How a dietitian manages IBS without going Low FODMAP

I have been working with clients on their digestive health issues for over 10 years. And even though I’m a registered dietitian, eight years ago, I discovered firsthand what it was like to struggle with my gut. I had recently given birth to my first child, who had come early, so I had to deliver him while on a penicillin drip. Sleepless nights and the stress of adjusting to motherhood followed and all of a sudden, I was in excruciating pain.

My first flare took me almost a year to get under control and ever since, I have been experimenting with different techniques for healing. I am now in a place where I rarely experience symptoms, unless I am in a stressful situation or there is a major shift in my diet. And I do this all without following a low FODMAP diet, which for many of my clients is my first line of nutritional therapy.

The low FODMAP protocol works extremely well for those in flare of diarrhea-predominant IBS, like I have. However, it’s not meant to be a long term dietary strategy as it both eliminates some of our most powerful anti-inflammatory foods such as garlic and starves out beneficial microbes in the gut that are critical for long term health.

Which is why, although I still strongly recommend a low FODMAP protocol for those looking to get their gut health back under control initially, I want people to go another route long term.

As someone interested in gut health nutrition who follows a plant-based diet of foods rich in fibre, the idea of going without generous amounts of legumes or having to cherry-pick my produce also doesn’t appeal to me. Nor does easing symptoms now at the expensive of my long term gut health.

No matter what the gold standard therapy is, if it doesn’t fit your ideal of how you want to eat, there has to be another way. And for me, there is. I have created a lifestyle that helps give me the latitude to live how I want to live without irritable bowel symptoms getting in the way. And trust me, I even wrote an entire cookbook on the issue!

Here are some of the strategies that have been most powerful for me:

  1. Loading up on vegetables instead of starches

My pre-IBS diet was filled with healthy choices, although I consumed starchier food like rice, quinoa and sprouted grain toast more than colourful vegetables. Probably the most transformative change I made was to ensure that 50-75% of my plate is covered in colourful vegetables most of the time. Many grains, such as wheat and barley, contain the FODMAP fructan, and eating fewer grains gives me more space to enjoy an abundance of high FODMAP nutrient-dense foods like legumes and vegetables. I also notice that for myself, even low FODMAP high starch foods like rice can lead to symptoms so I enjoy smaller portions of these foods in my veggie-heavy meals.

  1. Moving my body consistently

Exercise serves a few major purposes, including improving feelings of self-efficacy, relieving stress and decreasing bloating. My primary IBS trigger is stress; as an entrepreneur and mother of two, it’s safe to say that stress is a regular fixture in my life! However, consistent exercise nourishes my gut-brain connection by increasing my physical and mental resilience. Exercise helps de-bloat as it stimulates lymphatic drainage in addition to stimulating proper gas movement in the gut.

  1. Adaptogens

I take a trio of anti-inflammatory supplements – vitamin D, omega 3 and probiotic – to improve my gut health. However, I noticed a significant improvement in stress-related symptoms when I added ashwagandha to my morning routine. In addition to IBS, the other gift that pregnancy provided was hormonal cystic acne that I struggled with despite my plant-based anti-inflammatory diet and stress management techniques. When I started consistently using ashwagandha, my acne cleared up and I noticed that my gut seemed more resilient to life’s daily stressors. The reason I believe ashwagandha was the solution is that research suggests it helps to protect the immune system from the damaging effects of cortisol. This would means less inflammation in stressful times and fewer gut issues as a result.

  1. Cutting way back on caffeine

As someone with a tendency towards anxiety and sleeplessness in stressful times, I knew that a lot of coffee or matcha wasn’t a great idea for me but since I only drank one or two caffeinated drinks a day I was hesitant to give it up. Then recently, I decided to go for it. My energy levels improved…and my gut was far less stimulated and my skin tone visibly improved within a month. Now, I rarely drink more than decaf and a few cups of matcha each week and I’m surprised that I don’t miss caffeine.

  1. Getting mindful about meal spacing

As a dietitian, I was trained to counsel clients to eat regularly in order to maintain stable energy levels. However, as more of us become constant snackers, this presents a problem for digestive health: in the post-absorptive state, the body turns on a cleansing wave of peristalsis known as the migrating motor complex. This wave helps sweep the contents of the gut, reducing the potential for bacterial overgrowth. Once your meal has been absorbed, your MMC requires 90 minutes to do its job before you eat again. I have found, as have many of my clients, that spacing meals 4-5 hours apart improves symptoms. This means being mindful about crafting balanced meals with plenty of plant-based protein and healthy fats so you can stay full and satisfied until your next meal.

As common as irritable bowel syndrome may be, you can live with IBS and still feel well. Be mindful of how your lifestyle affects your experience of symptoms; you can absolutely find a balance that allows you to enjoy what you eat and feel great. And if you need some extra help, consider a one-on-one consultation to customize a nutrition approach that fits how you live.

Photo Credit: Melissa Quantz