Stress and IBS are as much related as food and IBS

IIf you’re one of the millions of people with irritable bowel syndrome, also known as IBS (between 10-15% of people in the United States have it), chances are you’ve heard talk about a diet called the low diet. -FODMAP diet. This diet was created in 2005 by experts at Monash University in Melbourne who were insightful enough to realize that for many, foods containing short-chain carbohydrates are poorly absorbed, leading to bloating and other problems. digestives.

The low FODMAP diet is a complicated diet and cuts out many nutrient-dense foods, which is a shame. But many people with IBS have found it relieves their symptoms, so it’s become *the* diet that GI doctors prescribe for many people who come into their office suffering from bloating, constipation, or of diarrhea on the diet.

Even if you haven’t officially become low FODMAP, if you have IBS, you may have tried to avoid flare-ups by cutting out certain foods like gluten or dairy. While scientific studies have shown that certain foods can exacerbate IBS symptoms, a new study has found that foods may play a lesser role in managing it than people have long thought. Posted in the Clinical Nutrition Journal, researchers found that cutting gluten and FODMAPs did not help symptoms that much. The researchers divided a group of 110 people with IBS into two groups. One group completely eliminated FODMAP foods and foods containing gluten. The other group did not. They found that FODMAP foods seemed to make symptoms worse, but not as much as researchers previously thought. As for gluten? It didn’t seem to have any effect anyway.

This is a small study; only 110 people. Additionally, there are other studies that have shown that reducing FODMAPs and gluten can benefit IBS. But what the study clearly shows is that managing IBS is not just about food. Here, two gastroenterologists explain why diet is only part of the solution.

What causes IBS?

Before discussing the best way to treat IBS, it is useful to know what IBS is. “Irritable bowel syndrome has formal diagnostic criteria that must be met to receive a formal diagnosis,” explains gastroenterologist Marvin Singh, MD. Basically, these formal diagnostic criteria ask a lot of questions about your poo. What’s it like, how often do you go, if you’re in pain… “There’s a calculator that takes [symptoms] into account and helps determine if it meets an official diagnosis,” says Dr. Singh. Gastroenterologist Rabia De Latour, MD, adds that there are also subcategories, IBS-Diarrhea and IBS-Constipation.

This is important to know because it shows that IBS is not just someone with any kind of digestive distress if doctors can’t figure out what else it could be; certain criteria must be met. If you think you have IBS, see a gastroenterologist to be sure.

While there are clear, established criteria for what IBS is, the two experts say what causes it is less straightforward. “IBS is multi-faceted; it’s not that simple,” says Dr. Singh. “Food, stress, sleep, and other lifestyle factors have been found to affect the microbiome, causing issues that ultimately lead to a diagnosis of IBS.” Dr. De Latour says one factor that scientific studies have particularly found to be linked to IBS is stress. “There is a very strong link between IBS and mental health,” she says. “It has been well established by many gastroenterologists anecdotally that a person who experiences a lot of personal stress or anxiety has more severe symptoms of IBS.” She adds that this is yet another example of how the mind and gut are truly intertwined.

This is exactly why the two GI docs say that food is only part of the solution to managing IBS.

How to Manage IBS Besides Changing What You Eat

If you suffer from IBS, Dr. Singh and Dr. De Latour say stress management has to be part of the solution. “The brain has a direct influence on the composition of the microbiome. If you feel anxious on a regular basis, not only can this change the bacterial composition of the gut, but it can also cause the digestive tract to work faster or slower,” said Dr. Singh explains. “This can lead to symptoms like constipation, diarrhea or bloating.” If you’ve ever experienced nasty stomach issues before a big presentation or meeting, you’ve seen this powerful connection firsthand.

That’s why both doctors advise finding a way to deal with stress and anxiety on a regular basis. They say it will be different for different people. Maybe your favorite stress reliever is going for a run outdoors after work. Maybe it’s breathing or stretching exercises. It could be a luxurious bubble bath. The key is to find something. Many of these pain relievers have been scientifically proven to help improve IBS symptoms, such as yoga and meditation. Others still need to be investigated to confirm a connection. (Where’s the sign-up sheet for the luxurious bath study?) But both doctors say managing stress is key.

Of course, if you regularly have flare-ups after eating, just eating can be stressful. If this is your case, Dr. De Latour suggests working with a therapist in addition to a gastroenterologist, specifically an eating disorder specialist. These experts can give you tips on how to actually enjoy mealtime instead of stressing yourself out while making sure you’re getting the nutrients your body needs.

In addition to managing your stress, Dr. Singh says it’s also important to make sure you get enough sleep to manage IBS. “Altercations in the sleep cycle are another factor that can alter the microbiome,” he says. In his opinion, scientific studies have shown that some people with IBS also have a sleep disorder.

If you’re on medication, Dr. De Latour says that’s another thing to consider, as some can make IBS symptoms worse. For example, certain painkillers, cough medicines, and antidepressants can exacerbate symptoms. For this reason, she says it’s important to tell your primary care physician (or other specialists) that you have IBS before you get prescribed medication. IBS isn’t just something to discuss with an IM doc.

So what about food? Does he still play a role in the management of ICS? Both doctors say yes, but not the only role. “The low FODMAP diet is not meant to be followed by someone indefinitely, as it excludes a lot of healthy foods, so I work with patients by very slowly reintroducing FODMAP foods, having them follow the way the different subgroups make them feel.” said Dr. Singh.

What is clear is that taking care of your gut goes beyond diet; you also need to take care of your mental health. It’s the only way to stop IBS from getting in the way of you living your best life. The most encouraging news of all is that he can be managed. It just requires a little more personal care, and it’s something that anyone can benefit from.

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