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  • Writer's pictureStacie Haaga

Learn How to Help IBS Flare Ups

Updated: Apr 22, 2023


As a functional dietitian nutritionist and digestive health expert, most of my patients have an IBS diagnosis or symptoms of IBS. It’s estimated that 10-15% of the world’s population has IBS and twice as many women in the United States are diagnosed with IBS than men. Still, based on my experience many more people suffer from symptoms of IBS without a diagnosis and accept it as “normal”... when the truth is that it’s not normal at all!


Here, you’ll learn the symptoms and treatment of IBS and ways to help IBS (without the use of medication) through diet and lifestyle strategies.


Symptoms and Treatment of IBS


IBS or Irritable Bowel Syndrome is a catch-all diagnosis or a diagnosis of exclusion - it is not a cause but merely a description of your symptoms. People often end up with an IBS diagnosis after more serious concerns like cancer and inflammatory bowel disease (Crohn’s and colitis) are ruled out.


The diagnosis of IBS is identified as a group of symptoms that occur together, including repeated pain in the abdomen and changes in bowel movements, which may be diarrhea, constipation, or both. These symptoms exist without any visible signs of damage or disease in your digestive tract.


Doctors also consider IBS to be a “functional disorder” which means that symptoms of IBS are not explained by identifiable structural or biochemical abnormalities and are likely related to gut-brain interactions. This interaction can cause your gut to be more sensitive and change how the muscles in your bowel contract. Yet most conventional treatments do little to correct the misfiring between the gut and the brain, and the root causes of IBS are rarely identified or treated. Patients are often given medications to address the symptoms and are told to accept their symptoms as the “new normal” without any guidance on nutrition and lifestyle modifications that could help repair the gut-brain connection and alleviate symptoms.


To completely relieve IBS pain, it’s essential to understand why the symptoms are occuring in the first place. Root causes of IBS symptoms include lack of or excessive stomach acid or bile acid, poor enzymatic function, Small Intestinal Bacterial Overgrowth (SIBO), dysbiosis of the gut microbiome, intestinal wall permeability (leaky gut), gut infections (parasites, bacteria and yeast), food sensitivities, and malabsorption issues. Other factors may include chronic illness, low-toned vagus nerve, autoimmune conditions, tick-borne illness, stress, thyroid/adrenal issues, hormonal imbalance, and side effects from medications.


Identifying the root cause is helpful and can be done with a dedicated practitioner through the use of dietary protocols and testing. However it’s possible to find some relief on your own with commitment to a few healthy behaviors.


How to Help IBS Flare Ups


Although the root cause can be very individual and, in some cases, very complex, there are general nutrition and lifestyle strategies that can effectively minimize symptoms of IBS regardless of the triggers. Natural treatment of IBS goes beyond diet - it often requires a lifestyle change. I consider these 3 ways to help IBS to be first steps when it comes to treating IBS at home without the use of medication.


1. Address Your Stress and Get Some Rest for IBS


how to help IBS flare up

Stress greatly impacts motility, enzyme, bile and stomach acid secretions, intestinal permeability, and diversity of the microbiome. Removing and managing stress is a priority to stop further damage and to support gut healing processes. The best way to reduce stress is to prioritize sleep, especially during a flare up!


Creating a healthy bedtime routine that encourages 7-8 hours of uninterrupted sleep can go a long way to decreasing stress and regulating the nervous system. This allows for gut healing and regenerative processes to occur.


Deep breathing is another strategy to reduce stress and support good digestion because it engages the vagus nerve (the super highway between the gut and the brain) and activates the parasympathetic nervous system. This is essential because the sympathetic nerves stimulate intestinal motility and urge to defecate, whereas, the parasympathetic nervous system has a calming effect.


Further, miscommunication between your gut and brain along the vagus nerve can lead to gut symptoms such as diarrhea, constipation or pain. While meditation may not be realistic for everyone, three deep breaths before each meal is a great place to start.


Another form of rest that is beneficial is digestive rest through time-restricted eating, intermittent fasting, or periodic extended fasts. At a minimum, I recommend a 12-hour overnight fast as a starting point. To do this, avoid eating 2 hours before bedtime and push back breakfast by an hour or two for a 12-16 hour fast.


During an acute flare up, a longer fast of up to 24 hours may be helpful to calm down symptoms. During the fasting window, it’s important to stay hydrated with water or herbal teas, minimize caffeine intake, and take sips of homemade bone broth as desired. If a fast makes you feel worse, it’s time to break the fast and eat something easily digestible like soups or smoothies.


Adopting stress-reduction techniques and prioritizing rest are not only helpful during a flare-up but are part of the long-term solution to IBS. You can check out my Guide To Natural Stress Management HERE.


2. Choose Nutrient-Dense, Anti-inflammatory Foods for IBS


When it comes to diet, avoiding processed foods with gut-irritating chemicals can make the biggest impact on your gut health. In fact, research has shown that eating a diet of highly processed foods for just 10-14 days can reduce your microbiome diversity by 40 percent, whereas switching to a diet of minimally-processed whole foods had a favorable impact on the microbiome in as little as 3 days.


A healthy microbiome is essential to managing your IBS symptoms so a good rule of thumb is that if it comes from the ground or has a mother, it’s fair game.


Keep in mind that during a flare up, digestion will be impaired so choose lean proteins, well-cooked vegetables, peeled fruits and opt for nut butters over whole nuts. These foods are easier to digest and are better tolerated than fattier cuts of meat and processed foods. Including both olive oil and bone broth can be soothing and healing to the gut lining, and fruit/vegetable smoothies can be a great way to make nutrient-dense foods easier on the gut. Avoid gums, emulsifiers and anything you can’t pronounce!


Removing other inflammatory foods such as gluten, dairy and sugar can be an effective way to reduce inflammation of the gut lining and help to calm down symptoms. For chronic IBS that is not responsive to these changes, I often recommend further food sensitivity testing with the Mediator Release Test (MRT) followed by an elimination diet to determine IBS trigger foods. While it may not be necessary for everyone, this is the most individualized approach to diet therapy and is highly effective at addressing IBS. You can learn more about this approach HERE.



3. Add Low to Moderate-Intensity Exercise for IBS Relief


Exercise and gentle movement promotes healthy bowel movements and improved gut bacteria, while sitting all day can slow down motility and contribute to constipation. However, there’s an important balance to be struck when it comes to exercise!


To be clear, exercise is beneficial for many reasons - physical activity has been shown to have positive long-term effects on IBS symptoms and psychological symptoms such as depression and anxiety with as little as 30 minutes of moderate exercise 5x per week (that’s just 1.5% of your time each week!). People with higher cardiorespiratory fitness have significantly greater gut microbiota diversity compared to less fit people.


Exercise also a great way to maintain a healthy weight, relieve stress, improve sleep, and support your body’s production of “happy hormones” that make you feel good. It is essential for relieving constipation.


However exercise also diverts blood flow from the GI tract and activates the sympathetic nervous system (aka fight or flight mode), and over-exercising can actually worsen symptoms - if you’ve ever run a marathon, you know what I’m talking about if you have experienced “runner’s trots”or diarrhea. High-intensity activities like endurance training and CrossFit may be more problematic than helpful for IBS sufferers and should be avoided during flare-ups.


So the best practice when it comes to exercise is to prioritize gentle movement daily such as walking and yoga first, then gradually introduce higher intensity exercises. Other IBS-friendly exercises include dancing, strength training, cycling, pilates, hiking, swimming or water aerobics. I encourage 10,000 steps a day to stay active and to avoid too much sitting.


Final Thoughts on Natural IBS Relief

The impact of IBS can range from mild inconvenience to severe debilitation. At the root of IBS is often a combination of stress, lack of exercise, dietary triggers and food sensitivities, and inflammation. By addressing these contributing factors, IBS symptoms may be minimized or eliminated. For more guidance on digestive health, download my free guide to better digestion HERE or schedule a FREE STRATEGY CALL to find out how we can work together!






Resources:



Johannesson E, Ringström G, Abrahamsson H, Sadik R. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World J Gastroenterol. 2015 Jan 14;21(2):600-8. doi: 10.3748/wjg.v21.i2.600. PMID: 25593485; PMCID: PMC4294172.


Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol. 2011 May;106(5):915-22. doi: 10.1038/ajg.2010.480. Epub 2011 Jan 4. PMID: 21206488.


Kim YS, Kim N. Sex-gender differences in irritable bowel syndrome. J Neurogastroenterol Motil. 2018;24(4):544-558. doi:10.5056/jnm18082


Knowles SR, Austin DW, Sivanesan S, Tye-Din J, Leung C, Wilson J, Castle D, Kamm MA, Macrae F, Hebbard G. Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness. Psychol Health Med. 2017 Jun;22(5):524-534. doi: 10.1080/13548506.2016.1168932. Epub 2016 Apr 4. PMID: 27045996.


Turnbaugh PJ, Bäckhed F, Fulton L, Gordon JI. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe. 2008;3(4):213-223. doi:10.1016/j.chom.2008.02.015


Shi Z. Gut Microbiota: An Important Link between Western Diet and Chronic Diseases. Nutrients. 2019 Sep 24;11(10):2287. doi: 10.3390/nu11102287. PMID: 31554269; PMCID: PMC6835660.


Singh RK, Chang HW, Yan D, Lee KM, Ucmak D, Wong K, Abrouk M, Farahnik B, Nakamura M, Zhu TH, Bhutani T, Liao W. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017 Apr 8;15(1):73. doi: 10.1186/s12967-017-1175-y. PMID: 28388917; PMCID: PMC5385025.



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