While there are a ton of recommendations for what your body needs (like 8 glasses of water a day or multiplying your weight by a specific percentage), I normally go by the colour and frequency of urination. If your urine is a deep yellow or amber, you need more water. If it's clear or you find yourself peeing so frequently it's getting annoying, you're drinking too much.
If your doctor or dietitian gives you specific instructions on how much you should be drinking a day, don't listen to the internet and do that, instead!
Manage Stress Effectively
While each IBS patient reacts to stress differently, in my experience, most community members agree stress is a common trigger. This means it's important to look for sources of stress in your daily life and understand how they impact your IBS.
I know saying “manage your stress” is easy from this side of the screen. Believe me, I know there may be stressful things happening in your life right now that are out of your control. But, you need to manage the stressors you can. This might involve delegating tasks at home or at work, taking time in your day to take a deep breath and relax, or practicing a short (or long) daily meditation to calm your nerves.
3. Change Up Your Diet
Contrary to popular opinion, looking for dietary triggers doesn't necessarily start with the Low FODMAP Diet. Because the low FODMAP program is so restrictive (and when done improperly can damage your gut bacteria), unless your health care team says otherwise, you'll want to investigate these common triggers first.
Remember to check with your doctor before you make changes to your diet. Some tests (like the test for celiac disease) require you to consistently eat the food being investigated leading up to the test.
Get Enough of the Right Fibre
Did you know there are two kinds of fibre? Soluble and insoluble fibre both fall under the “eat more fibre” umbrella, but they do very different things. Based on the type of IBS you have (constipation, diarrhea, or a mix of both) the type of fibre you choose can either help or hurt you. Check out Stephanie Clairmont's article What's all the Fuss About Fibre for a detailed explanation of each fibre type and what it can do for (or to) your IBS.
If you think adding some fibre to your diet may help, remember to add it slowly. Adding too much fiber to your system at once can cause bloating and cramping. So, be gentle and remember to add some extra water to your diet to keep things moving smoothly.
General Gut Irritants
When you're experiencing digestive issues, make sure you take a close look at these general gut irritants:
- Coffee/Alcohol/Soda Pop
- Artificial Sweeteners
- Spicy Foods
- Greasy or Overly Processed Foods
Try cutting out these foods for a week or two and see if you feel any better. If your symptoms improve, try adding them back one item at a time. If your symptoms return after you've added something back, you've likely identified a trigger. If you don't see any improvement, you'll know you likely don't react to these items in particular.
Natural Diuretics and Laxatives
Some of the foods we eat every day are natural diuretics and laxatives which can lead to diarrhea. Try removing these from your diet for a few weeks to see if your symptoms improve.
Natural diuretics cause the body to produce urine. They include caffeine (found in coffee/tea, chocolate, candy, sports drinks, soda pop, etc), many citrus fruits (like lemon or lime, grapefruit, and oranges), and common fruits like pineapples, cherries, and peaches, etc. You can ask your dietitian for a full list of natural diuretics to investigate.
Most people know plums and prunes are natural laxatives. But, common ingredients like licorice, ginger, turmeric, dandelion, etc. can also cause diarrhea. You can ask your dietitian for a full list of natural laxatives to test out.
Many IBS patients are also triggered by gums like guar gum and xanthan gum. Gums can pull excess water into the digestive tract, causing cramping and diarrhea. Not everyone reacts to gums, so you'll need to check your personal tolerance. If you want more information on gums, Chris Kresser has a great article on common gums in commercial products as well as a great article on xanthan gum, specifically.
Common Digestive Triggers
If making IBS-friendly lifestyle changes, avoiding common gut irritants, and cutting out natural laxatives haven't relieved your symptoms, try testing diary and wheat.
Now you need to make a decision. Both dairy and wheat are common culprits when it comes to digestive issues, so they're a great place to start. But, both of these items are also tested during the Low FODMAP Diet.
You need to decide if you want to test these two foods using an elimination diet (where the foods are removed for at least two weeks and then reintroduced to see if they trigger symptoms), or if you want to try the Low FODMAP Diet proper.
Just so we're clear, if you and your healthcare team decide to test dairy and wheat first, you won't need to test them again if you try the Low FODMAP Diet. But, if you test them as part of the low FODMAP program you'll only have to work through one elimination phase to test all five FODMAP groups.
4. Start the Low FODMAP Diet
If making lifestyle and basic dietary changes haven't improved your symptoms, don't fret! Now you know your symptoms aren't caused by a lack of sleep or dehydration, caffeine or fat content, gums or other common triggers, etc. Or maybe you've found some triggers, but your symptoms still aren't really under control. These are all important pieces of the puzzle, and the more you know about the inner workings of your IBS, the more efficient you'll be at managing it when you find the right tools for your toolbox.
If you or your healthcare team suspect you're IBS is triggered by sneaky FODMAPs, it might be time to start the Low FODMAP Diet.
Just so we're clear, the low FODMAP program is a tool used to help IBS patients find common IBS triggers. The elimination phase can seem scary and overwhelming at first, but it's only 2-6 weeks. If you need more information on the three phases of the low FODMAP program, check out my What is the Low FODMAP Diet article. It explains each phase of the program in detail and will give you a clear idea of what to expect.
If your healthcare team has already suggested the Low FODMAP Diet might be right for you, sign up for my mailing list here and I'll send you a free 5-step guide to help you get started.
If your IBS diagnosis has left you with more questions than answers, you may be wondering what your next steps should be. If you can, try to find a FODMAP trained dietitian. They can help point you toward the most likely culprits in your diet and let you know when if and when to start the Low FODMAP Diet. Try making some lifestyle changes to improve areas of your life that may trigger or worsen your symptoms. Check your diet for common gut irritants, diuretics and laxatives, and common triggers like dairy, wheat, and gums. If that doesn't quite do the trick, take the information you've learned so far and dive into the Low FODMAP Diet.
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© 2018 Amy Agur – The FODMAP Formula