“IBS symptoms can wax and wane, and the effectiveness of treatments can vary from person to person. Some people respond well to dietary changes; however, others may only find relief through medication,” – The Gut Foundation
Following Salmonella poisoning four years ago, Amy Darcy – health and wellness blogger and editor at www.eatprayworkout.com – became painfully familiar with all the major IBS symptoms. Amy experienced particularly severe bloating and the ongoing embarrassment of excessive wind associated with her alternating diarrhea and constipation. Although at that time Amy found relief by using over-the-counter anti-flatulent medication, “It took my body ages to recover… even when it was over, my digestive system was still all over the place,” she states.
At that point, Amy began to explore dietary options to manage her symptoms. She began to reduce her dairy and gluten intake – which appeared to ease her symptoms – and then slowly reintroduced them until she found a workable, comfortable balance. These dietary changes successfully cleared Amy’s symptoms up altogether for a couple of years – even during her later pregnancy, she remained IBS symptom free.
Unfortunately, following the birth of her baby boy, Amy was both surprised and disappointed to once again experience severe IBS symptoms,
“The fact that it got better for a significant period of time and then flared up again after pregnancy really surprised me. I didn’t expect it to come back. I think it flared up again after having a lot of food that I wouldn’t normally have eaten. We were very blessed to have a month of meals cooked for us by friends and family after our son was born. Unfortunately, I now know it was probably the high fat content, and lots of garlic and onion – combined with the stress of being a new Mum and running a business – which triggered it again.”
Amy believes that additional stress from the sleepless nights and general anxiety that goes along with being a brand-new mum this stress also exacerbated her symptoms, which worsened again when she threw herself back into producing content for her blog after a six-month break.
Amy was also distressed to again be experiencing painful and embarrassing IBS symptoms despite consuming what she thought of as ‘healthy’ foods like fruit and vegetables. Amy began avoiding going out in public for fear of flare-ups and being embarrassed by the foul-smelling wind she was constantly producing. The anti-flatulence medication that had worked previously was now having no effect.
Amy’s daily physical, personal and social challenges with IBD, diet, and stress also highlight the individual factors which can amplify the symptoms and effects of medical conditions like IBS.
As Amy explains,
“It can be hard to make good food choices when I’m stressed because I often respond to emotional situations by eating comfort food! The stress also plays a huge part in increasing my symptoms so it can be a bit of a double whammy.”
In relation to the psychological impact of stress and its relationship with IBS, Professor Bolin of the Gut Foundation states, “IBS is a long-term problem and people need to talk to a doctor or health care professional that will listen and respond to them, and any variations in symptoms. It (IBS) is not a stress-caused problem, but stress can definitely make it worse.”
In relation to options for reducing stress and the symptoms of IBS, Professor Bolin advises,
“Gut-directed Hypnotherapy, yoga and meditation can all be effective in reducing symptoms, however these options can be time consuming and expensive. Hypnotherapy can benefit all ages, as an alternative to medication. It is often recommended for children with IBS as it is non-invasive. However, it’s important to deal with diet as well.”
Eager to reduce her IBS symptoms and to further explore dietary options, Amy next looked at the ‘low FODMAP’ dietary approach. In the area of dietary management of IBS, a low FODMAP diet involves eliminating certain carbohydrates from the diet for a period between of 2 and 4 weeks, and then reintroducing them in a specific order to identify IBS triggers.
Prior to commencing the low FODMAP diet Amy visited her GP to confirm that her symptoms were in fact due to IBS, and not some other condition. The doctor performed a battery of blood tests and took stool samples, which all came back negative, thus confirming the diagnosis.
With dietitian Chloe McLeod (http://eatprayworkout.com/dietitian-shares-how-to-manage-ibs/)Amy commenced the Low FODMAP Diet Challenge to learn which foods to eat and to avoid, and utilised Monash University’s FODMAP app to better understand all the new information. Amy feels that familiarising herself with the diet prior to beginning the ‘elimination phase’ meant that it wasn’t such a huge change when she began the ‘elimination stage’ of the approach.
Amy believes she began to see an improvement in her symptoms after approximately three weeks. At that point, she made an error and ate food containing high FODMAPs which resulted in extreme pain and discomfort again. This convinced her to commit strictly to the low FODMAP diet in order to maximise its benefit.
Amy is now at the stage where she can begin reintroducing some high FODMAP foods to identify what her triggers are – all under the careful supervision of an Accredited Practicing Dietician. She has identified that onion and garlic are definite triggers for her, and that she can only tolerate very small amounts of dairy and gluten.
While Amy has always been careful to work with accredited health professionals and has chosen to rigorously follow the low FODMAP pathway, it is important to acknowledge that while one specific approach may work well for one individual, it may not have the same positive outcomes for another person regardless of the apparent similarity of symptoms.
“Low FODMAP diet should always be conducted under the supervision of a dietician. All elimination diets should be done under supervision…The low FODMAP diet may help some people with IBS, but not everyone. Low FODMAP is not something people should do long term. When you remove something from the diet you need to allow for a period for the body to adapt to it once you add it back in… There’s certainly something in it for some people, but a lot of IBS is from the small intestine – that’s where triggers like fat and caffeine are worse… There’s no difference if the fat is from extra virgin olive oil, or from KF, fat is just fat when it comes to IBS symptoms.”
Just as there are different ways that IBS is experienced, there are also many different remedies and strategies that are used to manage IBS symptoms. Some find relief through relaxation and gentle exercise such as yoga, or through allied health treatments like physiotherapy or gut-directed hypnotherapy, whereas others only find their symptoms eased through the use of over-the counter or prescription medications.
Even now, Amy still faces difficulties:
“I find it relatively easy when I’m at home, but I really struggle when I have to try to describe food that won’t make me sick when I am eating with friends. I get quite embarrassed, but unfortunately if I don’t tell and eat trigger foods then the symptoms can be more embarrassing… It has meant a new way of cooking and having to educate myself and other family members of this. It can be a frustrating process for both my family and myself learning what I can or can’t eat. It has also impacted my social life as where I can eat is now restricted and needs to be planned in advance to make sure there is something I can eat on the menu.”
Despite these ongoing challenges, Amy wishes there was more awareness of IBS symptoms in the wider community. She’d also like more people – particularly those in the food service industry – to be aware of what the low FODMAP diet is all about, and the kinds of symptoms that people following this diet are trying to prevent.
“I wish I could order the food I need to not be sick, without being seen as picky or difficult, or for people to assume that I’m just following a fad. There’s definitely a stigma around ordering ‘special meals’, and I wish there was more education around that so that we’re not embarrassed to ask for what we need,” says Amy.
Amy’s IBS symptoms – as they do and have done for many other Australians similarly affected – cause significant disruption and upheaval in both her personal and professional lives. Her willingness to explore a variety of dietary and medical options however has resulted in improved outcomes and greater awareness of IBS in the wider community
When managing and treating your IBS symptoms and making important decisions about your health and wellbeing, always work closely with your doctor. They should always carefully explain your condition to you, answer your questions, and work with you to develop a management plan suitable for your individual needs.
Your doctor can also work with you to discover if psychological issues like anxiety, depression or stress pose a risk, challenge or problem for you. In some cases, it may be beneficial to see a psychologist or counsellor who can assist you to develop strategies for dealing with these issues and for coping with IBS.
More information on Amy Darcy’s approach to IBS, health and wellness can be found at her blog Eat Pray Workout,an Australian-based online hub for women who want to be the healthiest, happiest version of themselves. You can also connect with Amy on Instagram or Facebook