Navigating IBS: Essential Tests and What to Avoid

Jessie Wong 00:00:00 Welcome to the IBS Nutrition Podcast, your go to source for navigating the complex diagnosis of irritable bowel syndrome. Here, we dive deep into IBS and discover the power of diet and lifestyle to find freedom from your IBS symptoms. I’m your host, Jesse Wong, Fodmap dietitian and a gut expert. For years, I suffered from debilitating gut symptoms that kept me out of work, feeling constant discomfort in my body and anxious around food. Today, I’m in control of my IBS, able to eat the food and love again, travel whenever I want, and spend quality time with loved ones. It is my mission to help you do the same and transform the way you live with IBS. Let’s get started! Today we are going to talk all about test. What test do you need to get an IBS diagnosis and what tests you can save your money on and why it is so important to get the correct diagnosis. Brooke, welcome again. My co-host.

Brooke Keenan 00:01:00 Hey, Nice to be here.

Jessie Wong 00:01:01 Yes. We want to talk about all the tests that is necessary.

Jessie Wong 00:01:05 So do you want to get started on some of the ones that we see all the time and maybe some of the ones that we don’t see, but if a symptom correlates that we will ask for it.

Brooke Keenan 00:01:14 Yeah. So some commonly done tests that we see frequently done would be colonoscopy sometimes endoscopy depending on symptoms we see usually see some bloodwork ruling out celiac disease. We definitely will see some stool tests a few blood tests sometimes. But those are the common ones we don’t often see. I don’t see that many tests for IBD, but those if that’s a consideration. Sometimes I see that and then sometimes we have to ask for it. And we, like we mentioned in our last episode, we definitely can have to ask for vitamin D, B12, ferritin, things like that, just because those aren’t regularly done right.

Jessie Wong 00:01:56 So those are not the nutrient tests are not usually on the mind of doctors unless they’re very seasoned gastroenterologists, they understand or they work with a lot of patients with celiac or inflammatory bowel disease.

Jessie Wong 00:02:09 Those conditions, they test more on the nutrient side of things than just regular PCP or a regular GI. right. So ruling out celiac disease. Right. So with celiac disease and inflammatory bowel disease, there are serology tests. So the blood tests that people can do and usually they start with an IGA. There are two types of IGA that they test for. And what they are trying to see is to make sure that they are not elevated and within the normal range. And if they are elevated, then the doctor may go further to do more celiac testing, because the gold standard in the US to get a celiac diagnosis is an endoscopy with biopsy. And they have to see a specific type of erosion or what is it?

Brooke Keenan 00:02:50 Inflammation.

Jessie Wong 00:02:51 inflammation in the small intestine. Yeah, exactly. And then with inflammatory bowel disease, there are blood tests and stool tests and biopsies that doctors will usually perform if they suspect inflammatory bowel disease. And what I usually see is patients will have those tests done already. And Cal protectant is a is a big one that they can either do a blood test or stool test.

Jessie Wong 00:03:17 if it’s diarrhea, I see a lot of GI may run a parasite profile as well, just to make sure that they don’t actually have parasites. So these are more routine, especially for people with diarrhea predominant symptoms. Now there are different types of IBS which we will dive deeper into in one of our future episodes. We’ve got a plans for you. But regarding test rate. So we talked about blood tests, stool tests and scopes and biopsies. So these are the tests that we commonly see. And one of the big reason why there isn’t a test for IBS is that IBS is a bunch of symptoms. There’s no structural damage in your gut and there’s no inflammation. There’s no, nothing really wrong with the, with the structure or the physical properties of your gut. So there’s really no test that we can’t use to identify IBS. Maybe with the exception of post infectious IBS, IBS smarts would be to test for that. But but it’s not, I think. I don’t think I’ve seen doctor ever ordered that.

Brooke Keenan 00:04:27 Yeah, I definitely haven’t.

Jessie Wong 00:04:29 No. With REITs with post infectious IBS IPS, we can usually just get a medical history asking more questions and we can determine whether somebody has post infectious IBS and post infectious IBS happens when a patient gets an infection that gives them gut symptoms, but the gut symptoms never goes away. Okay. So these are some of the common tests that we see. Now. What are some of the less common tests that we see. And or maybe we would suggest getting when a patient is diagnosed with IBS.

Brooke Keenan 00:05:02 Yeah. So H pylori EPI which is and.

Jessie Wong 00:05:08 Exocrine exocrine.

Brooke Keenan 00:05:10 Pancreatic insufficiency. Bowel acid malabsorption. sometimes x rays will be seen which I love seeing an x ray because we can see if there’s any stool buildup and CT scans, and we see a CT scan. If people are having a lot of pain as well, they will sometimes order a scan just to make sure that there’s nothing wrong with your liver, kidney or things like that too.

Jessie Wong 00:05:34 Right? They can see the structure of the gut as well, and sometimes they might be able to pick up some inflammation in certain parts of the intestine, because with scope you can’t really go through the whole small intestine.

Jessie Wong 00:05:44 So a CT scan can be very helpful in that aspect. Now to get these tests, like especially the ones we were talking about, you really have to be able to paint a clear picture for your doctor where your symptoms are. What type of symptoms do you have? How long do they last? And, really documents all of the symptoms and bring it to your doctor so that they know what test to order for you. For example, if you have more upper GI symptoms, right, the pain or bloating is more above your belly button, then they may look more into pylori, celiac disease, and sometimes maybe even Crohn’s disease. But then if it’s more lower GI, then they’re going to maybe focus more on, okay, are you constipated or do you have something else? And taking pictures of your bowel movements can be really, really helpful as well because being able to see your bowel movement, we get a very good picture of what’s going on inside of your gut, right? A lot of the times people neglect a part that or let’s put it this way, a lot of what we see is a buildup of stool in the guts causing bloating and gas and pain.

Jessie Wong 00:06:52 And people may tell us, I’m not constipated, I’m pooping every single day. But if your poop is not a full evacuation, the buildup is going to cost you all of those symptoms that we just mentioned. And it could be something very easy to resolve. But if you’re not recording or if you’re not recording appropriately, then it doesn’t give your doctor a clear picture of what may be going on. If you want to learn more about how to document your symptoms and what symptoms to document, go listen to our previous episode, our first ever IBS nutrition podcast episode, talking about documenting symptoms, and we have an amazing free symptom tracker on our website, npr.org. It’s spelled po o p e d I a.org. So go. Go to npr.org. Slash resources. The links will be in the show notes as well for you to make it easier for you to access documents your symptoms for a week or two, and to learn more about your body. But definitely document before you go see your doctor. Because when you can paint a clear picture of what is going on, your doctor will be able to understand better.

Jessie Wong 00:08:00 They can order the right test for you to rule out other conditions, and then maybe give you an IBS diagnosis faster, or get to the bottom of the root cause of your symptoms faster. Okay, so those are the tests that we see a lot. Oh, and you mentioned earlier some of the nutrients tests that we also ask for when we see certain reflux. Right. When people have nonstop diarrhea, when we maybe sometimes see fat floating on top of a patient or a client’s poop like, and then that really tells us, hey, we might want to look into nutrient deficiency as well because we are suspecting malabsorption in those cases. Sometimes malabsorption causes the diarrhea, but sometimes it’s vice versa. The the area causes the more sorption. Brooke, why don’t you walk us through a little bit about our process here? And what test do we usually ask for when we are working with our clients?

Brooke Keenan 00:08:52 Yeah, if we’ve seen a, like you said, a lot of diarrhea. We really like people to get vitamin D for the to make sure that they’re absorbing fat soluble vitamins B12, folate.

Brooke Keenan 00:09:05 All of these things can be not where we want them to be if you’re having chronic diarrhea. And that can also indicate the malabsorption. Usually with malabsorption it’s not from IBS. It would be for IBD.

Jessie Wong 00:09:17 So if and we usually want to dive a little deeper. So you cut out a little bit.

Brooke Keenan 00:09:24 Yeah. No.

Jessie Wong 00:09:25 Yeah.

Brooke Keenan 00:09:25 Well yeah for sure. We definitely have asked for a couple other, with people. I’m thinking of one client in particular. We actually sent her back to get, bowel acid, malabsorption tests, just to make sure that that wasn’t what was causing her symptoms. And while we sent her back for that, her poop got better and better. And so she didn’t necessarily need that. but we still want to make sure that it’s not something hidden.

Jessie Wong 00:09:55 Right? And, that particular client know exactly who you’re talking about has very yellowish or gray clay colored poop. So we were suspecting either epi or maybe biome acid malabsorption. and she had a lot of diarrhea with undigested food.

Jessie Wong 00:10:12 But we also made suggestions on dietary restrictions on certain things that we think she might be intolerant to. And sometimes, while implementing these elimination diets, it can take a while for the full effects or for your bowel habits to really change. So while it was making those changes, we saw also saw some maybe fat floating on top of her stool. So we make separate recommendations to get more tests, but her stool actually improved drastically. after she follows strictly the diet. We recommend it, but we don’t make diets recommendations lightly, and we always want to challenge before we say, hey, you may have an intolerance to this. So when we do a challenge, it helps us to understand whether it is a food trigger for you or not and how much of it you can actually tolerate, because some some foods there are people may be able to tolerate the small amounts, but there are some foods where trace amounts people cannot tolerate even to trace amounts. So it’s important to understand and don’t make a blanket recommendations when it comes to cutting out food.

Jessie Wong 00:11:16 All right. So we talked about the tests that we regularly see and test that we may request with your doctors may do on top of the previous tests that you might have done. Now, one of the things I think people get really discouraged about is they go to their doctor, or maybe go to a guest or interreligious. They get a bunch of tests done, like what we talked about. Right. And they’re really hoping for one positive test, like I have something is really wrong with me and they really want a positive test. And then they go into the doctor’s office, review the test and say, hey, everything looks normal, it’s just IBS. We hear that all the time, and I want to tell you that know is not just IBS. It’s extremely debilitating to have IBS. What your doctor means is that it’s not something more severe or maybe more that could be life threatening, which, you know, celiac disease or inflammatory bowel disease, these are conditions that could lead to a different outcome.

Jessie Wong 00:12:17 It increases cancer risk in people can die of malnutrition with these kind of conditions. Right. Whereas IBS your gut is normal. So which is why a lot of the times we may hear the verbiage is just IBS, you know, but, you know, we understand how debilitating IBS can be and it’s not to be written off of and you are not making anything up, even if you know all of your tests are normal. It’s very validated. And GI doctors know that. But sometimes when they are sharing the results within the 15 minutes that they have with you, it may seem like they’re just writing you off and telling you that you’re making everything up, that you need to go, you know, manage your stress or whatever. But no, that’s not what they mean. And we know because we work with a lot of GI as well. And we, you know, write to them and say, hey, maybe we are going to do this for our clients. We’re going to do that for our clients.

Jessie Wong 00:13:11 What do you think? And maybe we can get more tests. Can you do that for us so that we can better help this client, but just don’t feel like you’re being written off and don’t go to somebody maybe who are not specialized in gastroenterology and hoping that you will get help from them, because we see a lot of patients going to practitioners who don’t follow evidence based medicine and they run, they tend to do this. This is their whole business model. They would run a lot of tests, which is what we’re going to get into. Our third point is what tests you don’t need. So we see a lot of businesses or practices where they run a lot of tests. These hands are not evidence based, and usually when they review the results with you, they’re going to recommend a lot of supplements that they sell. which, you know, that one is a conflict of interest. Two is that these are not evidence based, and people tend to waste a lot of time and money on these things.

Jessie Wong 00:14:12 And one thing that we really, really hate a lot as a dietitian is that these providers sometimes put people on extremely restrictive diets without an endpoint. And whenever a patient stops following the diets and symptoms come back or symptoms get worse, they blame it on the patient for not following through on the protocols. So we just want to caution, you know, be very careful. There are predatory practices out there that targets the vulnerable population of people with irritable bowel syndrome. And we see it again and again. And we have a lot of clients who have done that, actually, I’ll share a client story, you know, that can kind of kind of use it as a cautionary tale in a little bit. But let’s talk about the test that we don’t need and why we don’t need them. How about that, Brooke? Do you have some in mind that we hear all the time?

Brooke Keenan 00:15:07 The, food sensitivity tests. Now, food sensitivity tests are different than allergy tests that are run by your allergist.

Brooke Keenan 00:15:17 Those are completely valid. It’s the food sensitivity tests that or that sometimes are called MRT or IgG. IG panel. Yeah. And that you can have positive reactions to foods you never eat. And you can have positive reactions to foods that you eat all the time. So that’s unfortunately people waste a lot of money on those. And they want them to, you know, to show them to us. And I feel so badly that they’ve just wasted, you know, they’re usually like $250 or more. and they really don’t mean anything. So it’s it’s sad. Right? yeah.

Jessie Wong 00:15:57 And the worst part about those tests is that everything you eat will show up positive. Yeah, because IgG is something we don’t fully understand scientifically. We don’t fully understand what they do. But we think now that IgG could be a marker of tolerance instead of intolerance. So everything you eat, it’s basically like a memory cell. Whenever you eat something, your body will create a memory of the food so that the next time you eat it, it knows what your your what you’ve eaten.

Jessie Wong 00:16:24 And we think that it could be an indication of tolerance instead of intolerance. So everything you eat will be positive. And we have so many clients coming crying to us, showing us the test results, saying they cannot eat any food, anything and hoping that we can help them, you know, through the list to find food that they can eat. But in reality, what we say is toss that list away. You don’t have to follow it. It’s stupid. I mean, no, sorry, I use that word too. No, it’s not stupid. It’s it’s very predatory for those companies to sell these tests. And usually they are directly marketed to consumers. Oh, and I hate that that certain pharmacies, national pharmacies, actually sell them on their shelf rack. And I’m just like, why? You know, and and, American Academy of Allergy, Asthma and Immunology actually put out a statement if you search food sensitivity tests and ay ay ay ay, I, you will be able to see their statement on the food ECG test and why they’re not valid.

Jessie Wong 00:17:32 So don’t fall scam to that if you’ve done it before. I’m really sorry. We are really sorry you have. But throw it away. Don’t worry about it. Right. Okay, so that’s one. What are the other ones that we see a lot of.

Brooke Keenan 00:17:47 The gut microbiome test. wouldn’t it be so great if these were valid? So we are in the infancy of researching the gut microbiome. It is super, super complicated, and there is some positive research in that area that someday we may be able to figure out what those tests actually are telling us, but it’s we’re too early in the research to be able, to know what those results mean. So someone that’s telling you they know exactly what they mean, they don’t. So, maybe down the road, I think it’s hopeful for sure. But for now, we really can’t tell much from those tests.

Jessie Wong 00:18:37 Exactly. And, and again, there’s a business model behind these tests. Right? They run the tests. They show you what good microbes you have, what their population is, or whatever, and then they will say, hey, you need to take the supplements to get rid of the bad one, or you need to take the supplements to generate more good ones.

Jessie Wong 00:18:56 The truth is, we don’t fully understand what is good, what is bad, what are good combinations. So we may have the technology to identify the microbes or identify even the quantity of the microbes. But we don’t have the data to help us interpret the results. And one thing about the gut microbiome, or any microbiome on our body, is that it changes all the time, every time you eat or every time you drink some water, the composition changes. And we don’t fully understand, you know, what the change means. And when you get the result. Your gut microbiome is probably very different than when your results when when your stool sample was collected. So again, this is a waste of money. And we have seen people who spent what, hundreds to thousands of dollars on these tests and then also following the protocols that they are being sold to. It breaks our heart sometimes to see some legitimate practitioners. Well, I guess, you know, practitioners or colleagues or medical doctors sell these tests and, and put people on these kind of supplements and regimens.

Jessie Wong 00:20:00 That doesn’t help them in the long run. And and more than doesn’t help. Right. It could delay actual treatments or delay a person to getting to the correct diagnosis. And it could have long term consequences when we do these kind of tests that have no evidence to it, and where we put our trust too. Right. And we’ve said it earlier, you know, sometimes people feel that GIS are they are not the nicest people. But, you know, it’s not really the guys. but I think more so the health care system that, that, we are in as a whole, they only have 15 minutes with you. They really need to get the most important thing through, like getting the test, the right test for you. and also sharing with you the results and maybe try to come up with a treatment plan with you in that short period of time. And it may seem like they’re not listening to you, but, but I think they have a big heart and there’s just a lot of limitation to what they can and cannot do.

Jessie Wong 00:21:02 but what I would wish is they would refer more to dietitians who are in this specialties, because we can spend more time with the patients and really understand more about what they’re going through and make recommendations accordingly. And being a really good support person on the team to and also maybe bridging the communication between the patients and the GI as well, because we know exactly what we want to communicate or convey to your doctor to get the test you need or to maybe get through, get the medications that you need. some of our clients actually have have our trialing some of the newer medications, and we are seeing amazing results. Well, we’re not going to talk about this here. Maybe in a future episode we can talk about medications. But yes, tests you don’t need. So you do not need anything that analyzes your gut microbiome. All right. Is there any more that we are hearing a lot of.

Brooke Keenan 00:21:54 If you have diarrhea, they definitely will do parasite tests, which I’m not sure I’ve seen the parasite tests positive because parasites are kind of a new buzzword as well, and it’s very rare to have a parasite in the United States.

Brooke Keenan 00:22:10 But they will run the tests just to be sure. But yeah, I think we’ve got most of them.

Jessie Wong 00:22:16 Yes. Let me get back on the parasite thing. I think. Parasite or fungus overgrowth or Candida overgrowth. These are a lot of buzzwords. And parasite is very rare in North America or in the US and Canada because we have very safe drinking water and we have very safe and strict food regulations. However, in other countries we cannot say the same thing. But I think most developed countries you don’t have to worry so much about parasites, except if you are drinking untreated water like from a whale, or if you are swimming in lakes or, you know, and sometimes that may be somewhere we would see a parasite contaminated water getting to human, you know, but your GI or your PCP will be able to run those tests via stool tests to help you identify if you have parasites. One that is maybe more common in the US is diarrhea, so it causes nonstop diarrhea. It would be way more than just IBS because you would have diarrhea at night as well.

Jessie Wong 00:23:20 So these are again a red flag of hey, this is not typical IBS symptoms. And people usually experience a lot of pain. and if you know, if you are experiencing those, go talk to your doctor. Ask for the test. Oh, one of the big red flags with all of these tests, you know, one of the big red flags. If you see any test that promises you once you get a fixed, you are going to feel amazing. Your skin’s going to glow, your poop is going to be great. You’re not bloated anymore. You won’t have brain fog. You won’t have, they have a ton of bogus claims. Let’s just put it that way. If any test tells you that you want to run away from it. Yes. Well, that brings us to sharing one of our clients stories that have done all of that before. And now we are sharing this. Not to say that if you’ve done it before, we are saying, too bad for you. We are telling you, you know, don’t worry about those test results.

Jessie Wong 00:24:19 Toss them away. Is not your fault that you fell for these kind of fallacies. It’s a whole market. It’s a whole business market out there where they know exactly how to target these vulnerable population. And I will say that I fell for it once when my baby had significant eczema. We as new parents didn’t know what to do. We went to our chiropractor, got this stupid test done, and and when I was like, when they were doing the test, I was just standing there looking at it and just felt dumbfounded, basically. I’m laughing now, but the tractor was touching a product that I would bring in, and then his wife would be touching my baby and he and his wife would be holding her hand. Then they would touch your products like a soap, dish soap or whatever things that we would use on the products that, that’s for the baby. and they would say like, oh, these products will affect your baby negatively. And if it has this kind of energy level or magnetic whatever, like they were saying, like, oh, we could test for you to see if it is causing an eczema for your baby.

Jessie Wong 00:25:22 And I was so desperate and I fell for it. And when I was standing there looking them perform this whatever test they call. I just thought I was the most stupid person in the world. And when I went to pay for it, the cashier would not even look at me in the eye. I think she knew this is a scam. You know, it’s quack. And she’s just like, I’m so sorry you did this. But she didn’t say it. Of course. But anyways, you know, we have those moments where we just are so vulnerable and we would fall for schemes like this. And looking back, we’re like, why do we do it? It’s like that was an obvious one, right? But with the food sensitivity tests, a gut microbiome test, or even a hair analysis like they are not as obvious for people who are not, in the scientific community or maybe not health care provider. And that’s exactly what happens to one of our clients in the past. And this is a man.

Jessie Wong 00:26:14 We do have many clients. They don’t work in our group program because our group program are only for women. But he came to us because his PCP recommended for him to work with us to sort out his IBS diarrhoea. So this is Ian. He is a business owner. He actually has a practice that is also in the health and wellness space. That is more in the exercise side of things, and he started having a lot of diarrhea all of a sudden. and he lost four, £30 in four months. His PCP said, hey, please go see Jessie. She helps a lot of patients with IBS. We had a call and I kind of walked him through. You know what we do? We do the low Fodmap diet. We don’t run tests. He was asking me about test, and then I didn’t hear back from him after that. but then a few months later, he came back. He was like, I’m ready to work with you, you know, please help me. Because, so what he told me was the first thing he showed me was I did the food sensitivity test.

Jessie Wong 00:27:11 Can you help me find food that I can actually eat? Because the test said anything I am eating, I’m sensitive to. And the first thing, of course, is like, please throw that away. And it turns out that he went to a holistic doctor that ran a lot of test and put him on a ton of supplement protocol. So poor guy, he was even giving himself B12 shots every week. Of course he was B12 deficient, right? He was having non-stop diarrhea, but that wasn’t the reason why he was having diarrhea. So, you know, the first thing we did was like, hey, let’s really understand what is causing your diarrhea. First, let’s look at what symptoms you have. And in his mind, he just wants those tests to tell him something and to stop his diarrhea. But what Those tests. It was really wasting his time making him afraid of food. he cut out so many foods that he could actually eat, but, you know, he still had diarrhea, but it wasn’t because of the food.

Jessie Wong 00:28:09 and and get his energy back so that he could be a better dad, be a better husband, and run his business properly. But, of course, none of those tests in the supplements helped him because they they didn’t identify the root cause. So when we started, we guided him through step by step, everything that we usually do with all of our clients. And the first thing is, let’s stop all of your supplements and let’s see what symptoms you have. And it turns out he had a lot of upper GI symptoms. And we knew it pretty quickly writes that it was Sibo, small intestine bacterial overgrowth. And we also looked at why he was having Sibo And the reason why he was having Sibo was he was trialing some probiotic supplements that one of his colleagues recommended. It was a drink and he was drinking it. And of course he didn’t get diarrhea right away, but eventually he got diarrhea. And in his mind, he thought the probiotics was something that was helping him. But in reality, the probiotics is a risk factor for small intestine bacterial overgrowth.

Jessie Wong 00:29:11 So the next step was also, you know, communicating with his primary care physician who we are, we have a relationship with, and also getting him with a GI because of his significant diarrhea and weight loss. You know, we just want to make sure we are not missing anything and get properly tested for everything. Everything came back negative except for Siebel. We already, you know, after assessing his symptoms, we already had a good idea he has Siebel. But let’s, you know, just get it properly tested and get the right treatments for it. So to treat Siebel you know antibiotics is the first line of defense. And most people will respond very well to our antibiotics. But you know, if you don’t identify what the root cause of your Sibo is, recurrence rate is very high. And in this situation, the recourse was the probiotics that he was taking. So since we have already removed it, his diarrhea, slowed. He was a lot better. And once he went through a course of antibiotics, it completely stopped his diarrhea.

Jessie Wong 00:30:10 He actually reverted back to a little bit more constipated and a little bit more bloating from the constipation. And the bloating was the reason why he took the probiotics to begin with. Because the probiotics that, oh, if you’re bloated, we can help you. If you have the mind fog or brain fog, we can help you. You know, it’s like, again, those supplements companies making bogus claims, when in reality they may be the root cause to why you have a lot of symptoms. So that’s really what happens. And one thing we do, of course, as dietician is create a plan for him to slowly reintroduce food, one group at a time, to see if he has any Fodmap intolerance. Because we know FODMAPs can trigger more diarrhea for patients who are already having diarrhea. In his case, once his Sibo was treated, his diarrhea stopped pretty much instantly, and at the end he was able to go out to eat with his family without worrying about having to run to the bathroom. He was able to be present for his kids again because he didn’t have to worry about his gut symptoms so much, and he was able to run his business properly again.

Jessie Wong 00:31:18 Because when you’re so tired all the time, you know there’s no way for you to function normally. And that’s a lot of what he was struggling with is the energy level. And, yeah, well, we are sharing this because, you know, again, we want to share it as a cautionary tale. Don’t go to people who may not follow the evidence. Go back to your GI if you need more tests. If you need more help. And one key message for all of you is document your symptoms thoroughly before you go to your doctor. You only have 15 minutes with them. You really want to use that time wisely and convey a message of your condition clearly, so that they can prescribe or order the right test for you and help you get better. Okay, so if you need a symptom tracker or go to talk, it will be in the show notes. It’s one of our free instruments to help you learn more about your body and help you. Documents before you go see your provider, whether it is a GI doctor or your PCP, or maybe you’re working with a different dietitian, it’s always helpful when patients come prepared and give us a full picture of what’s going on, so we can better serve you and guide you to a better place.

Jessie Wong 00:32:37 Yeah. Brooke, do you have anything to add to this?

Brooke Keenan 00:32:39 Also, just quickly for Poop media, you can actually see what a full evacuation looks like.

Jessie Wong 00:32:46 Oh yes. Oh my goodness I can’t believe I haven’t talked about it. So put media is our free websites. That is completely educational. IBS dietician has blocked information as well. But pedia. You can see what poop looks like according to different Bristol stool chart type and what full evacuations looks like. So normally we would like people to have type four stool on the Bristol stool chart and that is a sausage snake like poop that has no cracks on it. Type three is a sausage like poop with cracks on it. But, go take a look. If you’re not afraid of seeing pictures. And all of the pictures on PDA are actually from a client who struggled for a long time, and they finally came to us. And we really look at people’s pictures, their poop, their food intake, their symptoms, and their bowel movements to help them identify what is wrong and get them better.

Jessie Wong 00:33:40 And with those pictures. our clients graciously consented us to use them so that we can use it to educate more people about bowel movements and really talk about stool because there’s so much taboo. You know what? I think we would need an episode about poop. What do you think?

Brooke Keenan 00:33:59 I definitely think so. It’s not. We don’t talk about it enough in society.

Jessie Wong 00:34:06 No, we don’t. And there’s so much taboo about it. Why? We all poop. You know, must poop. Everybody poops. Everybody you know, everybody poops. And there’s no secret about it. But we just don’t talk about it enough. So go check it out. Learn more about poop. Oh, and we would really love for you to leave us a comment. Give us a review if you enjoy our podcast, because it will really. We will be very helpful for us and encourage us to do more of this and and hopefully help you get better from your IBS. All right. Thank you everybody for listening. And thank you, Brooke, for being here with me.

Jessie Wong 00:34:44 And we will be back with another episode. Bye bye. Thank you for tuning in to the IBS Nutrition podcast. We hope today’s episode has brought you closer to understanding and managing IBS. Remember, you are not alone on this journey and finding freedom is possible. For more on IBS, make sure to follow us on your favorite podcast platforms and please leave us a five star review! We would really appreciate that you can access links mentioned in this episode in the show notes, to learn more about your type of IBS and how to identify your own food or lifestyle triggers, Register for a free IBS masterclass. Three steps to IBS relief for our proven, holistic, three steps approach to managing IBS once and for all, head to IBS dietician. Com forward slash masterclass to register. Until next time, take good care of your gut and here’s to your health and happiness.