There is no cure nor specific cause for IBS. The symptoms and triggers vary, but the secret to a healthy life is within our bodies
An unbearable pain that knocks one off its feet, making lying down on the toilet floor the only option to ease such a terrible cramp. That is how Carla Righi, a health coach specialized in emotional eating, gut health, and hormone balance, describes what living with Irritable Bowel Syndrome (IBS) looked like for her back in 2006. Add to that a debilitating migraine and sleep disturbances, and you can imagine how hard it was to perform daily activities.
IBS is a condition that affects the large intestine, causing symptoms that can vary from person to person but are frequently related to abdominal pain that alleviates only after a bowel movement. Some people might face constipation, others diarrhea, or a combination of both. The appearance of mucus in the stool, bloating, gas, cramping, and migraines are common. Other signs include weight loss, nausea/vomiting, anemia, and less obvious ones.
During the chronic phase of Carla’s symptoms, she went doctor after doctor looking for answers but spent six months in this path. The IBS diagnosis does not rely on one specific test and involves a process of exclusion. It means the doctor needs to rule out other conditions, such as celiac or Crohn's disease, and assess all signs or symptoms to determine IBS.
Getting a diagnosis, though, is only the first step towards restoring health and well-being. The medication available only diminishes the pain and other discomforts but will not treat the root cause.
Triggers and risk factors
Doctors still do not know what causes IBS. Some risk factors include imbalances of the normal gut microbiota and improper work of immune and nervous systems. Besides, there are many triggers.
Carla noticed that something was wrong with her diet or eating habits, as the pain would show up often after lunch, and some days would start with breakfast and follow lunchtime. But she could not figure out what was setting off the symptoms. She would eat balanced meals and practice exercise.
IBS is often a lifelong disease, meaning that there is no cure, and once one gets this diagnosis, something needs to change in their life to manage all the symptoms. The challenge is to understand what needs to change.
Eating for IBS
A dietitian should be able to support someone with IBS to navigate through some necessary adjustments. But a study in the US shows that only 21% of gastroenterologists refer IBS patients to registered dietitians (1).
In Brazil, it was not different when Carla got her diagnosis. She says: “It took me about 5-6 months to see improvements, having less frequent symptoms. Instinctively, I decided to keep track of what I was eating and saw some patterns. Then, I started avoiding the triggers. Now, I know I was avoiding the FODMAPs.”
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Grains, vegetables, fruits, and dairy products are sources. FODMAP intolerance is common in people with IBS. The diet helps up to 75% of cases (2). But it is restrictive and, without professional help, can lead to vitamin and mineral deficiency, which would only worsen the condition.
In addition to that, doctors usually recommend avoiding gluten, carbonated and alcoholic beverages, and foods rich in insoluble fiber - meaning whole grains, some vegetables, and fruits.
Irregular eating habits can also be a trigger. The symptoms can worsen if someone with IBS skips meals frequently.
How stress stimulates the symptoms
There is evidence already that IBS is a combination of irritable bowel and irritable brain. That is why emotional stress perhaps overpasses diet when we discuss triggers.
Stress affects the nervous system, essential for controlling the sensitivity and motility of the digestive system. Stress also creates imbalances in the gut microbiome, leading to intestinal permeability (leaky gut). Saying that our gut is our second brain is not a metaphor. It has its own cerebral activity and intelligence. Studies have proved that a healthy microbiota helps maintain optimal communication between other body systems such as the nervous system and the immune system. And our gut immune system represents 70-80% of all our immune cells (3).
Managing stress is essential, and there is no medicine for it. Therapy, meditation, yoga, and any other mindfulness activity can help. But only our bodies know what works best for us. Some people might get more anxious trying meditation or yoga. Perhaps a routine of physical activity is enough. Exercises add to digestion and reduce stress. Be aware that too much high-intense activities might work the other way around, increasing stress levels.
Body awareness as a remedy for IBS
There is no treatment capable of curing IBS. The best strategy to regain health is to work on the triggers through diet and lifestyle. However, there is no one-size-fits-all recommendation. Understanding your own body signals and what sets off the symptoms is essential to overcoming this syndrome.
A food journal might work as a first step. Going beyond that, practicing mindful eating can be a game-change. In addition to directing your full attention to your food, letting you appreciate what you eat, and establishing a better relationship with the eating experience, this technique works well for the mind-gut connection. Mindful eating allows you to be aware of all the digestive processes. It can ease the role that the nervous system plays in it, and also reduce stress.
For Carla, learning to listen to her body was the most effective remedy. This habit changed her lifestyle and how she managed the stressors. She explains: “I was under stress and did not realize it. While eating well and doing exercise, I was a perfectionist, and it was taking a toll on my body. My gut was under stress, physiological and emotional.”
From pain to gain
IBS affects approximately 14% of the global population(4). Millions of people wake up every day for a life of pain, discomforts, mood swings, and more stress. Some of them are facing this condition for years, or perhaps decades. And no one should set for anything less than optimal health and well-being.
Becoming a health and nutrition coach, Carla transformed her life. Knowing how to address nutrient imbalances, feed the healthy bacteria in the gut to improve immune function, and manage stress, she established a well-nourished life in all aspects of it. She adds: “I never intended to be a health coach when I signed up for my course. I wanted to connect with my body. But after that, it was only natural I start helping people dealing with the same health challenges I have gone through.”
For those who are still fighting for their health, she says: “Everyone knows the root cause of the imbalances within their bodies. But it is not always pleasant to work on it. What I can say is that learning to listen to our bodies can change our lives forever.”
*Photo by Rose Jordao Binda