What to Eat During an IBS Flare-Up?

Have you ever felt held captive in your own home due to fear of stepping too far away from the washroom?

Not fun.

I think most of us have been there at some point or another, whether it be from eating some food that didn’t agree with us, having a bout of food poisoning, or some sort of stomach bug.

The ensuing result is often a raw, agitated, and unhappy gut, perhaps coupled with abdominal pain due to one too many trips to the loo.

If you suffer from Irritable Bowel Syndrome (IBS), with a tendency towards IBS-D, or any another other type of intestinal disorder of a similar nature, you’re likely a little more familiar with these types of episodes.

Even if your symptoms are pretty well-managed most days, if you have a sensitive gut to begin with, you may still find yourself with a flare-up every now and then, whether it be every few months, or even just a few times per year.

For some people, unfortunately, this is a much more frequent occurrence.

(By the way, if this sounds like you and you want help getting these symptoms under control so you can return to some form of normalcy in your life, I invite you to book a complimentary, no-obligation clarity phone session with me and I will help you. You can access my calendar on this page).

Everyone has their own triggers, but often times these flare-ups are provoked by certain foods or eating habits, and a lot of the time stress is a HUGE contributing factor. It can be a bit of a vicious cycle too because the symptoms themselves are enough to bring on more stress and anxiety, causing even further digestive distress.

Sooo…

What to eat when you’re experiencing a flare-up in symptoms?

This can sometimes be tricky because although you’re feeling uncomfortable, you’re not necessarily sick, so you may still in fact have quite an appetite.

Here’s what I suggest

The goal should be to soothe your system without causing any further irritation, while providing easy-to-digest nourishment and fuel.

Keep in mind we all have our own individual triggers – so if you know that something is disagreeable with you, obviously you should avoid it.

I know it sounds a bit like a cliché, but honestly, the best advice is to listen to your gut. Intuitively you know if something feels off-putting to you or if it may upset things further.

It will depend on the severity of your symptoms, but you can eat these foods for a period of time. For some people it may be up to a week or longer. For others it may be 3 or 4 days.

Don’t worry about getting in any particular ratio of macronutrients.

*Also, please keep in mind that it’s still important to get to the bottom of your own triggers (if you’re unaware of them) to help reduce the frequency and severity of future flare-ups.

 

What to Eat During an IBS Flare-Up?

But first…

If you don’t have much of an appetite, there’s no need to force feed yourself. Often just sipping on nourishing liquids like warm broths, soups, and purées is a nice way to give your digestive system a little rest.

Also, it’s the dead of winter right now where I’m located, so most of these foods are warming and take into account the cooler climate.

Lastly, I’ve made mention of FODMAPs since they can be a trigger for IBS-sufferers, however, if they’re not an issue for you, or you’re not keen on making an effort to eliminate/reduce them at the moment, feel free to eat them as you please. You can read more about the Low FODMAP diet here.

1) Bone broth, Veggie broth, Clear soups, Purées. Omit most high FODMAP veggies like garlic and onion if possible, although it might not be if it’s a ready-made soup. Also avoid soups made with cruciferous veggies such as broccoli and cauliflower which can contribute to more gas production.

I shared a recipe for my nourishing homemade veggie broth over on my Instagram (omit the onion if you know it to be an issue), but if you don’t have the patience or time for homemade then picking up ready-made broths is an easy option. There are some nice ones found in tetra-paks or glass jars.

2) Cooked and Easy-to-Digest Veggies. Green beans, zucchini, okra, carrots, etc. Avoid raw veggies or anything with tough skins or stems.

3) Bananas. Not overly ripe, but not green either (the image above is a good reference, actually).

4) White Rice (or Brown Jasmine Rice). White rice is less fibrous so easier on digestion – especially best if you’re experiencing loose stools. If that’s not an issue you might be okay with Brown Jasmine Rice – which is a shorter grain rice that tends to be more digestible than longer grain brown rice. Eat it bland – don’t add any spices or sauces. You might cook it in veggie or bone broth for some added flavour. Rice is starchy and absorbs water, and can help make your stools firmer. It also provides some substance if you’re unable to eat much.

5) Easy-to-Digest Proteins. Salmon, Poached or Soft-Boiled Eggs, Sprouted Tofu, Shredded Chicken, protein powder. I’m partial to grass-fed whey for easy digestion and suggest sticking with the whey isolate form if lactose is an issue for you. If you prefer a plant-based protein powder look for sprouted varieties for easier digestion, but be aware that some of them have a higher fibre content which may not be suitable for you at this time. In which case, you might want to avoid protein powder all together. I mention it only because it’s an easy source of protein that you can mix with a bit of water – good if you don’t feel like eating anything.

6) Kefir (plain, unsweetened). A fermented dairy (cow, goat, or sheep’s milk) drink rich in beneficial bacteria – aka – probiotics. You can also find coconut kefir if dairy is an issue for you, however, if it’s the lactose that’s the problem know that much of it is broken down via the fermentation process. It’s NOT the same as drinking a glass of milk. I suggest drinking it on an empty stomach or at the beginning of a meal. (I also suggest taking probiotics in supplement form for a more therapeutic dose of beneficial bacteria).

7) Black, Ginger, or Peppermint Tea. Okay, technically not a food but can be soothing nonetheless. Black tea is nice because it’s quite rich in tannins making it particularly astringent, which is helpful for diarrhea or loose stools. Be careful with extremely hot liquids though as they can be irritating to an upset stomach/intestinal tract. Sometimes a splash of milk can make it a bit more soothing and comforting. If you’re doing the herbal teas just let them cool a bit so the temperature isn’t so extreme, drinking them warm rather than piping hot.

8) Be Careful with Fruit. It depends how sensitive your gut is feeling but you might add in some more fruit as things calm down a bit. Besides bananas, any other low FODMAP fruit such as oranges or kiwi (peeled) could be a safe option. Limit consumption to one serving at a time. If you really want your morning orange juice, stick with ¼ to ½ a cup per serving and dilute it with water. Cooked, peeled, and stewed fruit is also an option (even if not low FODMAP, such as apples and pears, as long as you can tolerate it).

9) Sprouted and Ground Chia/Flax seeds. I suggest adding this in only after things have calmed down a bit. Start with 1 tsp and work your way up to 1 tbsp per serving in water or perhaps over some well-cooked oats. Both ground flax and chia seeds provide a good source of soluble fibre which creates a gel in your intestinal tract when mixed with water and can provide bulk which is helpful in slowing things down. You can also use ground psyllium powder but be sure to couple it with a lot of water (I don’t suggest putting it on oats) to move it through your digestive tract as it’s very absorbable and can really bung things up if you’re not attentive to getting enough hydration. I suggest avoiding most other fibre powders and only introducing them very slowly as they can make symptoms worse (bloating, gas, diarrhea, cramping) in some people.

10) Water. Okay, I added this one just to make it an even ten. But I can’t underestimate the importance of getting in plenty of liquids – particularly relevant if you’re losing them! Adding in a pinch of sea salt (perhaps with a squeeze of fresh lemon or lime) is a nice way to replace lost electrolytes.

Keep in mind that the severity of your discomfort will determine which foods you can handle. Again, it bears repeating. Listen to your gut. Your body knows best. If something doesn’t feel right to you, don’t eat it!

Any soothing, gut-friendly foods you would add to this list?

Share your suggestions in the comments below!

xo Elaine

The Low FODMAP Diet 101 (what you should know)

If you’ve been hanging around with me for a little while now, either through my blog, email letters, or over on social media, you may have noticed I’ve been dropping the F-word quite a bit.

No, not that F-word. (I’m much classier than that ;))

I’m talking about FODMAPs.

Don’t worry…if you’re not sure what that word means you’re most definitely not alone.

In this post I’m giving you a brief overview of the Low FODMAP Diet, what exactly it is and how it works, and what you should know before you begin one.

But first…

What the heck is a FODMAP?

FODMAP is actually an acronym for a group of short-chained carbohydrates (certain sugars and fibres) that are poorly digested and absorbed in the small intestine, and as a result, lead to unpleasant digestive symptoms in some individuals who have a sensitive gut – typically associated with Irritable Bowel Syndrome (IBS) and other gut-related conditions, such as Small Intestinal Overgrowth (SIBO).

These poorly absorbed FODMAPS travel to the colon largely intact where they become food for the microbes (healthy or otherwise) that naturally reside there. As a by-product of this “break-down” or fermentation process, these microbes produce gases that can contribute to bloating, abdominal distension, pain, and cramping.

Furthermore, these undigested FODMAPs also have an osmotic effect, meaning they draw water into the intestines – which can contribute to further bloating and distention. And if you’re somebody who already has fast motility to begin with, this can equate to loose stools and diarrhea.

Overall, this lovely little combo of gas and water can lead to altered and unpredictable bowel motility – both constipation and loose stools.

Enter…

The Low FODMAP Diet as a Tool for IBS Sufferers

The Low FODMAP diet is a dietary regimen that was designed by researchers at Monash University in Australia to help minimize the GI (Gastrointestinal) symptoms associated with IBS.

Research has shown that up to 75% of IBS sufferers experience relief when following a low FODMAP diet.

With up to 15% of the world population suffering from this functional gut disorder and its associated symptoms of bloating, abdominal pain, distension, excess gas, and altered bowel motility (constipation and/or diarrhea), the ramifications of these findings is quite significant.

Although each person’s experience of IBS can greatly differ within the known range of symptoms, for many people it’s a debilitating condition that can severely affect their quality of life.

 

FODMAP stands for:

Fermentable (carbohydrates easily broken down by gut bacteria)

Oligosaccharides (Fructans and Galacto-oligosacchardies aka GOS)

Disaccharides (Lactose)

Monosaccharides (excess fructose)

And

Polyols (sugar alcohols such as sorbitol and mannitol)

As you can see it’s quite a mouthful, so let’s just stick with the acronym, shall we?

 

High FODMAP Foods

Here’s a brief sampling of some high FODMAP foods by their respective categories. It’s important to note that foods can contain more than one group of FODMAPs.

Fructans: wheat, barley, rye, onions, garlic, nectarines, dried figs, inulin (added to many packaged goods)

GOS: legumes, cashews, pistachios

Lactose: milk, yogurt, cottage cheese, ice cream

Excess Fructose: apples, pears, mangos, asparagus, honey, agave nectar, high-fructose corn syrup

Polyols: apples, apricots, blackberries, mushrooms, cauliflower, snow peas, sweeteners like xylitol, sorbitol, and mannitol

 

Low FODMAP Foods

This is by no means a complete list, but some of the foods considered to be low FODMAP include:

Grapes, oranges, blueberries, strawberries, bell peppers, bok choy, carrots, eggplant, most leafy greens, cucumbers, brown and white rice, quinoa, polenta, almond milk, goat cheese, feta, cheddar, lactose-free yogurt, chia seeds, hazelnuts, pumpkin seeds, walnuts, beef, chicken, eggs, fish, firm tofu, tempeh, butter, olive oil, coconut oil, apple cider vinegar, soy sauce, peanut butter, maple syrup, dark chocolate, stevia (w/out inulin, FOS, or chicory root), most spices (except onion and garlic powder), black, green, and white tea, peppermint tea, coffee.

Keep in mind that FODMAPs are a type of carbohydrate, so if the food contains no carbohydrates, such as the case with many animal proteins and pure fats (i.e. oils), it’s safe to assume that it wouldn’t contain any naturally occurring FODMAPs.

 

Size Matters (BIG TIME)

When following this diet it’s not enough to just eat from a list of low FODMAP foods and avoid lists of high FODMAP foods, because in many cases the portion size matters.

Some foods that are considered low FODMAP can quickly become high FODMAP when eaten in larger quantities, just as some foods that are considered high FODMAP can be considered low FODMAP (and enjoyed) in a smaller portion size (i.e. 1 tbsp. vs ½ a cup).

A great reference guide for portion sizes is the Monash University Low FODMAP Diet app that can be downloaded to your smartphone. I highly recommend it as it’s continually being updated with the latest FODMAP research. (see resources below).

 

How the Diet Works (3 Stages)

1) Elimination Phase. For 2 – 6 weeks all high FODMAP foods are restricted. The point of the elimination period is to get GI symptoms under control and to assess whether or not these foods might be contributing to your symptoms.

2) Reintroduction/Re-challenge Phase. Each group and subgroup of high FODMAP foods are methodically tested one at a time and in varying portion sizes to see which ones might be potential culprits. You may discover that you can handle a small serving size of some foods, but a larger quantity triggers symptoms. And it’s not uncommon to find that only 1 or 2 categories of FODMAPs are problematic for you.

3) Personalization Phase. Based on your findings you can customize your diet to your unique needs and preferences. Once you know which foods trigger your symptoms, you can continue to either limit them or modify the portion size to suit yourself. Since FODMAPs have a cumulative effect, you may be able to eat small amounts of your “trigger foods” as long as your total overall FODMAP load is low.

 

What You Should Know Before You Begin

Before jumping into the diet here are some important considerations to be aware of:

It’s a Temporary Diet. After you complete the Elimination phase of the diet, the goal is to only avoid (or reduce) those foods that trigger your symptoms while adding back in all of the others foods that don’t and that you enjoy. It’s not about eliminating all high FODMAP foods forever.

Don’t Equate FODMAPs with Unhealthy. As you likely noticed from the food lists above, many foods high in FODMAPS are actually quite nutritious and considered part of a sustainable healthy diet. Remember, the idea is to find out which foods trigger your symptoms (and in what quantities) and then introduce them back into your diet in a way that you can enjoy them without suffering and having to police every bite.

(Of course there are some that you can ditch for good if you please. I’m *looking* at you high-fructose corn syrup.)

It’s One Piece of the Digestive Health Puzzle. While some people experience a significant reduction in their symptoms when following this diet, there may still be other factors that need to be considered alongside a low FODMAP diet such as overall diet quality, eating behaviours, hydration, stress, intestinal infections, and other potential non-FODMAP food sensitivities.

It’s NOT the First Place to Start. As you’ve likely gathered by now, this diet can be quite restrictive. While a little sacrifice upfront in the short-term can mean long-term freedom and empowerment if you can pinpoint food culprits, there are still many other factors that should be addressed first (i.e. diet, eating habits) that can potentially provide a significant relief in symptoms without having to be so restrictive from the get-go.

Seek Guidance. If you’re seriously considering following this diet fully (as in ALL in), at the very least download the Monash University app as mentioned above. Better yet though, consider working with a Certified Nutritionist or natural health practitioner who is well-versed with this diet and can guide you through each phase while keeping you accountable. 

 

Final Thoughts: Is a Low FODMAP Diet Right for You?

If you suffer from IBS, or another functional gut disorder, and the associated symptoms of abdominal pain, constipation, diarrhea/loose stools, bloating, and/or distention, then it’s definitely worth considering. Although to reiterate the point mentioned above under the list of considerations, it’s definitely not the first place to start.

It also goes without saying that it’s always important to see your medical practitioner first to rule out more serious GI diseases (i.e. Celiac Disease, Inflammatory Bowel Disease) and some gynecological conditions, which can have similar symptoms to IBS.

With that said, individuals with Inflammatory Bowel Disease (i.e. Crohn’s) or Celiac Disease can have IBS-like symptoms occur at the same time, so in conjunction with the standard treatments for these conditions (i.e. a gluten-free diet for Celiac Disease), a low FODMAP diet may provide further relief.

 

Sources/Resources

Monash Low FODMAP Diet app: https://www.monash.edu/medicine/ccs/gastroenterology/fodmap/education/iphone-app

https://aboutibs.org/facts-about-ibs

http://fodmapmonash.blogspot.ca/

 

Heal Your Gut in 5 Steps (Part 5 of 5)

Note from Elaine: This is the final part of our 5-part series on Gut Health

You can access Part 1, Part 2, Part 3, and Part 4 via the links below.

Part 1: https://www.elainebrisebois.com/healyourgut-part1/

Part 2: https://www.elainebrisebois.com/healyourgut-part2/

Part 3: https://www.elainebrisebois.com/healyourgut-part3/

Part 4: https://www.elainebrisebois.com/healyourgut-part4/

We’ve made it all the way to the final part of the series! If you’re still here with me please know that I humbly salute you for sticking around right until the end.

I realize this is a lot of information to cover, but given how many people I consult with who struggle with digestive problems (not to mention the population at large), I believe this information is critical to understand.

Moving on to step-5 of the protocol…

Step #5: Rebalance

Admittedly, this final step of the series is often the most overlooked in favor for the other parts – namely the diet and supplements aspect.

Truthfully though, you can be following the perfect diet and supplement regime and still have digestive problems if you don’t take into consideration this final point. In other words, don’t discount it for being too easy (it’s not), or something to put off until later.

You might recall from part 3 that our gut is home to our enteric nervous system, commonly referred to as our “second brain” – the part of our nervous system that controls our gastrointestinal tract.

Our brain and gut are connected by an extensive network of neurons (nerve cells) and a “highway” of neurotransmitters and hormones. This highway is known as our “gut-brain-axis” and it continually provides feedback about how hungry we are, whether we’ve eaten something disagreeable, or whether or not we’re feeling anxious or stressed.

Those butterflies you get in your stomach before a big presentation that perhaps have you running for the bathroom? That’s your gut responding to your emotional state!

Re-balance refers to all of those other lifestyle factors that impact our gut health, such as proper stress management, daily physical activity, and getting adequate sleep.

You know, all of those things that you know are important but don’t always happen because “life” gets in the way.

Deep breathing, yoga, meditation, positive affirmations, getting outside in nature, spending time with loved ones, and making time for play can all influence the release of hormones and neurotransmitters that help us to relax and reduce the effects of stress in our lives, positively affecting our gut health and our bodies at large.

I’m not saying that you have to drastically overhaul your lifestyle overnight, but consider the small changes you can create in your daily routine that ensure you’re not neglecting this area.

Perhaps it’s starting with just a few small tweaks such as:

  • Switching your cellphone into airplane mode at 9 pm to ensure a restful sleep
  • Creating a morning routine that allows you to start your day off relaxed rather than frenzied and rushed, and actually makes you excited to get out of bed (yes, it’s possible!)
  • Listening to an inspiring podcast on your morning commute to help alleviate the frustration of traffic or a jammed-packed train or subway car
  • Going for a walk outside on your lunch break or before dinner to decompress from work
  • Scheduling a weekly yoga class or massage
  • Limiting television/Netflix time to the weekend so you free up time
  • Making regular dates to connect with family and friends

Keep in mind: Progress, not perfection.

There you have it! I hope you enjoyed this series on Gut Health. If you ever feel you could use some help or guidance putting all 5 of these steps into practice in your own life, I invite you to consider one of my 1-on-1 nutrition programs.

Much love,

Elaine

 

References:

The Good Gut: Taking Control of Your Weight, Your Mood and Your Long-Term Health, by Justin Sonnenburg and Erica Sonnenburg, PhDs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/

Heal Your Gut in 5 Steps (Part 4 of 5)

Special Note: This is the fourth part of a 5-part series on Gut Health.

I’ve included the link for Part 1, Part 2, and Part 3 below, and I suggest reading those first before jumping into this 4th step.

Part 1: https://www.elainebrisebois.com/healyourgut-part1/

Part 2: https://www.elainebrisebois.com/healyourgut-part2/

Part 3: https://www.elainebrisebois.com/healyourgut-part3/

Step #4: Repair

The fourth part of the 5-step protocol involves repairing and nourishing the gut lining through the use of select nutrients, herbs, and functional foods.

Recall, I already discussed antimicrobial, digestive aids, and probiotics/fermented foods in the previous steps so I won’t be mentioning them again here.

Furthermore, be absolutely sure to address (at the very least) step 1 and step 2 before implementing step 4, otherwise you won’t be getting to the root of your digestive problems.

When it comes to gut repair there are many great supplements on the market that you could potentially use. When I work with my clients I like to make things as simple as possible and we always begin with a gut healing diet first before introducing any gut repair supplements. Once the diet is in place, then I’ll introduce supplements as needed.

Below I’ve listed some of my top choices for gut healing.

Many of the supplements can be found in combination via targeted gut healing formulas available on the market. I suggest consulting with a natural health practitioner or nutritionist who specializes in this area to find the appropriate formula and dosages best suited for you.

Gut Healing Supplements

L-Glutamine
A building block of protein, l-Glutamine is the most abundant amino acid in the body. It’s considered “conditionally” essential because although our body can produce it naturally, during times of stress it’s required in greater amounts. It also happens to be the primary fuel source for the cells of the gut, and when taken therapeutically can help maintain the integrity of the gut wall, or “heal and seal” the lining. If you’re buying it on its own, I suggest getting the powder over capsule form since it’s easier to get a therapeutic amount without having to swallow a handful of capsules.

Demulcent Herbs: Slippery Elm, Marshmallow Root, and Deglycyrrhized Licorice (DGL)
These herbs are all mucilaginous which means they produce a slimy substance that coats, soothes and protects the lining of the GI tract. They can be particularly helpful for calming inflammation and soothing digestive discomforts. These herbs can be taken in powder, tea, capsules, and lozenge form. Foods high in mucilage that you can add to your diet include: flax seeds, chia seeds, and okra.

Zinc Carnosine
A unique combination of the essential mineral zinc, well known for its antioxidant and immune support role, but also its critical involvement in tissue repair. When bound to the dipeptide carnosine, it’s been shown to protect and stabilize the mucosal lining of the gastrointestinal tract, support healthy gastric microbial balance, and relieve gastric discomforts such as heartburn, bloating, nausea, and stomach upset.

Hydrolyzed Collagen Powder
The main structural protein in connective tissue, collagen is abundant in cartilage, tendons, ligaments, marrow, and bone. When collagen is cooked it becomes what we know as gelatin. Collagen and gelatin have similar healing properties and both are rich in amino acids (particularly glycine and proline) that help to rebuild the intestinal wall. You can supplement with both through good quality grass-fed sources. I personally like the collagen powder over gelatin powder since it’s cold and hot soluble, and can be easily added to a smoothie or a warm drink without it clumping up. The gelatin powder is better for recipes where you want that “Jello effect”. You can also consume gelatin through nourishing, homemade bone broths.

Other gut-healing options include:

  • NAG (N-acetyl glucosamine)
  • Omega-3 fatty acids (particularly those found in fish and the algae they feed on)
  • Quercetin
  • Turmeric (and Curcumin)
  • Colostrum
  • Gamma Oryzanol
  • Vitamins A, C, E

As I mentioned above, you can find many of these compounds in various “gut healing” formulas on the market, although some, such as omega-3 oils for example, would be best taken as a stand-alone product.

Stay tuned later this week for part 5—the final installment in this series!