Nourish With Intent: IBS

Good morning Cadre. Happy first Saturday of May. I need to start playing music or something like JC does. This is always my awkward waiting game. Welcome, welcome. Today, if you saw I wanted to talk about as a continuation of my GI series, IBS specifically. Good morning, Jules. Happy Saturday. Glad to have you here. Let's see if anyone else pops in. How are you doing today, Jules? What are you up to? Feel like I need wall art or something. Okay, I'll just jump into it because I don't know how long I'm gonna talk today.

But talking about ibs, this is week, I think only week three of my series because I unfortunately was sick last week. Sorry about not being here, but actually I'm not sorry. I was taking care of myself. IBS and I wanted to talk about this because many, many people get diagnosed with IBS and then just sent on their way without really any guidance. So want to just briefly talk about what it is and then some nutritional recommendations. IBS is in the class of functional GI disorders, which means they there is no structural change to the GI system.

Like there might be in something like celiac disease where you're actually breaking down and flattening the villi, these little like fingery tissues that help you absorb and digest food. IBS is functional, so there's no physical change to the GI system. And functional GI disorders are characterized by typically dysregulation in the gut, brain interaction. Other things in this category include like gerd, some types of gerd. Jules, your daughter has been diagnosed with it. Amazing. Hopefully you can learn something.

Not amazing for her, but hopefully you can learn something today that might be helpful. Unfortunately, with IBS there's no conclusive diagnostic test because there's not a structural change, because there's no change to how your body is, you know, processing food and via lack of enzyme production or some something inhibiting absorption. It's typically a diagnosis by rule out you should you. I mean your doctors should be ruling out things like irritable bowel disease, celiac disease, stomach ulcers, other conditions that would cause similar symptoms.

There's four types of ibs. IBS C, which is primarily constipation. IBS D, where you primarily have diarrhea. There's a mixed version and then there's an unspecified version that doesn't usually get used but does technically exist in the classification Some of the causes of ibs. We don't have a lot of knowledge when you think about just any sort of health subject. There's a lot about IBS in the gut that we don't know. But some of the causes that we've been able to pinpoint include chronic antibiotic use, specifically, like in childhood, that can lead to alterations as you get older, foodborne illness and viral infections.

So we will see an increase in IBS after, actually, Covid was a big one. We saw an increase really, since we had so many people getting this virus. Chronic stress, stress doesn't typically, doesn't typically cause it. It's often kind of the environmental trigger that like sets it off. But in some cases, if you have chronic severe stress and then basically anything that can just alter your GI function. So things like chemotherapy, radiation, any sort of bowel surgery where you're disrupting motility, those are kind of the big ones when it comes to what we understand the most well understood cause of IBS is the foodborne illness.

So there's a bacteria called Campylobacter. It's a species typically it gets contracted from raw or undercooked poultry. Raw milk and then contaminated water are the three heavy hitters of that. And this bacterial infection causes us to produce antibodies, which is normal. It's what our body should do. But these antibodies can actually get into your GI cell tissues, cells and tissues, and cause nerve damage and almost like an autoimmune response. And this is seen to be a main cause of something called visceral hypersensitivity, which is essentially your perception of what's going on in your GI tract through the feedback in your nervous system is exaggerated.

So what, someone without IBS might feel some discomfort? In ibs, it's perceived as extreme pain or pain in general. So that is the most well understood like we can pinpoint. Okay, why is this happening? Some of the other causes are studied, but not as well understood. Four main drivers. So things that continue to perpetuate IBS dysbiosis, meaning our microbiome is out of balance again, you'll hear that word thrown around. Doesn't necessarily mean things every time you hear it, because there's so much we don't know.

But we do have some understanding of bacteria that is either beneficial or pathogenic. 50% of people with IBS have a more pathogenic gut microbiome profile. Number two is motility. So if you were here two weeks ago, I talked about motility, basically food moving either too fast or too slowly through your system. Gut brain miscommunication, which is kind of what I was talking about. Hypersensitivity. It's in that same realm where your central nervous system is communicating with your enteric nervous system.

So your all those gut organs and there can be this like severe feedback loop between pain. Right. We're perceiving pain that causes anxiety, that causes goes back to our gut, motility gets worse, digestion gets worse, and then altered immune activation. So a lot of our immune system involves our gut and this can impact pain sensitivity, gut functioning and food tolerance. Treatment is typically holistic. So I don't know if you have like a full team for your kiddo. Jules, pcp, usually for labs, some sort of GI for any medication management, if that's something that you're doing, either like a therapist or a GI psychologist.

Those are harder to come by, but they do exist because there's a lot of really solid evidence behind like hypnotherapy for ibs. I've mentioned the Nerva app before. That's a really great resource. And then a dietitian to help with the nutritional pieces, which is where I come in. The first thing that most people want to do with IBS is cut things out of your diet. And that can often lead to more issues than what it will help. So the first thing is always supporting digestion, supporting the things that are in your control.

You don't have control over a lot of things, but what you do have control over working on those things. That includes sleep. So poor sleep can impact ocean consistent and adequate intake. So making sure that you're meeting your body's base needs so that your GI system actually has the energy to function, produce digestive enzymes, move food through the system with those muscular contractions. Consistent intake kind of goes back to two weeks ago as well. When you're leaving space between your meals, you're migrating motor complex.

So almost like that broom, if you remember, helps to sweep things through. So consistent adequate intake, regular movement, any sort of exercise routine is a big one. And then nervous system regulation. And those two things are kind of paired together. So those are the things that we can work on that are within our control to best set yourself up for success. Oh no. Went to a dietitian and said you're not worried about her. That's frustrating because if she's feeling bad, like I don't know, that's definitely frustrating because I think yes, in the sense of like IBS doesn't typically cause increased risk for things like colorectal cancer, whereas something like IBD can.

You're not necessarily damaging the structure of your GI system like in celiac. But regardless if she's experiencing symptoms, that's. You don't want that. That's Uncomfortable. And we want to be working on figuring out ways to help her. So hopefully there. Maybe there's another dietitian out there who can help. Yeah, that's frustrating. I'm sorry. But that was the experience you had. Number two, reducing gut irritants and initial triggers. So this might be. For the most part, we do this through food journaling.

So writing down symptoms. And it's not like you don't have to write down the exact amount that you're eating or the exact brand, but just to identify the types of foods that you're experiencing systems. Systems. Symptoms with. And then we can. The goal of this is to inform a potential elimination diet. So you don't want to jump to just eliminating foods. We want to reduce first, eliminate if we have to, and then challenge those foods back in to confirm that it's a trigger. The goal of nutritional management of IBS is not to just restrict and cut out and eliminate.

The goal is to build resiliency and find tolerance levels so that you can live your life without feeling like you have to be super restricted. That can often lead to fear around food as well. Your stomach hurts every day with several different foods. It gets painful. Oh, my gosh. Jules, remind me where you're located. Yeah, I don't see. If you're. If she's in pain, that's like. I would be. I don't want her to experience that. So I also wonder if it was like a GI specific dietitian or just like a kind of like a more general dietitian.

Yeah. I can't remember where you're located. Let me know. Potentially, if she hasn't already, one of the things that she could do is start. You are in Minnesota. Okay. Oh, you're up there. Oh, my gosh. If she hasn't done a food journal already, I would maybe try that out. There's also apps. If she's like, more of a digital person than a physical food journal where you can log symptoms, that can be really helpful because then we can draw trends from that. I would start there if she hasn't. And you really only need to do food journaling for, like, I don't know, two to four weeks.

Generally, I. That just kind of depends on severity of symptoms. But if she's, like, in pain every single day, it probably is not going to take a month to figure out some trends with what's going on. So I would start there. The third thing is modifying fiber. So I've talked a lot about fiber. I know you've been here through a Lot of it. I appreciate that you have been doing a food journal. Okay. Has the food journal been brought to the dietitian? So with fibers, there's soluble and insoluble. Insoluble is that.

I describe it as the kale. Right. So the more like rough moving, pushing things through the digestive tract, that is, that can be really irritating on the gut lining. So sometimes reducing super high insoluble fiber foods can be helpful. Fermentable fibers. So I don't know if you guys have tried the F low FODMAP diet, because fermentable fibers are fermented by your gut bacteria and produce gas. And if you have that visceral hypersensitivity, the gas can be really perceived as pain. Jules, I might have you email me.

I feel like we could figure something out. And then once you've done all the things within your control, FODMAP diet or any elimination diet typically comes in a little bit later. Because once you've done those things and you have some, most people have some improvement in symptoms in doing some of those first things I mentioned, you are less likely to be as restrictive on an elimination diet if it's not the first thing that you do. So bringing in fodmap and then again kind of remembering that the goal is to support your overall gut function and resiliency and not just symptom management.

So the goal really is to build your GI system back up to a place where you understand your triggers, you understand the amount of food that is the trigger, because the amount can be different for everybody. And ideally, if we're cutting things out, work to a place where potentially we can even add those things back in so that you don't have to avoid them forever. In general, balanced meals, because that's going to help. Basic needs, gut motility, plants and plant diversity. Plants are a really good source of fiber, obviously micronutrients, but then also antioxidants.

And many plants are also anti inflammatory. And I say that cautiously because no one food is going to just like magically make inflammation go away. But think about like an overall eating pattern. Your antioxidants are going to be in your really deeply colored fruits and vegetables. So think dark leafy greens, your dark purples, things like cabbage, even red onion blues. So dark. Your blueberries are a really great source of antioxidants. And then things like olive oil and saddy fish have been shown to help with lowering inflammation, which can be an issue in people with ibs.

You have this kind of chronic low level inflammation that can increase gut permeability or leaky gut, and that can cause more pain and discomfort as well. Two years. Oh, my gosh. Okay, Jules, you should email me. And I can either. I am licensed in Minnesota, so I. I'm not like, a GI expert, but I've worked with GI in the past. Otherwise, I can help you find someone that's maybe a little more specialized in Minnesota. Yeah, I mean, losing and gaining weight is a. Is like a definite red flag, but again, if she's feeling really bad, that's not okay.

So. Yeah, Jules, shoot me an email. com K R I S T I N and what we can just. Let's figure out a way to help her, because that's not great. Hopefully something today was a little bit helpful. That's all I've got for you on ibs. Yeah, shoot me an email. We'll figure it out. Or I'll help you find someone who can help you figure it out. Either way. Yeah. I want her to feel better. Okay. Jules, I'm so glad that you popped in today, even though it's just us. I shouldn't say that. It's not just us. It's us.

JC Popping in my mind. Not using the word, just working on it. Cool. It was good to have you here, Jules. I will see you probably next week, and we'll keep talking about GI and to anyone who's watching on the replay. Glad you're here. Have a good rest of your weekend.