In part 1 of my series on Intuitive Eating and IBS, I covered what IBS is, some of the possible causes/contributors to IBS symptoms, and how intuitive eating and a non-diet approach, especially when combined with medical nutrition therapy . can help support the management of IBS. I also broadly discussed the commonly recommended therapeutic diets for IBS and some of the potential advantages/disadvantages of elimination diets. Read it if you haven’t but basically the first one was that IBS is a very individual diagnosis and there is no single “right” way to treat it. What helps one person may not work for another and may even cause harm.
In part 2, I share specific non-diet tips and strategies for managing IBS. As I mentioned in Part 1, there may be some situations where reducing or eliminating a food is appropriate, but this is lot less common than it seems Dr. Google! For most people, I recommend using non-diet strategies before trying an elimination diet or giving up a food you love. I will note that some of these non-diet strategies involve food, but they are more about increasing intake and eating patterns, so I still consider them non-diet.
Non-diet strategies for managing IBS symptoms
Deep breathing before eating.
Because there is a strong connection between the brain and the gut, there is a strong link between stress and IBS. The vagus nerve runs from the brain down through the gut and is involved in regulating everything from breathing to heart rate to digestion (aka the autonomic nervous system). Most people are familiar with the “fight or flight” stress response (also called the sympathetic nervous system), which is part of the autonomic nervous system. In this condition, digestion slows down and blood flows away from the gut to the extremities. As you can guess – or maybe you’ve experienced it yourself! – when you are in a constant state of sympathetic activation, your IBS symptoms increase.
Another part of the autonomic nervous system, which is regulated by the vagus nerve, is the parasympathetic nervous system. Another name for our parasympathetic nervous system is “rest and digest.” In this condition, blood is directed to the intestine to aid in the digestion and absorption of nutrients and helping the muscles of the intestine to move things along.
To help activate your parasympathetic nervous system, it can be helpful to give yourself a moment of deep breathing before you eat. Any breathing technique that helps you feel calm is great, but I like to recommend diaphragmatic breathing, which stimulates the vagus nerve. Here is a helpful description and demonstration of diaphragmatic breathing. Even just 10 seconds of slow breathing can be helpful! Another meditation/breathing exercise I recommend is progressive muscle relaxationwhich I find to be especially beneficial for people who hold tension in their gut.
Aim to eat every 3-4 hours during the day.
One of the biggest IBS triggers I see in my clients is a chaotic eating plan. Eating on an irregular schedule, going long periods of time without eating and then eating larger amounts, can cause far more discomfort than any single food. In fact, I often find that when clients eat on a regular schedule, they can tolerate foods that were causing symptoms. While you don’t need to follow a strict diet plan, a steady flow of food is helpful as it gives your gut a chance to settle into a predictable rhythm. I will note that the 3-4 hour recommendation is a general recommendation to prevent prolonged periods without food, but some people may benefit from eating more often, and occasionally there may be someone who does better for longer periods.
Aim for balance at meals.
By balance, I mean I aim to include a source of protein, fat and carbohydrates in meals, ideally with some produce. As I described above, aiming for balance at meals allows your body to expect consistency in how you feed it. Also, each of the macronutrients stimulates the release of different digestive enzymes, which is helpful for digestion. Dietary patterns that are deficient or excessive in one or more of the macronutrients can lead to digestive symptoms. Including different foods in your meals helps ensure you don’t get too much or too little of anything.
Try gut hypnotherapy.
Gut hypnotherapy is a type of hypnotherapy, but for the gut. Hypnosis is nothing like the sensational depictions you often see in the media, but rather a therapist helping a client achieve a state of deep relaxation, then using guided imagery and meditation, as well as education about how the gut works. It sounds kind of “woo”, but there is research that shows it can reduce symptoms by up to 80% and it is just as effective as a low FODMAPS diet. Here is one useful article about treatment if you’d like to learn more, and here’s a list of trained providers intestinal hypnotherapy. If you can’t find a provider, I’ve had clients who have had good success Nerva, a hypnotherapy app that targets the gut.
Consider supplements.
There are a TON of supplements out there being thrown at people with IBS. I am quite cautious about recommending supplements as they are often not backed by rigorous research and can do more harm than good. The regulation of dietary supplements in the United States is also a bit poor. Just because something is natural doesn’t mean it’s harmless. Most medicines are originally derived from a natural source, and if something has a medicinal effect on your body, that means there are potential side effects. I guess the good news is that most supplements don’t actually do what they say, and the most likely result is what we like to call “expensive pee!”
That said, there are some supplements that may be beneficial for some people. Please note, these are not individual recommendations, and if you choose to try a supplement, do so under the guidance of your doctor or a dietitian experienced in IBS.
