Dealing with digestive issues, especially Irritable Bowel Syndrome (IBS), can be an incredibly frustrating and isolating experience. Many individuals, like Lesley, often turn to a dietitian as a last resort after exhausting various medical avenues, supplements, and even food intolerance tests that can lead to more confusion than answers.

In this blog post, we’ll explore a real-life case study of Lesley, a 45-year-old woman battling daily gut pain, discomfort, reflux, and other IBS-related symptoms. We’ll look at how Bianca, as a gut health and IBS dietitian, worked with Lesley to unravel the complexities of her condition. Note, for confidentiality reasons, this client’s identity has been changed.

Lesley’s Profile:

• Age: 45
• Symptoms: Debilitating gut pain, reflux, minor constipation, and bloating
• Medical History: Ulcerative colitis, long COVID, anxiety, depression, reflux
• Previous Input: GP, gastroenterologist, naturopath
• Diet: Following a restrictive diet based on a food intolerance test, avoiding most FODMAPs, and following a pescetarian diet
• Other Issues: Low energy, poor sleep

Lesley’s Initial Struggle:

Lesley approached Bianca feeling confused and highly anxious after grappling with gut issues for about two years. Her symptoms were taking a toll on her relationships, work, and mental health. She was determined to understand the root cause of her troubles and find clarity on what she could or couldn’t eat to alleviate her symptoms.

Collaborative Approach:

Over multiple sessions, Lesley and Bianca worked together on the following:

• Expanded Food Variety: Reintroduced foods that Lesley had eliminated based on the food intolerance test but were unlikely to cause gut issues, such as rice, fish, hard cheeses, eggs, spinach, herbs, and spices.
• FODMAP rechallenges: Individually tested different FODMAPs to identify sensitivities and then reintroduced well-tolerated FODMAPs back into Lesley’s diet.
• Supplement Adjustment: Identified and stopped supplements that were likely worsening gut symptoms.
• Fiber Increase: Gradually increased fiber intake to support regular bowel movements.
• Meal Guidance and Recipe Ideas: Provided meal and snack suggestions to ensure Lesley enjoyed a nutritionally balanced diet.
• Stress Management: Encouraged Lesley to speak with a psychologist and explored stress management techniques to address the connection between anxiety and gut pain.

Discovering the Root Cause:

As Lesley started to reintroduce foods back into her diet, she realised that food was not the cause of her IBS symptoms. A clear pattern between anxiety, poor sleep and gut pain arose and Lesley realised that her anxiety was the main trigger for her IBS. 

Outcome:

At the end of our sessions, Lesley had achieved significant improvements:

• Increased fiber intake for a regular bowel routine, eliminating constipation.
• Embraced a nutritionally balanced diet with a wider variety of foods.
• Understood the concept of visceral hypersensitivity, identifying anxiety as the major trigger for her IBS.
• Overcame food fears, confidently including most foods in her diet without impacting her IBS.
• Regularly seeing a psychologist and using stress management tools such as Nerva app, exercising, socialising and doing things she enjoyed to manage her anxiety and depression.

Lesley’s journey highlights the importance of a personalised approach to managing IBS. Think of IBS management as solving a puzzle. A single piece alone won’t do the trick, but when all the pieces come together—such as dietary adjustments, stress management, fiber supplements, and movement—they form the complete picture for effectively managing IBS. Remember, everyone’s puzzle is unique. Collaborating with a dietitian can help you identify the specific puzzle pieces that might be necessary for your individualized IBS management.

If you would like to speak with a dietitian about your gut symptoms, you can book in for your FREE Discovery Call today or contact us HERE. 

Published: 22nd January 2024

Author: Bianca Berton-Scarlet, Monash FODMAP trained Dietitian