IBS Part 1: Why Do I Still Have IBS Symptoms?

Irritable Bowel Syndrome (IBS) is something I see very often in my nutrition clinic, and it frequently overlaps with other conditions, including dysregulated mood.

For some people, it’s an inconvenience. For others, it can really get them down. Bloating, pain, unpredictable bowel habits, gas, or urgently needing to find a toilet can start influencing what you eat, what you wear, where you go, and even whether you want to go out at all.

And if you’ve lived with digestive problems for years, it’s surprisingly easy to get used to feeling awful and accept that this is just how your gut is. However, it doesn’t necessarily have to be.

“I’ve been told I have IBS. Now what?”

Receiving an IBS diagnosis can initially be a relief. Finally, there’s a name for what you’ve been experiencing - the frustration comes when that’s where the support ends.

IBS describes a collection of digestive symptoms, but those symptoms, and what drives them, can look very different from one person to another. That’s why two people can both have IBS and need quite different approaches.

My job when working with someone with IBS isn't simply to give them a list of foods to avoid. It’s to look at the bigger picture and start piecing together what might be contributing to their symptoms.

What might be contributing to IBS symptoms?

There isn't always one culprit, food can certainly play a part, including how well certain carbohydrates such as lactose or fructose are tolerated. However, digestive symptoms can also be influenced by changes within the gut microbiome, bowel motility, previous gastrointestinal infections, stress and the communication between the gut and brain.

Small intestinal bacterial overgrowth (SIBO) is something that also comes up frequently when working with people with bloating and IBS-type symptoms. However, I've moved away from routinely using SIBO breath tests in my practice. The tests have limitations and, importantly, a test result doesn't necessarily change the foundations of how I support the person in front of me.

Sometimes we can become so focused on finding a label that we overlook the everyday things influencing how the digestive system is actually functioning.

How you eat, when you eat, your normal bowel pattern, stress, sleep, movement, previous illness, and medication use can all be useful pieces of the puzzle.

You don't necessarily need another restrictive diet

When your gut is unpredictable, removing foods can feel like the obvious answer.

Sometimes dietary changes are helpful, but continually cutting foods out isn't something I encourage without good reason. It can make eating unnecessarily complicated and, in some cases, leave people frightened of foods that aren't actually the underlying problem.

Good gut support should be about understanding your digestive system better, not simply ending up with an ever-shrinking list of foods you feel safe eating.

And sometimes surprisingly simple changes can make a considerable difference.

Next week: I'll look at some of the areas I consider when someone comes to me with IBS, and why supporting your gut involves much more than what you eat.

If you've been living with bloating, pain, or unpredictable digestion for years and would like some help working out a way forward, you can find out more about working with me here