Think your irritable bowel is too sensitive for the microbe-building diets of the moment? It could be quite the reverse, discovers Anna Blewett
If you’ve been diagnosed with IBS, or suspect that this vague label may explain the cramps, bloating or bowel issues you’ve experienced, you’re probably more than a little sick of the current trend for gut-healthy treatments. Swapping to wholegrains and guzzling kombucha is all very well for steel stomachs, but what’s the answer for those of us with a more delicate constitution? As varied and broad as the symptoms of IBS are, there is a common thread: sensitivity to foods on which others around you seem to thrive. And yet, if anyone needs a little digestive healing it’s you, right? So what do the experts say?
“For most people with IBS, the first stage is to work with a professional to understand the underlying cause,” says registered nutritionist Jenny Tschiesche, author of Gut Heath and Probiotics (White Owl Books). “The doctor can give a diagnosis of IBS but that doesn’t tell sufferers anything they don’t already know. They may be given anti-depressants or even sent for counselling, which really isn’t very helpful at all. That’s generally down to a lack of knowledge on behalf of the general practitioner.” But while the NHS plays catch-up on functional nutrition, help is out there. “I’d recommend seeing a functional medicine practitioner, a nutritional therapist or maybe a naturopath,” says Jenny. “Someone who can understand what your problem might be and will therefore recommend the right test for you. That could be a stool test, for example. Some doctors are using a private company for stool analysis but they have to know what they’re dealing with and I’d say the majority aren’t there yet. We have to take control of the situation ourselves.”
We know that the health of our gut can impact on our brain function, but new research suggests this relationship is a two-way street, with cognitive activity able to influence – and improve – gut conditions. An American study published this spring suggests that cognitive behaviour therapy (CBT) has a significant impact on IBS symptoms. For the research, 436 sufferers were split into three groups – one was taught practical CBT techniques to control and monitor symptoms at home, a second was given clinic-based treatment, and the third group received extra information on their condition. Sixty-one percent of the first group reported improvements in their symptoms, making it the most successful intervention in the study. Researchers noted that the success indicates mind-based treatments should be offered as a first line of defense against IBS, rather than a last resort.
The received wisdoms around nutrition rarely keep pace with discoveries, particularly in the dynamic field of gut microbiota. So you’ve been told gut-friendly foods aren’t for you? Be prepared to test that out. Probiotics (foods or supplements that contain live microbes) – and prebiotics (foods that feed microbes and help them flourish) may not be off limits after all. “I’d suggest most people with IBS are in a position to positively enhance their health by introducing some tolerable pre- and probiotics,” suggests Jenny. “But they have to do it very carefully, as with the introduction of any food. If you’re suffering with symptoms of IBS already you’ll have probably worked out what foods you can digest and which cause you problems. It’s the same with gut-friendly foods.” As Jenny points out, the resistant starch in many prebiotic (that is, bacteria-encouraging) foods is problematic for some. “That includes under-ripe bananas; cooled rice and potatoes and legumes. You’ll identify the better ones for you but most of us can benefit from introducing some prebiotic and probiotic foods.”
What helps to ease someone else’s symptoms may not benefit yours, so being selective is crucial. “Different strains of bacteria have different effects, so it’s really important for someone with specific symptoms to try targeted strains that have been well researched,” says registered nutritionist Naomi Osun, nutritional advisor at OptiBac Probiotics (optibacprobiotics.co.uk). “A general probiotic off the shelf may be good for the overall health of someone without digestive symptoms but, if you have a particular problem, you might find it’s not helping. I’d always recommend, if you have specific symptoms, you consider what particular strain you need. A health food shop should have information on that, and also products like Optibac specify which problems they’re designed to ease. Someone with diarrhoea, for example, wouldn’t be recommended to take any product with fibre in it. It’s just not appropriate. We’d recommend the culture saccharomyces boulardii, which is well researched.”
If you have IBS symptoms you’ll be well used to checking labels to determine if the ingredients inside are friends or foes. Supplements should be approached with similar caution, says Jenny. “Supplements quite often contain FOS (fructooligosaccharides) or inulin, which in some cases can contribute to dysbiosis. This is an imbalance of bacteria in the gut and so the prebiotic isn’t just feeding positive bacteria but also feeding the bad bacteria, thereby exacerbating the problems the IBS sufferer has. So, someone might be taking a prebiotic supplement thinking they’re doing the right thing and their IBS is getting worse.” Naomi agrees that knowledge is power when it comes to choosing. The bacterial blend she recommends for bloating is indeed formulated with FOS, which acts as a food source, but it’s carefully recommended for groups who shouldn’t suffer ill effects of the prebiotic “When you pick a probiotic supplement you need to make sure you choose one with a lot of research behind it, with strains that are robust enough to make it to your gut. Our products have all been clinically tested to make sure the cultures make it to the gut alive and can survive the low acidic conditions en route.”
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