Why IBS Feels So Out of Control — And How to Finally Get Clarity

Jessie Wong (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 everyone. Welcome to another episode of the IBS Nutrition podcast. Today’s title is why IBS feels so out of control and how to finally get clarity. If your IBS feels like a mystery, bloating, one day urgency, the next and safe foods still causing flare ups, then this episode is for you.

(01:06)Now, before we get into all the juicy information from this episode, I want to share something. Symptoms don’t just show up randomly. They follow patterns, but without the right process, you will miss those patterns and stay stuck with your IBS symptoms. And in today’s episode, I’m going to share more about how to identify those patterns. And it is not that you haven’t tried hard enough, it’s that no one gave you the right process to understand what’s really going on in your body. And I will walk you through three reasons why IBS feels so out of control and what to do instead in this episode. So let’s get right into it. So education points number one, well we’ll talk about three points, right? But education points. One is IBS feels out of control because most people are guessing. So most people with IBS are stuck in a loop of trial and error.

(02:14)You might have cut out food like gluten, dairy or even try the LOM map diet, but never really feel confident that they are your triggers. But you are left feeling anxious when it comes to eating. I’m going to say you a lot in this episode. That doesn’t mean that you are doing all the things I’m talking about, but I’m referring to the general IBS population because that is a lot of the times what we see in clinic. And maybe you too are cutting out food and feeling anxious when it comes to eating. And this episode is here to empower you to take action for controlling your IBS. Here’s what food anxiety typically looks like. You were recommended a diet, it can be the low format diet or the gluten-free dairy-free diet, or worse, it could be more restrictive diets such as the carnival diet or have gone completely vegan.

(03:21)It could have been recommended by your provider or advice you found online, Reddit, Facebook, other support groups or forums. And you might have started the loof map diets by yourself, but got stuck in the elimination phase, afraid to reintroduce or don’t know how to reintroduce or you don’t know you need to reintroduce. You might have removed random foods based on social media posts, Reddit influencer advice without any strategies, and you might have trialled supplements such as probiotics or enzymes or detoxes or cleanses without knowing whether you actually need them or sometimes these can make your symptoms worse. You might be tracking your symptoms mentally, but not in a structured or usable way to show pattern. So these are all things we hear and see a lot from our online communities from patients that we directly work with. Now I’m going to share with you what actually works when managing IBS five points here.

(04:33)So take notes and use whatever is helpful for you. Okay, number one, understand that IBS triggers are personal and often multifactorial. It’s rarely just one food. Okay? Number two, following a structured process of elimination, reintroduction and symptom tracking to help you identify your own trigger. Okay, number three, look at symptom timing. And for example, sometimes reactions are delayed, but you really want to look at when symptoms happen to understand how your body processes, triggers. Also frequency and consistency. Don’t just assume I ate eggs and now I feel y some reactions are delayed and where can with someone? This is point number four. Working with someone who can help you interpret the data you’ve collected. A food log or symptom tracker is only helpful if you know how to read it. Number five, I’ve said this earlier but I want to reiterate it. Sometimes food reaction is delayed, sometimes delayed by a few hours, sometimes by a day or two.

(05:59)And the longest we’ve seen in our clinic was seven days. The client ate her trigger and the symptoms didn’t show up until seven days later and we were able to catch that by using a systematic elimination and reintroduction process. It is confusing, and I’m going to repeat again what I said earlier in the beginning of the episode. Symptoms don’t just show up randomly. They follow patterns, but without the rights process, you will miss those patterns and stay stuck in fear. Now I want to share a client story with you, and this is probably one that many people can relate to. And this client, her name is Sharon, and I’m also going to read some of the testimonial she wrote so that you can better understand her situation. So Sharon had IBS diarrhoea, lot of bloating, lot of distension, and she was very afraid of food and afraid of leaving her house because she never know when she would need the bathroom.

(07:09)So before working together, she spent years googling, researching, trying to self-diagnose, and she did also went to her healthcare provider as well. But after the IBS diagnosis, that was pretty much it. And she eliminated a lot of food and she was terrified of food. And here’s what Sharon wrote to give you her perspective. She had, she wrote severe gut extension, severe gut inflammation, severe heartburn, severe diarrhoea without warning or consistency, discomfort and complete fear of food leaving the house. She was tired and she had depression from her IBS symptoms. She was doing a lot of research online trying to find any supplements or cures that’s out there to help her manage IBS. And she found some very expensive powders and also probiotics online, which really only made her symptom worse, especially around urgency, bloating, and diarrhoea. She was exhausted, she was anxious and she was avoiding life events to just try to manage her IBS.

(08:19)And of course that’s when she found us and she joined our programme in a heartbeat after she found us. So what we did was creating structured symptom tracking with her to track what she was eating, what her symptoms were, when did she needed a bathroom, and to see if we can find a pattern. And again, let me read something that she wrote in the testimonial in regards to what we did. Okay. Jesse did a one hour intake interview, requested labs and full history once she knew colonoscopy and the end endoscopy ruled out life-threatening issues, she immediately had me upload food diary including daily bowel movement, then fully supported me with her intentional step-by-step process to identify my trigger and heal my gut. I haven’t felt this good in three years. Here’s something that we do for everybody that comes through our programme. We always start when working with a client, we always start with a medical assessment to understand to patient’s medical history, any previous diagnosis, other diagnosis, and also family medical history as well because it is so important to understand thoroughly what that person is going through, what their family members have.

(09:45)And we pay special attention when there is other GI disorders in the family as well. And then we really dive into current symptoms, what food patients are eating, and more importantly, what’s going on in their life as well and understanding their lifestyle. Now, what we did for Sharon was we identified her food triggers and helped her rebuild trust with food and stopped restricting and regained freedom in her daily life. So once we identify her food triggers, we remove that food. Actually it was a couple of foods from her diet to allow the healing process to start and her diarrhoea stopped and her bowel consistency improved. Gradually she came to us very afraid of food, feeling inflamed, having lots of diarrhoea. But when she finished our programme, she felt empowered knowing exactly what triggers her symptoms and how to avoid these triggers moving forward to finally feel good in her body and being able to live her life to the fullest.

(10:54)Now I want to share this story with you to tell you that there is a reason why you are feeling your symptoms. And the key is to understand this reason. Stop guessing what triggers your IBS symptoms. Identify it properly by using a structured process. And if you need help, always work with professionals who can help you understand your data. So that’s point number one. Symptoms don’t just happen randomly. There is a pattern, there is a reason and you need to understand it. Now let’s move on to education points. Number two, food isn’t always the problem. Your motility bowel habits and lifestyle patterns also plays a huge role. So many people think that IBS or if you have any of the IBS symptoms, like if I’m bloated or have diarrhoea, it must be something I ate. But that’s not always true and in many cases it’s only part of the story.

(12:03)And here are three things you need to also consider. One slow gut motility, especially in constipation. Predominant IBS slow gut motility can cause bloating distension from stool buildup. It can also feel like incomplete evacuation and you’re still feeling full all the time. And sometimes slow gut motility can cause diarrhoea as well and it is overflow diarrhoea. And this is when you have impact stool into your colon or in your rectum and your body wants to produce a bowel movement and it’s trying to squeeze really hard. That’s where the pain comes from, right? And then all you have coming out is liquid and watery stool that leaks past the impacted stool. Now if you want to learn more about overflow diarrhoea and what it means to have blockage from impacted stool, watch our free IBS relief masterclass. We have visual images in the free masterclass to show you what it looks like to have diarrhoea that is associated with constipation.

(13:11)So there are two diarrhoea. One is overflow diarrhoea, the other one is flareup diarrhoea. Both of these are actually caused by constipation. So if you want to learn more, go watch our free IBS Relief Masterclass. You can go to ibs dietician.com/masterclass to find it. Alright, so three things you need to consider, right? We just talked about one look at motility. Now let’s talk about number two, stress and nervous system dysregulation. Also AKA, the gut brain access. So when there is dysregulation, it can speed up our gut motility or slow down our digestion significantly. It can worsen the perception of bloating and urgency and pain even when there’s no inflammation in your GI tract. This is a confusing part with IBS. Everybody feels so inflamed, but there is no inflammation because there is a disconnection between your gut brain axis and it causes what we call hyper visceral sensitivity.

(14:16)On episode 19 of the IBS Nutrition podcast, I interviewed Dr. Ali Nadi from GI psychology talking all about gut brain interaction and nervous system regulation. If you are interested, take a listen. Dr. Nadi also shared some tips that you can do right away to help improve your gut brain connection, but this is number two. Okay, number three, lifestyle and behavioural pattern matters. And what I mean by this, and it is inconsistent eating times, low fibre intake, dehydration, poor sleep, lack of movement, these are huge factors that can affect our gut motility. It can also affect our nervous system regulation, and these often trigger or worsen symptoms more than food. This is exactly what happens to me. Before I had my IBS diagnosis now, and I also want to share with you one of our former client’s story, and this is Lindsay. Lindsay came to us for having multiple diarrhoea a day, which made her really afraid of leaving her house and she was even afraid of going to the grocery store or dropping her kids off in school, and she started cutting out a lot of food.

(15:39)The symptoms she was having beside diarrhoea was daily bloating and also food fear. At the time of her joining a small group programme, she’s already cut out most of the food she was eating, broth, jello and rice I think, I can’t remember fully, but she also came onto our podcast to share her story as well. She’s tried everything Imodium, restrictive diet supplements. She’s seen many doctors and nothing really worked and she was really anxious and she was really only eating a few things. So when she joined our programme, she watched our course, which all of our clients have access to our IBS Freedom course to learn more about IBS. And what she did that really helped him was daily movements improve her water intake, improving her fibre intake and also gentle motility supports. And sometimes it includes products like MiraLax. And she also recognised that stress, lack of sleep and anxiety around food can all worsen her IBS symptoms even when the food is a safe food.

(16:50)I wanted to share her story and also invite her on our podcast. It is because she’s somebody who doesn’t have any food triggers. What we did together was really understanding the pattern in her lifestyle in her daily life that was causing her symptoms. And we were able to pinpoint what we call in our programme lifestyle triggers. And once we were able to pinpoint the lifestyle triggers, we were able to create new lifestyle or behaviour that doesn’t trigger her IBS. And remember, she came to us being afraid of all foods. She only had a handful of foods that she felt safe eating, but in reality she did not have any food triggers. The most important thing for her was working on her lifestyle. And this is the key takeaway I want you to remember. Well, another key takeaway to remember, not all IBS symptoms are food related. If you are constipated or your gut isn’t moving properly, any food can cause symptom. The solution isn’t just cutting out more food, it is about resolving your root cause.

(18:10)Now for those of you who are wondering, what do I do? How do I get started with all of this or any of this, we do have a free symptom tracker so that you can start tracking your symptoms, your bowel habits, and see if you can see a pattern. But again, data is only useful if you know how to interpret it, but it’s always helpful to track your symptoms for a few days before going to see your healthcare providers or see your dietitian. That way we can look at the data and help you interpret it and better and understand it so we can better understand your body to help you overcome your IBS symptoms. Now you can grab our free symptom tracker on pedia.org. I know it’s so funny. It’s P-O-O-P-E dia a.org/resources. It’s completely free, it’s extremely helpful and it really sheds lights on patterns that you may or may not have noticed in the past.

(19:13)Okay? And I want to share with you another client story to talk about why understanding your root cause is so, so, so important. Now, if you don’t know what your root cause is, you might be treating the wrong IBS symptoms. And I want to share with you one of our past client story, and this is Kathy. Kathy came to us believing that she had IBS diarrhoea. She had frequent loose stool, guess bloating, daily urgency. She’s seen multiple doctors try Imodium elimination diets, herbal teas, probiotics, you name it, she’s tried it. She’s even seen naturopaths and dietitians and nutritionists. But here’s the thing, once we started tracking her bowel movements and symptoms closely, we discovered that she was actually severely constipated and her diarrhoea was overflow diarrhoea caused by constipation. And our next step was to resolve the constipation and to stop the overflow diarrhoea. And more importantly, we looked at why she was having significant constipation to prevent it from happening again.

(20:24)We worked together closely to monitor her symptoms, bowel movement, and eliminated and reintroduce food systematically to identify her food trigger as well. We found out that a particular group of foods caused her to have slower gut motility leading to significant constipation. And after adjusting her fibre, her meals and removing that trigger her symptoms completely shifted. She’s now regular pain-free and no longer having to have really painful bowel movements or no longer needing to plan her life around bathrooms. If you are wondering how we figured this all out, it all started with clear tracking. And once we stopped guessing and looked at her symptoms with the right tools, we could see the pattern and help her make real progress. And for those of you who are ready to get started with symptom tracking, don’t forget to grab our resources from put pd.org/resources so you can understand what your gut is telling you.

(21:38)I’ll link everything in the show notes for you. Also, don’t forget to check out episode one of the IBS Nutrition podcast where we break down different types of IBS symptoms and what they actually mean. So you can stop guessing and start understanding your body. Okay, so that’s education point number two. Not all IBS symptoms are food related. If you are constipated, your gut isn’t moving properly. Any food can cause symptoms and the solution isn’t just cutting out more food, it is resolving your root cause. All right, now education points number three. What you need to do to really identify your root cause and resolve it as a clear structured plan, it will change everything in terms of managing your IBS. Here’s what you don’t need more random food elimination, please, please, please stop cutting out food. We see so many people getting hurt by just cutting out food.

(22:45)Yes, it may sound benign, but when you cut out the food and you don’t know if it’s causing you symptoms, it’s a drain on everything. You become afraid of food, you become afraid of social events that have food and it is not necessary. So please stop cutting out food randomly. No more spending money on expensive supplements without a reason. There are certain supplements on the market that can be helpful, but most of the supplements on the market are not going to be helpful and they are waste of time, waste of money, and sometimes it can make your symptom worse. And three, no more vague advice like just manage your stress because you know what IBS is not in your head. People have physical symptoms and emotional symptoms, not just the pain, right? It really affects your life and it is debilitating to say the least.

(23:43)Okay? What you need is a real plan and a system that you can follow with experts guidance that is built on evidence and personal data. And here’s what a structured approach often includes. Four points here that really includes that can be very helpful for a structured plan. One, a smarter thought map strategy with proper elimination and reintroduction so you can identify your trigger and more importantly, the level of your tolerance so that you can eat these foods. Again without fear, it’s not just about elimination. Okay? Number two, structured tracking of food symptoms, stress and bowel habits. You need to track it structurally so that it can give you number three here, a pattern to analyse and identify what’s really going on. Symptoms. Again, I’m going to say this again, I know I’m repeating this a lot, but it is so important for somebody with IBS and struggling to understand symptoms don’t show up randomly.

(24:56)You need to pinpoint your triggers so you can avoid the trigger and avoiding symptoms. Point number four here, after understanding your pattern is get guided support to reduce fear, answer questions, and bring in lifestyle changes. That is extremely helpful for you in managing IBS without feeling overwhelmed. Okay, so here again, four points really to help you have that structure. One, smarter font map strategy so that you can pinpoint your food triggers. Number two, structured tracking of food, symptom stress and bowel habits. Number three, pattern analysis to identify your real trigger and understand what is really going on. Number four, guided supports to help you overcome the fear and answer questions and create a plan that actually works for you. Alright? So again, the key highlights here to help you move away from guessing to clarity relief comes from when you actually know what’s going on in your body and resolve the root cause.

(26:11)If you have a food trigger, then you need to identify it and also know your tolerance levels so that you can eat food you love safely and not worried about symptoms. And this is what we do in our IBS Freedom programmes. We take you step-by-step through elimination, reintroduction, bio pattern tracking, symptom interpretation, and making the lifestyle shifts that you need to stay symptom free with expert guidance along the way. And I always say, and here’s a question I get all the time, because sometimes people hear, I share our patient’s testimonial and people ask me, Jesse, it sounds like you guys can cure IBS. Is there a way to cure IBS? Now I want to say this to clarify, there’s no cure for IBS because there is nothing really wrong in your gut. But by understanding your body and your specific trigger, you can’t prevent symptoms from coming back.

(27:15)And you can also have a plan of action to manage symptoms if you can’t avoid your triggers or if somehow you get into the trigger because life do happen. But the key is you know how to prevent symptoms and you know how to minimise symptoms if they do happen. And having the right tools by understanding your body and building on the tools, it can help you do just that. And which is why we have so many clients getting on our podcast and sharing their story. I actually want to highlight one of our clients who came on the podcast to share her stories and kind of share her journey as well. And this is episode seven, and the client’s name is Mercedes. So Mercedes is somebody who started having IBS later in her life and she went to four different gastroenterologists, and I’m sure a lot of you can relate to that.

(28:07)Sometimes it’s just so frustrating. Getting to the diagnosis can take up to six years, and that was close to her experience. A lot of frustration, not straightforward answer. So Mercedes, before she came to us, she had already tried the LOM diet on her own. She got stuck in the elimination phase and she was terrified to reintroduce food and she was living her life in fear of flareups. But once we gave her structure and support, she reintroduced foods properly, identified her triggers, and started travelling again without fear. I would love for you to listen to her story because so many people have emailed me and messaged to me and said, they relate so much with Mercedes’s story. Go listen to it. Learn how we were able to help her take her life back and identify her triggers and expand her diet. I think at one point she sat in a podcast like I thought I had a reaction to these food.

(29:06)But in reality, when we actually do the challenge, she could tolerate some of it. It’s not one size fits all. It’s not like, oh, I can’t eat it. I have to take it all out. She was able to eat most of the food that she cut out. So for those of you who might be struggling, don’t feel despair, you are not broken, you are not meant to live in food fear, you just haven’t been shown the right process yet. So go listen to our episodes. We mentioned two clients in this podcast. One is Mercedes and one is Lindsay. Both of them came onto our podcast to share her story. And Lindsay, of course, again, is somebody who didn’t have any food triggers. We really worked on her lifestyle triggers and managing triggers to help her get to a better place so that she could eat everything she loves again.

(30:00)And Lindsay’s episode is episode 13. I just love that story so much because she cut out so much food before she came to us, and in reality, she didn’t need to do that. So go listen to it. And if you can resonate to this episode, I would love for you to join us in my free 45 minute masterclass. Go to ibs dietician.com/masterclass. I will walk you through the exact three-step plan that we use with all of our clients that helps them go from being stuck and afraid to calm and in control. Thanks for tuning in today. I’ll see you in the next episode. 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 our 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.