They say, as a writer, you should write about what you know and although my website is dedicated primarily to travel & food, it also covers lifestyle too. IBS is a condition that I have which at times heavily influences my lifestyle, it dictates when I can go out, what I eat and how I feel.

In the past year it has affected my life particularly badly and it affected my ability to work, my relationships and how I felt about myself and my body. With help from loved ones I came to a point where I realised I couldn’t continue as I was and I needed to really begin to understand my condition better and how to manage it and live with it in a more positive way. I have done a lot of reading on the subject, I have trialled different diets, undergone further tests and tried new things which have ultimately helped my condition and my understanding of it. I am by no means an expert and there are days when I still struggle with the condition but after years of having it and trying different methods to cope with it I have learned a lot about it.

I write this article in the hope that it also helps someone out there and if it even helps just one person, it will be worthwhile!

What is IBS?

Irritable Bowel Syndrome is a chronic condition. It affects 1 in 8 people and more women than men. In simple terms, your digestive system does not function in the correct way. It is different for each person who has it. That means that two people could both have IBS but their symptoms could be different, their triggers different and even the most effective treatments for them may be different. There is no cure for IBS but it can be brought under control.

How do you know if you have it?

You must work with your doctor to correctly diagnose IBS. This can be a bit tricky, this is because there is no one test to say ‘Yes you have IBS’ or ‘No you do not’. In order to diagnose IBS you have to do other tests to rule out other conditions and diseases such as Celiac disease & Chron’s. This can be a bit of a confusing process. You should have blood and stool tests during this process. Professor Peter Whorwell puts it well when he explains: “this can lead to major misunderstanding between the patient with tummy problems and their doctor, if they are told their test results are ‘normal’, sometimes with the implication that ‘there is nothing wrong with you'” which is obviously not the case. So IBS is diagnosed by ruling out other conditions with similar symptoms. It is a condition in which a lot is still unknown but medical professionals are learning more about it everyday.

Contributing factors:

It is a multi factorial disorder which means that it does not have one cause alone. It is likely associated with the effects of multiple genes in combination with lifestyle and environmental factors. It is difficult to say what exactly the cause of IBS is. This is largely unknown, however these are looked at as possible contributing factors:

• Genetic predisposition
• hypersensitivity of the gut
• dysmotility – muscular overactivity
• central processing – abnormal processing of pain signals to the gut
• dysbiosis – disturbance of the balance of the bacteria in the gut
• diet
• psychological influences

Taken from ‘Take control of your IBS’ by P Whorwell

Results of having IBS:

These are possible results of having IBS. People with IBS may experience more than one of these symptoms and it is more than likely that they will. Although they will probably not experience all of the symptoms. It is different for each person.

• Abnormal bowel function/ changes in bowel habits
• Diarrhoea
• Constipation
• Abdominal pain
• Cramps/ spasms
• Wind
• Bloating
• Nausea
• Lack of sleep
• Poor concentration
• Backache
• Lethargy
• Headaches
• Chest pain/ palpitations
• Symptoms worsened around your period due to change in hormones
• Lack of libido
• Changes in mood

(NB. Bleeding in stools or rectal bleeding is not connected with IBS and if this happens to you, you should go directly to your doctor as it could be bowel cancer or IBD (Inflammatory Bowel Disease). This can be tested for using a Q fit test from the doctor. If this result is positive it is important to have a colonoscopy which can be used to rule out the above mentioned. This can be a scary process so try not to think the worst until you have all of the results. My advice is to share this with those closest to you and don’t go through it alone. If you have any questions or are going through this process feel free to message me.)

Triggers for IBS:

Triggers can be different for each person with IBS. Basically a trigger is something which makes your symptoms more aggravated and causes a flare up. Triggers can include:

• Diet
• Food Intolerance
• Stress
• Anxiety
• Lack of exercise
• Hormones – menstruation for women
• Cortisol levels increased
• Gastroenteritis is a well recognised trigger

Stress and IBS:

There is a lot of research to show the relationship between the gut and the brain. This is called the gut-brain axis. There is research to show that high levels of stress or stress over a long period of time can cause many issues healthwise, both with your body and your mental health. When you are feeling stressed, your cortisol levels raise and your body goes into ‘fight or flight mode’, this was very important in the past when humans would have to face situations like running away from a bear for example, and is still important if you are put in a dangerous situation now where you may have to run to safety. During this fight or flight mode your body changes, your senses are heightened, your digestive system shuts down and it prepares to be put under physical stress like running very fast for example. However, it is not often you are put in that position. If your body is constantly doing this every day over a long period of time you can see the damage that it can do in terms of aggravating your digestive issues which already exist. Stress & IBS works in a cycle; if you are stressed it can worsen your symptoms and if your symptoms are bad it can then in turn stress you out.

“There is no doubt that stress can result in IBS becoming more severe, but if someone with IBS is asked whether they had any tummy problems, however mild, before whatever caused the stress, they often say “I have always had a funny tummy” or “my tummy has always been sensitive”, especially before something like an exam. This leads to the idea that the tendency towards IBS has always been present but the stressful event has changed it from a minor nuisance to a major problem. As we have previously seen, IBS sufferers tend to be anxious but only seldom depressed. However, it would be rather surprising if someone with severe tummy pain, bloating, and a completely unpredictable bowel habit did not become a bit anxious or down in the dumps as a result of their condition.” Prof Peter Whorwell explains rather well.

So it is important to find ways to lessen your stress. If you are in a stressful situation, do what you can to ease the stress or in extreme cases, do what you can to get out of that particular situation. Keep reading for possible solutions to help with stress & IBS.

Treatments

As I see it, IBS is caused and triggered by many different things, therefore the treatment has to also be many different things, a whole lifestyle change. You may be doing everything right with your diet, but if your stress levels are high and exercise levels are low, you could still have issues. My advice, from experience is to try what you can from the suggestions below and remember to look at all sides of the condition, body, diet and mind before you turn to medication.

Remember, “What may help one person may not help another…one size does not fit all and inevitably treatment has to be a process of trial and error until a treatment plan that suits the particular individual is found” P Whorwell.

Healthy Body:

Exercise can help ease the symptoms of IBS so it is important to take this into account in your lifestyle. It is important to note that some people find very intense exercise unhelpful with IBS, this is due to raised cortisol levels when you exercise in an intense manner, this is of course not true for everyone so you should test it out for yourself. The following suggestions have had studies done which prove the benefits with IBS:

• Yoga
• Stretching
• Walking
• Light exercise eg. dancing
• Exercise in nature
• Low impact workouts
• Regular 8 hour sleep (in a darkened room/ with eyemask, ear plugs, digital devices outside the room, an ideal temperature of 18 degrees to allow your body time to repair)
• Heat can help cramps, for example a heat pad or hot water bottle
• Take peppermint capsules for bloating
• The L massage (found on lilsipper instagram)

 

Healthy diet:

• Your doctor may recommend you try the FODMAP diet.

“For many years’ people with IBS have reported symptoms with food and the development of the Low FODMAP diet in Australia verified what patients have always known – eating certain foods can increase symptoms of IBS. The term FODMAPS is an acronym that stands for:

Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. They are a collection of poorly absorbed simple and complex sugars that are found in a variety of fruits and vegetables and also in milk and wheat.  The process of drawing fluid into the bowel and the fermentation of FODMAPs by bacteria produce the symptoms experienced by people with IBS. Symptom improvement can follow the reduction of high FODMAP foods for around three-quarters of people, including improvement in bowel habit, especially diarrhoea. These sugars are found in a wide variety of foods in the diet, and not everyone with IBS will have symptoms with all of them.

The diet involves reducing high FODMAP food for four to eight weeks and then re-introducing them using a specific protocol, if symptoms improve, to identify which ones are problematic for the person. Participants then follow a FODMAP modified diet, particular to their circumstances.” Explanation taken from The IBS network

• Low FODMAP diet
• Food intolerance
• Increased soluble fibre
• Lots of water (especially if you have IBS-D)
• Reduce caffeine
• Reduce fizzy drinks
• Spicy food can be a trigger for some people
• Avoid/ reduce high sugar (FODMAP sugars)
• Probiotics (There are different kinds of probiotics so you should try one at a time, for a few months and see if you notice an improvement in symptoms. If not, try another. It should be noted that if you do experience improved symptoms then you should continues to take the probiotic because the effects stop if you don’t continue to take them.)
• The evidence based ones are:
• Lactobacillus strains, (such as L. acidophilus, L. plantarum, xi)
• Bifidobacterium strains, (such as B. infantis (Align), B. longum, B. bifidum)
• L – glutamine (an amino acid which has some evidence to show it helps IBS)
• Eating within a certain window of time (for most extreme cases 8 hour window -> 12 hour window) This way your body has time to digest properly outwith this time.

It is important when monitoring your diet and symptoms it is best to keep a daily diary of the two. This helps you to spot patterns and help identify certain foods which you might need to reduce or eliminate.

Healthy mind:

A healthy mind and mental health is something which is coming to the forefront these days and I think it is particularly worthwhile to talk about it more.

‘The majority of your serotonin – the happy and calm hormone – is made in the gut. In 2013 a study found that gut bacteria also has an effect on the production of GABA – the neurotransmitter that calms the brain. So, a healthy gut = a healthy mind” Chloe Brotheridge

Here are suggestions which I recommend to improve your mental health and therefore your gut:

• Mindfulness (studies are showing that mindfulness can help ease IBS symptoms.)
• Mindfulness classes (in person/ online)
• Mindfulness apps such as Calm & Headspace. (Calm can be bought for free if you are a teacher as the importance of mindfulness with children is being seen as beneficial)
• Meditation
• Yoga
• Cognitive Behavioural Therapy (Can be accessed through the NHS)
• Psychotherapy
• Hypnotherapy
• Digital detox (limit screen time when eating and 90 mins before bed)
• Spend time in nature
• ‘Worry time’ (If you are particularly worried about things, set aside worry time each day for 20mins max, where you write down your worries, look at them and ask yourself: 1) Can you do something about it? If so what? Then make a plan to do it. 2) Will this matter in 5 months/ 5 years time? If not, try to stop worrying about it. It isn’t worth your time.)
• Gratitude Journal ( Buy a journal that you love & that will motivate you to write in it. Start slowly and each day, maybe for 5 mins before you go to bed, write 3 things you were grateful for that day. By focusing on the good, it can change how we perceive ourselves and our environment.)
• Do things you enjoy – singing, dancing, playing football, reading, writing…
• Learn something new – learn a new recipe, language, song…

Medication:

At times we need medication to treat our condition. However I have had times in my life where I was on multiple medications every day and I do not think this is necessarily the answer long term as it only treats the symptoms but not the cause. That’s why I am now taking a multifaceted approach and taking medication only when it is extreme. When you do need medication these are what are used for treatment of IBS:

• Antispasmodics (such as buscopan)
• Laxatives for IBS C
• Antidiarrheals for IBS D
• Antidepressants (are sometimes prescribed as they treat the low mood, and therefore the gut through the gut-brain axis)

Travel & IBS:

This is a travel blog after all. Take these things into account when travelling:

• Plan the journey well to avoid stress
• Meditate before your journey
• Take safe foods with you on your journey in case there is nothing suitable on the plane/ train/ car.
• Take water with you to keep you hydrated
• Make sure you move or do stretches if on a long haul flight or train journey.
• Avoid caffeine.
• Pack a bag with heat pads, peppermint capsules etc
• Take emergency medication with you in case you do need it
• Talk to your travel partners about your condition to help them understand your needs and help in any way they can.

(Some travel tip ideas taken from The IBS dietician on Instagram)

Helpful reading:

• Take Control of your IBS – Professor Peter Whorwell
• The Anxiety Solution – Chloe Brotheridge
• The 4 Pillar Plan – Dr Rangan Chatterjee
• The Stress Solution – Dr Rangan Chatterjee

Helpful social media accounts:

• the.ibsdietitian
• ibs.nutrition
• myibslife
• lilsipper
• thetummydiaries
• shecanteatwhat
• scarlettlondon

Helpful podcasts:

• Dr Rangan Chatterjee – has a guest speaker on each week and a few podcasts specifically about IBS

 

I hope you have found this article helpful, if you are suffering from IBS yourself or have a friend or family member who suffers from it. It is important to work together to help that person get their IBS under control and therefore increase their quality of life.

Please feel free to contact me if this article helped you or you have any advice to add!

You can screenshot these tips on Instagram on story highlights for easy access!

Thank you,

The Wee Wanderer x x