Key Topics Covered
IBS is very common and it can be important to know all the options available for managing this.
Beyond just the low FODMAP diet and avoiding common triggers (which we have covered in previous episodes), there are many other strategies you can implement to help improve outcomes and symptom management.
Although this is a common recommendation, it is underrated for a few reasons:
- It’s one of the most effective non-medical options for helping constipation. Many people with constipation haven’t tried it, which is why I consider it underrated.
- It can also help with mild diarrhea. Because it is water soluble it absorbs some of the water. So it helps with all forms of IBS.
- Sometimes constipation contributes to diarrhea as well, so addressing that is even more important.
- Intoleran – This offers various enzyme types. Quatrase provides a range of different enzymes so this is great for those who have issues with multiple FODMAPS.
- FODZYME – This is a newer brand and can be used to sprinkle over food.
- BeanAssist – This helps break down galactooligosaccharides. This is also less expensive compared to others.
- Lacteeze – This breaks down lactose.
Digestive enzymes can help with quality of life, particularly if you can take it when you go out for meals.
Gut-directed Hypnotherapy / Nerva
- This is underrated because it seems like alternative medicine and not necessarily evidence-based.
- However, we have nearly 10 RCT’s exploring this approach, with almost all of them finding significant benefits.
- This is in line with many gold standard approaches.
- Nerva is an app you can use daily for 6 weeks and has very effective results. This is also probably cheaper than working with a practitioner so this can be worth trying.
- Bowel retraining can be helpful for both chronic constipation and when there is frequent loss of bowel control.
- It is essentially aiming to have a bowel movement at the same time every day in an attempt to train the bowel to have regular movements that are more predictable.
- These regular movements are normal for most people, but with IBS it often is far from normal.
- A suggested protocol is to sit on the toilet for 5-10 minutes each morning after breakfast/coffee as the morning is when the gastrocolic reflex is the most active (this reflex is basically when the stomach is stretched there is an increase in overall gut motility through the intestines and is the bodies way of preparing for more food to enter the GI tract and ideally get rid of some waste).
- You can also do bowel re-training at another time of the day – the point is that the time should be consistent.
When doing bowel retraining it is important not to strain or force a movement but it can be helpful to have your feet propped up on a stool and to do some diaphragmatic breathing work (both of which we will talk about soon).
- Digestion starts in the mouth, so when done properly this can help the whole process of breaking down your food.
- There isn’t actually much research on this. It’s largely common sense and we see anecdotal improvements.
- A study has shown that “chewing insufficiency” was significantly linked with IBS though.
- A poop stool or a squatty potty is a great way to simulate a more natural position to pass a bowel movement.
- We are designed to do this in a squatting position, allowing for easier passage for the stool.
- Research does show that pooping in this position results in more complete bowel movements and a reduced risk of haemmorhoids from straining.
- This is underrated as we now have 4 out of 4 RCTs showing significant benefits.
- Although this isn’t a lot of evidence overall, it seems promising so far.
- This has been mentioned in a previous podcast, so you can see that for more details.
- This is one that I have been recommending a lot to clients lately simply because it is such an easy win that requires no tools or devices and can be done anywhere.
- Diaphragmatic breathing is a type of deep, controlled belly breathing. A video is linked in the below resources for instructions on how to do this.
- It can bring you more into the parasympathetic nervous system which is the rest and digest mode.
- A lot of the time a huge part of IBS can be stress and anxiety which puts up more into fight and flight mode where digestion is not being prioritised.
- It can be helpful to use diaphragmatic breathing upon waking as part of the morning routine, during bowel retraining, whilst using gut-directed hypnotherapy, before/after meals or whenever you feel a flare coming on.
- The other pro of this breathing is by pulling that air, down into your belly, you can almost give your intestine a little massage which can help with gut motility and even pushing through trapped gas.
What’s great about these underrated tips is that none of these actually requires you to change what you’re eating. They are all practical tips you can try to add to your current intake to see if it can help in any way.
Relevant Blogs / Resources
- Managing IBS on a Plant-Based Diet: A Guide to Low FODMAP for Vegans
- Are Probiotics Helpful for IBS?
- Peppermint Oil for IBS and Bloating: Everything You Need to Know
- IBS Management and Treatment: Everything You Need to Know
- The Effect of Fiber Supplementation on Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
- Irritable Bowel Syndrome: A Concise Review of Current Treatment Concepts
- Gut-Directed Hypnotherapy
- Dietary Behaviors in Relation to Prevalence of Irritable Bowel Syndrome in Adolescent Girls