As a gut health nutritionist (and someone who has experienced IBS first-hand) I have few bones to pick with how IBS is often treated these days.
Today on the blog, I’m debunking some of the top myths when it comes to IBS, and some of the ways we can work together to dispel these misconceptions.
First off, What is IBS?
Before we begin, let’s do a quick recap on Irritable Bowel Syndrome (IBS). IBS is defined as a functional disorder, meaning that despite no obvious medical abnormality, an individual experiences a laundry list of digestive symptoms such as cramping, abdominal pain, bloating, gas, diarrhea, and/or constipation.
There are three sub-types of IBS, including IBS-D (Diarrhea-dominant), IBS-C (constipation-dominant), and IBS-M (mixed), all three of which are incredibly common in North America. In fact, according to the Canadian Digestive Health Foundation, 5 million Canadians suffer from IBS...
So, why with such a prevalent diagnosis, is IBS often overlooked, oversimplified and often-times completely misunderstood?
Here are a few of the myths that contribute to the confusion surrounding IBS.
Myth #1: A low FODMAP diet is the only answer.
If you’ve been diagnosed with IBS, you’ve likely been told to try the low FODMAP diet - a temporary elimination diet that reduces your intake of Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (short-chain carbohydrates / sugars found naturally in plant foods).
On a low FODMAP diet, you are meant to eliminate foods with high concentrations of FODMAPs and then slowly phase them back in, one category at a time, to determine which of the FODMAP groups are causing your digestive issues.
For many people, a low FODMAP diet can be life-changing. It can help to pinpoint some foods that may be contributing to their symptoms so they can start to understand what foods agree with them and which ones don’t.
But the Low FODMAP diet is not an end-all-be-all solution, especially since it
isn't actually addressing why the IBS is happening in the first place (the root cause). This means that in order to continue being symptom-free, need to stick to eating a low fodmap diet forever... (a bit of a band-aid approach).
Another issue with the low FODMAP diet is that it just doesn't work for everyone with IBS. This is because it is primarily effective for SIBO (small intestinal bacterial overgrowth), which is just one of the many possible root causes of IBS. If the root cause of your IBS is a Yeast overgrowth, a parasitic infection or a digestive in-suffiency, the low FODMAP diet won't do much for you.
For this reason, it’s always best to work with a gut health expert before eliminating an extensive list of foods to see if that is in fact the correct approach.
Myth #2: It's okay to cut out all low FODMAP foods long-term.
As mentioned above, a low FODMAP diet can help many people find symptom relief. So you’d think that that means they should just keep eating that way forever, right?
Well, that’s actually not the case. The low FODMAP diet is not meant to be a long-term solution to the problem. In fact, it shouldn’t be used for more than 8-weeks (12 max). This is because the low FODMAP diet is meant to help you figure out what triggers your symptoms, while giving you a period of time to focus on healing the underlying cause of your symptoms.
During your low FODMAP period, you and your gut health practitioner should work on replacing missing digestive supports like HCL and enzymes, repairing the intestinal wall, removing pathogens and rebalancing your gut microbiome. This is especially true if your IBS is rooted in SIBO - you need to work on getting rid of SIBO while the foods are removed!
The end goal is to be able to comfortably reintroduce, tailor and personalize how much, how often and what FODMAP foods agree with you. Following your low FODMAP protocol, you should expect to feel in control of your digestion and have the least restrictive diet possible to maintain a healthy microbiome and a good quality of life.
Myth #3: Just increase your fibre intake
Fibre is key for proper digestion and supports a healthy balance of gut bacteria. It helps with the elimination of waste and toxins, and helps create regular bowel movements. Sounds great, right?
For those living with IBS, though, it can be hard to find the perfect balance between too much fibre, and not enough. And depending on the severity of your IBS, fibre can actually make bloating and gas worse.
On average, a good fibre goal to set is 25-35 grams a day, but getting it all at once can cause lots of digestive distress—especially if you're already susceptible to IBS-like symptoms. A better way to bring in fiber is by spreading out your intake throughout the day, so you don't overload your stomach. You may also want to consider scaling back on raw fruits and veggies and focusing more on cooked foods that are easier to digest.
The amount of fiber we can tolerate is unique, so if you're not used to getting much fiber in your diet, start small and increase the amount per meal slowly.
Also, “high-fibre” products are super trendy right now, which can provide convenient ways to meet your fibre goals. While it's great fibre has gone mainstream, it’s important to look into the ingredients when incorporating these products into your diet. One common trigger of IBS is inulin, a common source of added fibers in foods. While inulin is in fact good for the gut, it can be a huge trigger for IBS and if anything, should be brought in very slowly.
My advice is to stick to fiber from wholefoods (like fruits, vegetables, grains and legumes) instead of those “high-fibre” snacks that are starting to flood the shelves.
Myth #4: Probiotics fix everything
How many times have you heard someone say “you need a probiotic”? If you have IBS, I’m sure you’ve heard it a TON (I know I did). After working with hundreds of clients and analyzing numerous stool tests, I can tell you that contrary to popular belief, we don’t all need to be taking probiotics.
Here are a few things to consider:
The list of probiotic names you see on the back of a bottle make up a very small number of the probiotic strains that exist out there (there are literally 300+ species) and different probiotic strains serve different functions. Some are good for immunity, others for diarrhea, constipation, skin, yeast, etc. There is no “one size fits all” probiotic and it’s important to know what you need before supplementing blindly. A practitioner can guide you with this!
I often see cases in which a stool tests come back with probiotic levels that are actually way too high. This often occurs with SIBO. In these cases, layering more bacteria on top by taking a probiotic supplement is like throwing fuel on top of the fire. Since SIBO is a leading diver of IBS, this is often why probiotics can make IBS symptoms flare like crazy.
Food first!!! Although I often use probiotic supplements therapeutically in my practice, I also let my clients know that they usually don’t need to take them forever. Once the gut is healed, the focus should be on maintaining a healthy microbiome through food. This includes daily consumption of fermented foods like kimchi, sauerkraut, and yogurt. I also emphasize plant variety, since plants contain prebiotic fiber that feed healthy gut bacteria. Different probiotics feed off different types of fiber so make sure to mix it up!
Myth #5: IBS is a life sentence
Look, I’ve been there. IBS can often-times feel like the end of the world. It’s uncomfortable, painful, awkward and sometimes embarrassing.
But let me set the record-straight: IBS is not a life sentence.
Fortunately, there is a lot you can do to help manage IBS and reduce your symptoms. By reducing inflammation, restoring your gut microbiome, improving gut motility and incorporating some stress management strategies on a daily basis, you can reduce your symptoms and heal your gut (I know this because I helped hundreds of people overcome their digestive issues through root-cause healing).
If you have tried the low FODMAP diet, increased your fiber intake, and tried a laundry list of supplements and probiotics and still feel discouraged, confused or frustrated, it might be time to work one-on-one with someone who can support & guide you towards long-term relief.
That’s where I come in. Check out my Gut Rehab program or schedule a free discovery call so that we can work together to finally get to the bottom of your IBS.
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