Eat For You Dietitian

A large proportion of what I come across as a Registered Dietitian in outpatient clinics is due to IBS-related symptoms. There can be whole clinics which almost every client can be experiencing some type of IBS symptoms.

What is IBS and how is it diagnosed?

IBS is a common condition affecting the gut which is diagnosed by the presence of intermittent stomach pain associated with diarrhoea, constipation, or alternating episodes of both.

Unfortunately there is no diagnostic test to confirm IBS. The symptoms of IBS are non-specific and tend to vary from person to person, which makes it even harder to diagnose and often the diagnosis slips through the net and many cases go undiagnosed, or what’s more it can be wrongly diagnosed. If you are experiencing any symptoms for longer than 6 months, which is impacting on your daily life activities you should go to your GP to rule out serious gastrointestinal conditions such as coeliac disease or inflammatory disease. Your GP can do this by ordering a blood test and stool sample if required. Remember though, to ensure the test results are accurate for coeliac disease you need to still be eating gluten in your diet regularly.

Usually when I have a client come into a consultation for the first time the belief is that their diet is the primary cause of their IBS-related symptoms. Dietary triggers vary from person to person, however the main key dietary triggers that be common include caffeine, fizzy drinks, alcohol, spicy food, high fat or fried foods, and poor fluid intake. Usually individuals are not aware of their intake of these types of foods and particularly how much water they drink until they have to write it down on paper.

Other triggers I also try to identify is when did all these symptoms begin. Was there something that caused a huge amount of stress and ongoing stress? What I commonly find out is that a big life event (usually negative) occurred such as bereavement, accident, starting a new job or starting university or an illness such as travellers diarrhoea, gastroenteritis, food poisoning or taking several courses of antibiotics for a variety of reasons. Can you identify an event like one of these that may have triggered the onset of your IBS-related symptoms?

I think Runners/Athletes can relate stress to negative gut symptoms very much. Anyone who has ever been nervous before a 5k, 10k, half marathon, marathon or other endurance event will have experienced running to the loo several times before the start. If you keep on going then pretty soon you finds ways to manage your nerves and get your pre-race routine down to a T.

1 in 5 people in the UK at some point in their lives will be affected by IBS and it affects twice as many women as men. Key points to remember is to not focus all your changes on your diet and begin excluding foods unnecessarily. If we are stressed and anxious prior to eating bread or pasta and then after finishing to eat we feel symptoms then this might make us feel like its the wheat or gluten that have caused it.

Real-life story: 

This week I had a lovely 80 year old lady attend clinic with her husband who was experiencing severe abdominal pains interrupting her sleep, with no change in her bowel movements. She had a major gastrointestinal surgery 7 years ago and recent investigations have not identified any clinical cause for her symptoms. So I asked the question, when did these symptoms begin? And that’s when it was identified, they started approximately 18 months ago following a significant event to a close family member that has led to significant changes to her and her family’s life. She was crying as she explained this to me and I almost followed her with her tears. She is under an enormous amount of stress which alongside severe abdominal pains she has lost a significant amount of weight. When I explained the link between stress levels, and the connection between our brain and gut, I could see a light bulb moment go off. Overall, her daily diet she described is varied and balanced and she has been restricting herself of favourite snacks and puddings that she will watch her husband have instead. Towards the end of the consultation she was extremely happy to have the dietitian say she could eat peanut butter and ice creams her husband keeps in the freezer (alongside other specific dietetic advice) to promote gradual weight gain. Regarding stress management, this is not my area of expertise so I have to make sure I provide information regarding healthcare professionals that can assist and trying methods to relieve stress management – such as breathing exercises, taking time to do something you enjoy independently like reading, or listening to music.