IBS Success Story – How Stacy Beat Severe Diarrhea and IBS Without a Low FODMAP Diet

Jessie (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 diets and lifestyle to find freedom from your IBS symptoms. I’m your host, Jesse Wong, fo dietitian and a gut experts. 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 I 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. Hi everybody. Welcome to another episode of IBS Nutrition podcast. Today we are going to share one of our past clients’ story, and this is Stacy. Stacy struggles with a lot of diarrhoea prior to working together, and we will share about Stacy’s journey, how we helped her identify her triggers and also what her lives look like now. So for those of you who might be struggling, I hope this episode gives you some encouragement and know that there is a way to make IBS more manageable. Hi Stacy, how are you? Hi, Jesse. I’m good. How are you doing? I’m doing great. Thank you so much for coming here and sharing your story.

Stacy (01:22):

You’re welcome. I’m super happy to be here. I was really excited when you reached out to me to ask me to join on this podcast to be able to share my story. So I really hope it’s helpful for some of the viewers.

Jessie (01:33):

Yeah, I’m pretty sure it will be now. I can’t remember when did we work together? Was it 2023 or

Stacy (01:40):

22? It was 20. It’s actually been, well, it was exactly two years and March, so it was March of 2023 is about when we started working together.

Jessie (01:55):

Right. Oh my goodness. It’s been a while. And how are you doing nowadays?

Stacy (02:01):

Now? I’m like the healthiest I’ve ever been. I am the most gastrointestinally stable I’ve ever been. Yeah. But yeah, in terms of my health, I am definitely the healthiest I’ve ever been. And that is honestly all due to working with you and your expertise.

Jessie (02:23):

Thank you. And wow, I can’t believe it’s been two years and everything is still going well. You have the tools to manage your symptoms. Well, tell us a little bit about who you are and feel free to share as much as you want or as little as you want.

Stacy (02:38):

So I’m Stacy. And actually it’s funny because when I originally wanted to start, when I wanted to go to college, I actually wanted to become a dietitian. I was actually enrolled in school to become a dietitian, and then I later changed my degree to being a medical laboratory scientist. Right now, my life is just, I manage a quality control lab at our local blood centre, and I live at home in Ohio with my boyfriend and my two cats.

Jessie (03:11):

That’s awesome. So you are in the medical and healthcare field as well,

Stacy (03:15):

Correct? Yes,

Jessie (03:16):

I’m, that’s amazing. Okay. And tell us, I know this is a tricky question for you. Tell us what was your life like before IBS?

Stacy (03:25):

I don’t really remember a lot. I feel like I really struggled with my IBS symptoms. Honestly, majority of my adulthood probably since I was like 15, 16 years old, I experienced the loose stool. So previous to that, that would’ve just been kind of like my childhood from kindergarten to high school. And then it took off from there is when my symptoms started, was probably mid high school or right after graduation. So I don’t really have much of an adulthood memory of non IBS symptoms except for the current state that I’m in.

Jessie (04:05):

Yeah. Okay. Well, I’m glad you’re much better. Tell us more, if you don’t mind. What symptoms were you experiencing prior to working together?

Stacy (04:14):

So I experienced diarrhoea. That was my biggest issue. It definitely as time went on and it was pretty much right up until I finally decided to, alright, I need to do something about this. I need to go to the doctor, I need to hire a dietitian. It had gotten worse and worse as time went on. And so it got to a point where it was, this is gross, and I’m sorry to the viewers, it’s fine. It wasn’t just like chippy diarrhoea, it was literally the consistency of water. When I would use the restroom, it was I would eat food and within minutes it would be out. And obviously because of that I was extremely exhausted because I would eat the food and I wouldn’t really absorb any of the nutrients. And so I would basically in one in and out the other, and I would essentially spend my off days from work laying in bed all day because I would be so tired.

(05:17):

And I do a lot of working out and strength training and I would work out from home. And even a lot of times when I would be working out, I would have to stop mid workout to run to the restroom and then go back to my workout or I’d have to run to the restroom and then lay down for a few minutes because I would be so exhausted and then I’d have to go back to my workout. So it definitely really impacted my life negatively. And the other thing that I would say the constipation was a symptom that didn’t happen initially. I think the constipation kind of came later on when I would start having the diarrhoea towards the end, when I started going to the doctors, it’s like I would have diarrhoea for multiple days at a time and then I would get constipated for several days. And then it was just a constant cycle of diarrhoea, constipation, diarrhoea, constipation. So I guess, and in terms of other symptoms that I had, sorry, now I feel like I’m rambling. So I would also get severe stomach cramping. I never ever experienced bloating, which I feel like that is something that a lot of people tend to experience. But mine was diarrhoea, constipation, and then severe stomach cramping and fatigue, I would say were my four main big symptoms that I had.

Jessie (06:52):

Yeah, pain is the biggest identifier for IBS, so that’s cramping. And pain is probably, I mean, bloating is what patients complaints most of. But not everybody has bloating, especially in significant diarrhoea cases, just nothing in there.

Stacy (07:08):

Sometimes that makes sense.

Jessie (07:10):

But some people do have, I would say distension, probably some bloating and distension when they have diarrhoea. Yeah. Oh wow. Thankfully it hasn’t happened for two years. That’s a lot. Exactly. Yeah. Now tell us, if you don’t mind, what were you using at that time to manage your symptoms?

Stacy (07:33):

It’s funny because when I was thinking back prior to coming on this podcast, what were all the things that I used to do to help manage those symptoms? And I used to be the queen of taking Toms. I took them religiously. I would take them probably four or five a day. I’d take some in the morning, I’d take some when I got home from school, anytime my stomach hurt, I would take a Tums. And then on top of that, whenever my diarrhoea would really was really bad, I would take Imodium all the time, just help with the symptom management. And then I also, for a kind of short stint of time, I took a probiotic and it’s so embarrassing. Looking back now, I’m like, gosh, I can’t believe I did that. But it was this probiotic that Jillian Michaels endorsed and I was like, oh, I’m going to try that. Maybe that will help. And it made my stool really a weird texture, but it didn’t fix anything. It wasn’t the root of what was causing my symptoms. So yeah.

Jessie (08:42):

Yeah. I’ll say it for everybody else listening, do not take a probiotics unless you talk to your physician or work with a dietitian who understand. We just recorded another episode yesterday with my really good friend, Bailey Hannah, who created a database for probiotics. And we also talked a lot about what to do if IBS patients are considering a probiotics. So that’s episode 17 of the IBS Nutrition podcast for anybody else who are interested, but be very careful. Most of the time what we see in our clinic is patients get more significant diarrhoea. If they had some loose stool prior to taking probiotics, they will have complete watery diarrhoea after they’ve been on it for a while. That happens quite often, so be very careful. Alright. Okay. Now tell me about the S and Imodium. Did it help? What happened?

Stacy (09:36):

They did. I mean, Imodium is a reputable drug, right? I mean it’s symptom management for diarrhoea. So it did help it kind of relieve the gurg leaf stomach and would temporarily relieve the diarrhoea, but it was obviously not permanent, which is why I would have to constantly take it. And same with the Tums. Yes, it did temporarily help, but I was obviously taking it frequently because it was just sort of putting a bandaid on the symptom instead of actually knowing what was causing that trigger. And since that trigger was still being ingested unknowingly, it never actually resolved the issue. But I do want to say mean now if I do mistakenly or accidentally ingest the food trigger that I have, I will utilise an Imodium for symptom management just to help me feel better. And especially because like I don’t want to have to call off work. I have diarrhoea or something if I can utilise that medication to be able to help with the symptom management, management,

Jessie (10:47):

Absolutely. Imodium is a great tool and especially when people are travelling or at events where you can’t like going to work, you have to do it. It’s a great tool to help ease the symptom time. But like you said, it’s more like a bandage. It’s more important to understand what the trigger is. What would you say was your biggest frustration and challenge prior to working together?

Stacy (11:08):

Definitely the diarrhoea. There are so many instances when I look back where I’m like the diarrhoea would ruin situations. I remember specifically one instance, me, my mom, my stepdad and my brother, we were all on our way to go for a hike at this park ways or a couple of hours away in Indiana. And I remember we got really close to parking where the trail was that we were going to hike. And I all of a sudden got that feeling of diarrhoea. I told them, I was like, I can’t go on this hike. I need a bathroom and we’re going to have to go back out into the town and we’re going to have to stop at a store so I can get medicine so that I can go on this trail. And so it was frustrating having those instances. Or a lot of times if I was going to go out with my friends on a Friday or Saturday night, it was right before going out, of course I would have to run to the bathroom and then I would just be so tired and exhausted and be like, alright, I’ll take a Tums.

(12:19):

Hopefully it’ll make me feel better. And so it definitely interfered with a lot of the things that I wanted to do in my life. I still did them, but it’s like I would do them not feeling well, not feeling my best. So

Jessie (12:35):

Yeah, that is really frustrating. Now tell me what made you decide to work with us?

Stacy (12:43):

So when it got up to the point, so we started working together in March of 2023 and I would say a few months prior to that, that is when my symptoms just started getting so out of control. I remember what finally prompted me to make an appointment with my doctor was that I had lost three pounds in one week because my diarrhoea was so bad, I could not, anytime I would take a bite of food and it would be in one end and out the other within seconds of eating. And I was like, okay, there’s something wrong with me. So I had gone to my doctor’s appointment, I had told her what was going on, she assumed it was likely IBS, but since she is not a gi, she referred me to a GI doctor. Now if anybody knows getting into a specialist, there is typically a waiting period.

(13:35):

So my appointment wasn’t for about four weeks before I was able to get into the gi. And so I was like, in that time I’m like, I’m going to go on Instagram and I’m going to try and find a dietitian who specialises in IBS. Since that was likely what I probably had based on what my physician had told me, I follow a relatively decent amount of reputable scientists on Instagram. So I have a pretty good sense of who is reputable versus not. When I was seeking out somebody to a dietitian to help me with what I was experiencing, and I literally searched in the Google or in the Instagram search bar IBS dietitian and your page came up and I did some scouring through your page and I was like, I’m signing up. And I literally signed up the day I found your page, and then we had our consultation. The reason I wanted to work with the dietitian, only because I was sort of fearful that if I only worked with a GI doctor that they wouldn’t potentially be able to identify a food trigger, which is why or wouldn’t necessarily refer me to a dietitian, which is why I wanted to seek one out personally.

Jessie (14:56):

And I actually do remember our first call and you said your doctor appointment was coming up. Now a lot of the times people come to us after they’ve exhausted everything with their doctors. And I think it doesn’t have to be that way. And I think a lot of the times too, when you go to the doctor, there’s only so much they can do. They’re great. You have to get those tests, but having that opportunity to talk to you before you going to the gi, that was really helpful because we talked about what it potentially could be. We talked about what tests would be helpful for your case just to rule everything out and make sure it actually is IBS and nothing else. And this is very different person to person because depending on your medical history and or your family medical history, the recommendation would be different. Exactly. Yeah. And do we talk about tracking symptoms and presenting your symptoms to your gastroenterologist? Do you remember that?

Stacy (15:51):

So I did, but because I saw the GI doctor after we had started working together, so by the time I started working with my GI doctor, my symptoms had essentially pretty much resolved. So I was able to go to that visit and say during this interim period from when I went to that initial doctor’s appointment until I saw her, I started working with a dietitian and this is what we identified. And I was like, at this point I’m basically symptom free. And so she was really happy about that. I think she was relieved that the identification of what was causing all of my symptoms had been made and that she wasn’t having to start from scratch with me and she didn’t feel like her toes were being stepped on or anything. She was grateful for that knowledge and me being able to provide that to her. Oh,

Jessie (16:49):

That’s great to hear. See, I actually don’t remember this part, but I do remember talking about, Hey, I think this might be it. Let’s try this and see what’s happening. And then you go into to present all the information to your gi. But I did remember your GI was very, very nice and she was very understanding of your situation and supportive of what we found out. Oh my God. Okay. So you had symptom relief within a few weeks and it was

Stacy (17:16):

Fast.

Jessie (17:16):

Not, I have to say, clarify this here for everybody listening, not everybody respond as fast and IBS is very complex. It could be so many possible reason Stacy happens to be one of those cases that she responded very well to our recommendation and just gone back to, I would say baseline probably within four weeks of working together.

Stacy (17:37):

I did.

Jessie (17:38):

Yeah. Oh, that’s great to hear. Okay. Well, let’s talk more about our process, right, because we did identify a trigger for you, but you came to us also thinking about doing the low FMAP diet as well. Correct? Tell me more.

Stacy (17:52):

Yeah. Yep. So, and actually I didn’t say this earlier when I mentioned about when I made that initial doctor’s appointment with my doctor and went to that appointment, she had recommended the low FODMAP diet to me. And I remember when she gave me the documents for how to follow a fodmap, I was so overwhelmed. I was like, I cannot do this by myself. I’m like, I don’t even know where to start with this because it’s complex and there’s so many different categories of FODMAPs and it’s like I don’t even know where to start. And it was just daunting. I’m like, oh my gosh, I have so much food that I would need to cut out of my diet. And me, I love to cook and I cook from, I eat a lot a very vegetable diet. So it was just like, oh my gosh, the fact that I would have to cut out every single one of these, I was like, I need help.

(18:45):

So that was also part of the other reason why I had sought out you or an IBS dietitian specifically. So one other thing that I want to say when trying to seek out a dietitian is be aware of dietitians who recommend things like gut microbiome tests or food sensitivity tests or hair mineral tests because those are not regulated tests. And the other thing that I want to say too is if you see dietitians or providers badmouthing drugs like MiraLax, that’s also a huge red flag because MiraLax is a really safe and regulated over the counter medication and it’s a stool softener and it doesn’t get absorbed into the GI tract. And I personally have had to unfollow a GI dietitian that I had been following for years, and I unfollowed her specifically for badmouthing MiraLax, especially because it’s such a helpful medication and it’s not a dangerous drug. And she was essentially saying that it was dangerous and that people shouldn’t be taking it.

Jessie (19:50):

Yeah. Yeah. That’s not very helpful. A lot of people are afraid of the counter medications when we know actually they are regulated by the FDA unlike supplements because in the US supplements are not regulated. Now you mentioned a lot of tests earlier, and we actually had a podcast episode, I think it’s IBS Nutrition podcast, episode six with Dr. Andrea Love. And we really well, she debunked all these tests and why they are not accurate. And if you see any providers, not just dietitians selling these tests run, they are not, and you most likely end up spending a lot of money on things that is not going to help their service will probably still help you. But the test itself is unnecessary and it’s one of the moneymaking gamut or tricks. Okay. Well, let’s talk about what we did when it comes to the low format diet.

Stacy (20:48):

So when we had our initial consultation call for you to get my medical history based on my medical history and my symptoms, you were actually suspicious that I had a different trigger and not necessarily a fodmap. So I didn’t actually cut out any FODMAPs during our time together.

Jessie (21:13):

Right. Did you go low FODMAP at all or was it just a gentle, what we call gentle FODMAP approach? So not all of the FODMAP foods?

Stacy (21:21):

Yeah, I did not go low FODMAP at all.

Jessie (21:24):

Okay. And I want to clarify for everybody listening, because a lot of the times patients come to us thinking that they have to be on LOM map, and oftentimes patients have been on LOM for a long time, but oftentimes not everybody needs to be on a full LOM elimination diets. What we recommend nowadays is we want to really assess what your symptoms are first and medical history first before we recommend any diets to be honest. But we’ll still do a FO map challenge even when a patient is not on the low diet, to see if there are any groups of maps that may trigger a bit of symptoms. And in Stacy’s case, Stacy came to us thinking about the LOB diet, but didn’t do the lemab diet at all. And your symptoms has drastically improved. Was it two weeks or four weeks or within

Stacy (22:13):

That short timeframe? I would say it was probably, yeah, between two to four weeks that I was, I would say probably at four weeks I was at a total what you would define as baseline. So normal GI functioning two weeks, I would say I was much better than where I was two weeks prior, but not perfect,

Jessie (22:37):

Not completely symptom free, but so much better, right? Correct. The diarrhoea slows significantly.

Stacy (22:43):

Yes.

Jessie (22:43):

Yeah. Okay. Well, tell us more about how we identified your trigger.

Stacy (22:49):

You suspected a couple of triggers and so during that time I had to remove them from my diet, and then once I removed, so I had two separate triggers that you were suspicious of. So I removed both of those completely from my diet and that I had to be very strategic about it and careful about it to make sure I had none and my diet whatsoever. And then once I got to a baseline, so totally normal stool, stomach felt good, no diarrhoea, then I reintroduced one of the triggers, and then I saw what my symptoms were. So when I reintroduced the first suspected trigger, I remember I did it right before work and I was like, this might not be a good idea. And I remember I took a bite of the trigger and then within a few minutes I had severe stomach cramping, and then all for the rest of the day at work, I had diarrhoea.

(23:57):

So anyway, it was very clear that that trigger that you had suspected was what was causing my symptoms. But then we had that second trigger that we now had to see if that was a trigger as well. But since now I wasn’t at baseline anymore, I had to then get back to a baseline. So that took probably one or two weeks. And then I reintroduced the second trigger. And that one was a little bit trickier because I didn’t react in the way that I thought I was going to, but I could tell something was off my GI system, my stomach just felt off. So I knew that, I knew that it definitely caused me symptoms even though it wasn’t as severe as the other trigger. And so then again, once I removed that trigger back out of my diet, and then so that both of them were gone again, I got back to a baseline pretty quickly.

Jessie (24:59):

And I love you sharing about the details of how fast the symptoms came on, but I also want to remind our listeners, not everybody respond the same way. And sometimes the symptoms can be delayed. Well, I’ve seen the longest delay is up to seven days. You wouldn’t have symptoms when you do the challenge, but down day seven, suddenly everything comes back. So everyone is different. And most likely, depending on what that trigger is, some foods can react a bit faster and last in the system longer. Whereas sometimes with thought maps, it can’t stay in the system for about two to three days. So different food have different type of trigger reactions and also trigger durations. Now, did we do a FODMAP challenge for you? Did we do all the groups of the FODMAPs?

Stacy (25:44):

We did not. We didn’t do any of the FODMAP challenges in my scenario.

Jessie (25:49):

Okay, because your symptoms were so well managed by the end of identifying those triggers and completely removing it from your diet.

Stacy (25:56):

Correct,

Jessie (25:57):

Which I was

Stacy (25:57):

Very thankful for.

Jessie (26:00):

Yeah. I want to just remind, listen, sometimes in different cases, depending on a person’s confidence level with the food or the symptoms they may be experiencing, some patients will still do some form of a low fab diet in combination of other triggers that we suspect to challenge, and then we would still challenge the maps. Challenging doesn’t mean you have to be fully low fodmap, but it gives a lot of people a chance to know that, Hey, I’m doing a proper challenge of this food. I can actually eat it. I’m not worried about it. In Stacy’s case, Stacy’s not worried at all. So you just resumed back to eating a normal diet except without those two food triggers, right? Correct.

Stacy (26:39):

Yep, that is exactly right.

Jessie (26:41):

Yeah, that is amazing. Okay. It’s the best outcome. And of course, not everybody have food triggers. Some people don’t even have any triggers. They really have something else going on that we need to resolve. And with IBS, this is often a common misunderstanding, is that people think that they always have a food trigger. They have to cut out certain food. And I would say that it’s not always true because sometimes it could be significant constipation causing symptoms. It could be overflow diarrhoea causing symptoms. It could be a flare up diarrhoea causing symptoms. So in those cases, they’re not necessarily food triggers, but in some cases there are food triggers. And sometimes the food triggers can speed up the motility, like in Stacy’s case, causing diarrhoea. And in some cases the food trigger would slow down gut motility a lot, causing significant constipation. Sometimes that constipation lead to something else like overflow diarrhoea or flareup diarrhoea or what we also call ibs, mixed biotech. Okay. Sorry, I’m getting very explain me here. But we do have other episodes in the IBS Nutrition podcast talking about different types of constipation and different types of diarrhoea. So if you’re interested, go and listen. Go and find those episodes. Now, Stacy, let’s share about the bright part of this podcast. How is your life now, nowadays, after working together two years ago?

Stacy (28:10):

My life is so much better. I always say if I had not found you, I feel like I would still be where I was years ago. I just think you’re such a professional in your field and you are so smart and you’re really good at intuitively knowing what’s going on with people with their GI symptoms. At this point, I would essentially describe myself as symptom free. I do obviously get the occasional unintentional exposure or ingestion of my trigger. I never intentionally eat my trigger ever again. I never will. But aside from those, every once in a while, occasional accidental ingestion of my trigger, my GI system is great. It’s so nice to be able to just go about my life and not having to worry about like, oh my gosh, I need to make sure there’s a bathroom nearby, or I need to run to the bathroom, or making sure I have Imodium stocked up in my purse or anything like that. So yeah, my life is compared to where it was. I am definitely, even though I’m the oldest I’ve ever been, I am the healthiest I’ve ever been.

Jessie (29:33):

That’s wonderful. Well, thank you so much for sharing that. What would you say to people who currently are struggling with IBS symptoms now?

Stacy (29:43):

So a couple of things. One, it can get better. And two, make sure that if you are considering cutting out foods from your diet, do not do it alone. Because in my case, I mean, had I just done what my doctor recommended to me, which was to just immediately do a low FODMAP diet, I would’ve never been able to identify exactly what my trigger was. If I hadn’t had Jesse’s guidance to assist with it, I would probably still be where I was historically. So I definitely don’t recommend doing it by yourself. Definitely hire a professional. Or even if you don’t go with Jesse, ask your doctor to refer you to a dietitian. And doctors are experts in what they do. And medicine doctors are not experts in nutrition, and that’s okay. That’s not their job. They’re not expected to be experts in nutrition. But as a patient, it is important to advocate or make suggestions to your doctor so that you’re getting all the care that you need.

Jessie (31:00):

That’s amazing. And I love what you said about don’t do the LOM diet on your own. In fact, any elimination diets, nobody should try it on their own unless they know what they’re doing. And oftentimes it’s very sad. What we see in the clinic is people have been doing the elimination diet for a long time and they don’t know how to reintroduce the food. Or when they reintroduce the foods, their symptoms come right back and it makes them very afraid of food. And sometimes, oftentimes it’s unnecessary. I will say that most of our clients come think throughout programme, they will be able to tolerate, if not most of the format maps, if not all of them. And you’ve seen it. You were in the group and everybody talks about their results. Yeah. So that is a great advice. Do not attend any restrictive diet on your own. Yeah. Oh, Stacy, thank you so much for your time. It’s such a great trip walking down the memory lane again, it’s been two years. I can’t believe that. It feels like a long time ago, but then I still think about our sessions a lot.

Stacy (32:01):

I know. Yeah. It was really honestly prior to coming onto this podcast and just kind of thinking back on my history of what my life was before, and I’m like, gosh, it was so long ago. It’s so hard to believe the state in which my GI health was then. And it was like that for so long, and I tolerate tolerated that life for so long. And now it’s like I can’t even imagine being in that state now just because it’s like, I feel so good and I’m like, I want everybody to feel this way. Anybody who has GI symptoms, like, I want you to get help. And it’s like, just know that there is help and there is symptom relief. It’s just being able to find the right person to help you identify what the trigger is. So

Jessie (32:52):

Thank you. Thank you for tuning into 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 favourite 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/masterclass to register. Until next time, take good care of your gut and here’s to your health and happiness.