Marissa Mekelburg Functional Medicine Dietitian
I have IBS, Now What? Your Beginner’s Guide
Updated: Apr 3, 2022
Your doctor has given you the news: You officially have an explanation for your digestive health issues. So you think to yourself, “I have IBS, now what?”
This blog covers some of the very first steps that you can take to begin to learn about what IBS is and how to best manage your symptoms. Everyone is a bit different, and it can take some time and practice to figure out how to feel your best.
But you should also know that these are not the last steps you’ll be taking to get a handle on your IBS.
Quick note: the purpose of this blog post is to help you get started with what IBS is and how to manage your symptoms so that you’re not feeling so crummy all the time. It is not meant to be an exhaustive list of all that you can do to live life to the fullest with this diagnosis.
Once you’ve gotten started with the management of your symptoms, then you might feel good enough to start digging a little deeper. Why did you get a diagnosis of IBS to begin with? The deeper level of exploration can offer further clarification on how to best treat your condition.
So let’s start at the beginning: What is IBS?
Photo by Matthew Henry on Unsplash
What is IBS?
IBS is a condition that affects your large intestine. It can cause cramping, gas, pain in the stomach, and diarrhea or constipation. IBS is a chronic condition which means you will have to take care of it for a long time (1).
IBS symptoms can vary, but might include:
Constipation, diarrhea (or both)
Gas and bloating
IBS can be caused by more than one thing, which is why a concrete diagnosis can be a bit elusive. IBS can be caused by:
Changes in how your GI tract muscles contract
Changes in the microbiome (the community of organisms in your gut)
The above factors can lay the foundation for being more susceptible to IBS. And then, different things can trigger IBS symptoms, such as specific foods and stress.
IBS is more common in women than in men and is more common in younger people.
Before you assume that your doctor’s diagnosis is correct, I always recommend a few steps to confirm that you do have the correct diagnosis. Let’s walk through how to do that, now.
Confirm your diagnosis
It surprises many of my clients to learn that IBS doesn’t have an exact lab test or way to confirm that you have it.
Because of this, it is important that you know how your doctor came to the conclusion that you do have IBS and what has been ruled out. IBS is a difficult diagnosis to pin down because the symptoms can overlap with so many other conditions, such as Crohn's disease or celiac.
But, one very important note, the treatments for these conditions are very different. Unfortunately, you cannot expect to have maximum symptom relief if you have not reached the correct diagnosis.
For the full scoop on confirming your correct diagnosis, please review this blog post: Do I have IBS or Something else? No self-diagnosis, please!
Photo by Agence Olloweb on Unsplash
Calm your flare
If your body is in IBS crisis mode, the first step is to put out the fire. Think of this as a sick day and offer your body rest, quiet and easy-to-digest foods, such as well-tolerated soups and smoothies.
You’ll want to bookmark this post to have a reference for when you have a flare day: How to Calm IBS Flare-Ups: Things You Can Try Today.
Get started tracking very basic things such as food and symptoms to see if you notice any connections. For my clients, I recommend the MySymptoms app for this as it also allows tracking of sleep and other things, and then it will help provide feedback regarding connections between food and symptoms. It also allows for logs to be exported and sent to a practitioner.
Using your favorite app, keep track of meals, snacks and drinks throughout each day. Even the afternoon iced coffee, even the evening snack. It all counts!
The more complete and comprehensive this data is, the more easily you’ll be able to see patterns between what you eat and how you feel.
The reason I love the MySymptoms app is that it also allows you to track symptoms all in one place. So if you’re feeling energetic, bloated, fatigued, or constipated, the app can track it.
Meshing your food and symptoms is powerful information to use to make changes to have you start feeling better, more quickly.
Track symptoms such as your bowel movements, belly pain, and bloating. Then you’ll mesh this data with potential triggers, such as sleep, stress, and intense exercise.
Did you know that having a good night’s sleep is important to allow your digestive system to rest and recharge? If you’re not sleeping enough, not having restful sleep, or eating well into the evening, this actually impacts your digestion.
Did you know that there are certain foods that can actually boost your sleep quality? If you’re curious about those, check out this post for delicious snack ideas (just not too late at night, please) Do Pistachios Help You Sleep? Yes!
Quick disclaimer: Pistachios are a high-FODMAP food and might make your IBS symptoms worse. Keep the above article bookmarked for when you’re ready to do reintroductions.
Your digestion is connected to your brain by multiple pathways. If you’re feeling stressed, anxious, happy, or calm, your gut knows all about it. And if your digestive system is not feeling great, be prepared for headaches and brain fog.
Tracking your stress levels and moments of calm is also important for managing your IBS.
We all know that exercise is supposed to be good for us...and it is. For IBS, certain exercises can help to manage symptoms. Exercise can help to reduce stress, help with muscle movements along the digestive tract (something that can be different for folks with IBS) and it can even promote microbiome diversity – cool, right (2, 3)?
The best exercises for IBS are walking, yoga, biking, and other activities that you enjoy, just not at a breakneck pace. Intense activities, such as sprinting and HIIT exercises might actually make your IBS worse.
As you’re tracking, note the important details of the type of activity, time of day, and duration. This data collection will be so useful as you figure out what lifestyle helps you to feel your best.
Chances are if you’ve been experiencing constipation, diarrhea, or both, you probably need a bit more water. Sip on water throughout the day and drink enough to make your urine pale like lemonade. When you go to the bathroom, if your urine is dark like apple juice, you’re dehydrated. Drink up!
If you’re in a flare, you might feel better hydrated with electrolyte replacement, such as a sports drink or coconut water with a pinch of salt. On a regular basis, they’re probably not needed.
Focus on stress management
If you think about how feeling excited or anxious can lead to a feeling of butterflies in your stomach, it might not come as a surprise to learn that your brain and gut health are intimately linked.
When we’re stressed, even if we don’t have IBS, we can experience diarrhea and constipation. If you have IBS, those symptoms might be even worse.
If you have IBS, you might also suffer more symptoms if you’re eating too quickly or in an agitated state of mind, such as eating at your desk while you’re rushing to meet a work deadline. IBS management isn’t just about what you’re eating, it is also about how you’re eating.
What helps you to unwind and feel more at ease? I don’t mean tuning out such as scrolling through social media or watching a few episodes of your favorite show. I’m suggesting activities like stretching each morning or as part of your routine to wind down at night. Taking a leisurely walk and not listening to headphones (crazy, I know), having a hot bath, or writing in your journal. These may seem like unexpected suggestions coming from a dietitian, but our whole lifestyle can impact how we digest our food!
You can also ease digestion if you take a few deep breaths before and after meals and do your best to slow down and really chew each bite of food. Not only does this get digestion started by breaking the food down into a more digestible paste, but it also stops you from swallowing so much air with speedy bites. Your belly will thank you!
Try a digestive enzyme
You might feel better if you try a digestive enzyme to support your body as it recovers from this IBS flare. I recommend trying an enzyme that doesn't contain HCL initially just in case you do have something like H. Pylori. A probiotic can sometimes be helpful, too.
P.S. Finding the right supplement and dose is something I help my clients with!
Begin gentle food eliminations
Figuring out what foods might be a trigger for your IBS involves a bit of trial and error. There isn’t a perfect or best place to start. Basic dietary change can be trying a Paleo diet or the low FODMAP diet.
The low-FODMAP diet is an evidence-based intervention that has helped many people to subdue their symptoms. But it is a bit tricky to implement well. That is why I am launching The Low-FODMAP fix so that my clients can work through the details in a systematic and effective way.
Want to know when The Low-FODMAP Fix goes live? Be sure to click on the link and join the waitlist.
Remember how I mentioned that these suggestions are the preliminary steps for IBS management? It is 100% possible to be on an elimination diet for too long. I’ve seen it again and again with my clients. Here’s more on that topic: Have you been on an elimination diet too long?
Photo by Brett Jordan on Unsplash
Ask for help
If you’re not making good progress on your own, please reach out to a digestive health dietitian such as myself. There are too many good strategies and resources available! Please don't suffer for months, or worse, years, as some of my clients have before finding me.
Don't get stuck removing so many foods that you’re only left with 6-10 safe foods. Try a few things and if those few things don't work, don't keep compounding different things - get help to dig deeper.
Key Takeaways: I have IBS, now what?
If you’ve recently been diagnosed with IBS, don’t feel stuck or lost wondering, “I have IBS, now what?”. This blog post offers many tools to get a handle on your own triggers and for how to calm a flare.
If you’re ready to try a low-FODMAP diet with the guidance and support of a registered dietitian, please check out The Low-FODMAP Fix, my signature program that guides you through the same methods that have helped hundreds of my clients finally feel good after months or years of IBS misery.