IBS – or irritable bowel syndrome – is the label given to pretty much all gut pain that has ‘no known cause’. While IBS does affect about 15% of the adult population in Australia and other developed countries, there are other gut conditions that are less well known. These affect another 15% of adults and need different dietary management methods, but tend to be labelled as ‘IBS’.
In this blog, we are going to share our approaches to supporting Help Yourself clients find out what is really going on with their gut and demonstrate how a team approach and some good dietetic detective work can be needed to ‘get to the bottom’ of gut pain.
Our ‘first five’ steps for managing functional gut conditions are:
FIRST, we need to find out that our clients have a gut problem
This may sound odd, but more than half of the people we consult with are referred to us with a different health condition. We often only find out about cripplingly debilitating diarrhoea, pain, bloating, wind or constipation when we ask about lifestyle influences on eating or prompt a discussion about bowel habits.
Sensitive Talk: Understandably, our clients are embarrassed to mention their bowels the first time they meet us, but they are also incredibly relieved to tell someone who cares when asked!
SECOND, it can be hard to comprehend that such intense pain and symptoms have no ‘organic’ or structural cause
While it is somewhat reassuring to be told that there are no ‘red flags’ indicating the need for a colonoscopy or endoscopy, or a ‘negative’ (meaning nothing sinister is found) scope result, it begs the question how can ‘nothing’ be so debilitating’? A functional gut condition affects the function but not the ‘form’ (structure) of your gut, and is medically diagnosed based on the combination of symptoms you experience. For example, IBS relates to ‘mal’functioning of the large bowel whereas functional dyspepsia relates to the upper gut, with pain often experienced just below the rib cage. The location and nature of your symptoms provides our first clues for dietary management approaches.
THIRD, we want to hear your story!
Every client with a gut problem has a story – and we need to hear it.
Your ‘story’ gives us many clues about what could be going on in your gut. You may wonder why your dietitian is interested in your birth, your early life environment, how you manage stress, where you have travelled, where you work and what type of pets you have. All these factors influence either the bacteria in your gut or how your brain processes information from your gut.
Why? Your answers to these questions help us decide on our dietary management strategy.
FOURTH, we want to unravel your confusion
Combined with ‘your story’ we believe that you know your own body better than anyone, but that conflicting advice and information overload can leave you questioning your intuition about your body and the food you eat.
What is our role in in this?
Our responsibility as your dietary specialists is to use observation, association and expertise to match symptoms and diet, being mindful of not have our clients obsessing over everything they put in their mouth (because the obsessing can be a problem in itself).
FIFTH, time for a ‘RESET’
You deserve specialised, evidenced based advice to help implement a gut friendly way of eating that works with your lifestyle and gives you the tools to achieve a balanced diet overall.
We are very aware that clients who consult with us may have already spent a huge amount of time, energy and money on treatment methods that haven’t been tailored to their individual condition.
So, the bottom line here is:
Detective work happens before we actually start providing dietary advice. We aim to form a team with the client to work through their gut issues together.
In most cases, the likely appropriate dietary management approach becomes obvious within a consult or two, so we can get started with dietary management.
In other cases, where there are lots of contributing factors, complex health conditions and curve balls, it takes a bit longer.
What is our commitment?
We pride ourselves in our commitment to navigate the complexity with our clients and to persist until we optimise our dietary management approach.
In our next blog we will provide some insights into ‘classic cases’ of some of the common and a few unusual gut health conditions we have supported our clients to manage with dietary approaches.