Wondering how to Heal your IBS? This is the Strategy I use With my Clients as a Gut Health Nutritionist
Have you been diagnosed with IBS (or presume you have it based off your symptoms) — and feel confused, frustrated, and hopeless?
Worried that you’ll feel this way forever?
I get it 👋 I was in the same boat, and my clients who I work with, were/are right there with you.
I’m hoping this article will change these feelings for you, however 👀
IBS tends to be a “catch-all” diagnosis, where folks who meet the Rome iv diagnostic criteria and have ruled out other gastrointestinal issues (like Celiac, IBD), receive the label.
Typically in a gastro’s office, an IBS diagnosis will result in a recommendation for less stress, more water, maybe fiber supplements like Metamucil or Restoralax, probiotics like Align, or even scripts like Escitalopram, Motegrity, Omeprazole, or Linaclotide.
One of the greatest pleasures of being a gut health practitioner is when I get to speak with folks — whom have historically felt hopeless, confused, frustrated, and defeated navigating their digestive health issues — about strategies we can explore together, to help them get to the bottom of their gut issues.
Which is possible, BTW.
Before I share with you the step-by-step process I use with my clients to help them get to the bottom of their chronic gut issues — it’s important to understand the potential root-causes of your IBS.
There may be a few things at play driving your symptoms, and it’s important to know what may be contributing to how you’re feeling!
Common Root Causes of IBS and Digestive Issues
Below is a non-exhaustive list of common drivers for chronic digestive issues (they’re the more common ones I tend to see in practice! I definitely recommend a read through them to see if any of these may resonate with you and your case
Some other things that may be playing a role are things like post-infectious IBS, stealth infections, mold, etc.
NUTRIENT DEFICIENCIES
Nutrient deficiencies can impact our digestion in a number of ways. Lacking in certain nutrients (like sodium, zinc, iron, potassium, magnesium proteins, etc), can alter our ability to produce digestive secretions like stomach acid, bile, and enzymes. They can also impact our body’s ability to contract muscles throughout the digestive system, which plays a big role in our “motility” (how things move through the digestive tract). Without the raw materials to make sure we’re able to produce our digestive juices, and move stuff through our gut in a timely manner, symptoms can arise.
Food quantity also matters. Eating ENOUGH food is important (including adequate fiber intake!), to make sure our body can form healthy bowel movements 💩
CHRONIC STRESS
Simply put = stress shuts down our digestion. When our body experiences stress, the body prioritizes all functions that are necessary to deal with that stressor, and de-prioritizes all functions that aren’t as important in the moment… things like digestion 🙂
The chronic stress we face nowadays is a huge driver of digestive symptoms, including IBS presentations. Chronic stress can also impact our stomach acid production, which has a domino-like impact on the rest of our digestion, and can lead to different digestive symptoms, AND leave us more susceptible to things like microbial imbalances and infections.
POOR DIGESTIVE FUNCTION
(low stomach acid, poor bile flow, poor output of pancreatic or brush border enzymes)
Our digestive system produces different chemicals and fluids that help the breakdown process of our food, into their smallest parts, so we can absorb them through the intestinal barrier in the small intestine. Our digestion can suffer, and symptoms develop when our digestion is dysfunctional.
Gallbladder issues, or cholecystectomies, can impact our fat digestion, and poor bile function as a result can lead to a variety of digestive issues and imbalances.
Poor digestive function can not only lead to digestive symptoms, but also impact ALL the systems in our body, and can lead to symptoms and issues elsewhere 👀 (like in our hormones, skin health, thyroid function, detoxification, energy production pathways, etc)
IMBALANCES IN THE GUT MICROBIOME: LIKE DYSBIOSIS, SIBO
Whether it's not enough of the “good” bugs in our gut microbiome, or an overgrowth of the “bad” bugs, or both — imbalances in the gut microbiome can lead to symptoms like acid reflux, indigestion, bloating, gas, cramping, abdominal pain, discomfort, altered bowel movements, and more. I see this all the time in practice!
Infections like H.Pylori, parasites, and fungal or yeast overgrowth (like Candida overgrowth) can also play a role in IBS type presentations.
SIBO is a common dysbiosis pattern, and refers to an overgrowth of bacteria in the small intestine (too many bacteria, in the wrong place). The small intestine is the primary location where we absorb nutrients. Bacteria = ferment fibers in the GI = produce gases as a byproduct. Hence why some of the hallmark symptoms of SIBO and IMO (intestinal methanogen overgrowth) are bloating, distention, gas, abdominal pain and discomfort, and altered bowel movements! SIBO/IMO are MEGA drivers for IBS!
MOTILITY AND MMC ISSUES
“Motility” refers to wave-like movements that happen throughout our digestive tract, movings things along from the time we eat, to the time we poop. When we eat a meal, it can take upwards of 2 hours to digest. After our food is digested, the MMC springs into action, like a janitor in the GI tract, "sweeping" things along, so that they can be excreted from the body via stool. If these motility functions aren’t working properly, symptoms may develop (especially along the lines of constipation, bloating, distention, and gas).
HORMONAL IMBALANCES
Our hormones play a huge role in our gut health! Imbalances in our hormones — thyroid, stress, and reproductive — can contribute to GI symptoms. Low thyroid function can slow digestion and motility contributing to constipation and bloating, cortisol and adrenaline are involved in the stress response & impact digestion, and imbalances like low progesterone can lead to bloating and water retention. In many cases, our digestive system and hormonal pathways are in a reciprocal 🔄 relationship, meaning they can impact each other. It’s important to look at both!
STRUCTURAL ISSUES
Structural abnormalities, adhesions, scar tissue, physical alterations due to physical traumas, endometriosis, and surgeries in the abdominal cavity, can all impact our digestive system’s ability to function well. These structural ‘issues’ can alter movement and motility throughout the GI tract, disrupting microbial balance, and potentially contributing to symptoms.
My IBS Healing Framework
Inside my 1:1 programs, my clients and I use a completely personalized, phased approach that leads to incredible health outcomes.
Through this method, I’ve had clients:
☑️ Get rid of their GERD, IBS-D, lose over 20 lbs (without actively trying to lose weight), and improve blood markers like HBa1C, lipids, and thyroid antibodies 📊 (you’ll read more about this case below!)
☑️ Overcome constipation (with a long-term on reliance on laxatives), significant food sensitivities, improve anxiety, fibromyalgia symptoms, and increase energy levels
☑️ Correct urgent, unreliable, loose bowel movements, get rid of bloating and acid reflux, and ditch food sensitivities 🥦
☑️ Wean off their long-term PPI use, heal acid reflux, and overcome bloating and irregular bowel movements 💩
☑️ Get pregnant (!!) after struggling with endometritis
… and so much more
Wondering how we did it?
Here’s the step-by-step process my clients and I follow inside my 1:1 programs:
📑 HEALTH HISTORY & NUTRITION AND LIFESTYLE AUDIT
Getting to know my client’s health history — basically everything that’s happened in their life until this point — is the first step. I always want to feel like I have the most comprehensive understanding of my client as a person, their health history, and what this client has experienced in their life leading to the point where they want to make change re: their health. This helps me make the most well-informed, personalized recommendations to help my clients get the best results possible.
This includes two main facets:
THE DEEP DIVE COMPREHENSIVE HEALTH HISTORY: This is where we look at symptom analysis, family health history, personal health history, medication/hospitalization/surgical history, lifestyle analysis, dental health, environmental analysis, and more.
LIFESTYLE AUDIT: Then we take an a audit of the clients current lifestyle (things like stress, work, sleep, movement, hydration, rest), nutrition, relationships, hobbies, and responsibilities, mental health) to see where there mat be opportunity for us in our work together
🧪 ROOT CAUSE & HEALING OPPORTUNITY DISCOVERY
Here’s where we consider the client’s health history and lifestyle audit, and we ask: what simple lifestyle contributors do we have the opportunity to tweak and adjust?
We also ask which types of labs might we consider to find more answers?
Things like:
bloodwork and micronutrient testing (we love to lean on what client’s have accessible to them via insurance coverage!)
conventional labs and diagnostic screenings
functional labs (stool tests, hormone panels, micronutrient testing, organic acids, etc.)
Labs can help us get much more clear on various root causes that could be driving symptoms, that we aren’t 100% sure on through analyzing symptoms 🤓
In practice, it’s always important to me that we’re using targeted, strategic labs. If lab results aren’t going to inform our work together moving forward, I don’t think there’s much point in running them — so we always choose very wisely!
🤝 FOUNDATIONS AND SYMPTOM RELIEF STRATEGIES
This is where we hone in on the important stuff (the fundamentals), while also focusing on symptom-relief tools (so clients can feel better — asap). It’s important to me that clients start to feel better, as soon as possible. Even if its using short-term “band-aid” strategies, while we work on root-cause.
Here, we look at things like:
supportive, personalized nutrition
sleep, circadian rhythm & rest
digestive function support
blood sugar regulation
nervous system & stress management
movement
detoxification
hydration
mental & emotional health
community
These are generally the “non-sexy” things that most of us likely know we should be prioritizing — they’re the fundamentals that’ll support good gut health long term, which is why we start here!
📊 TARGETED, STRATEGIC HEALING PROTOCOLS
We can use lab results, diagnostic screenings, bloodwork to our advantage — they can help inform the healing process and make strategic plans to address imbalances 🧪
Targeted healing protocols may look like therapeutic dosages, therapeutic diets, gut healing protocols (like H.Pylori or Candida eradication, or gut barrier repair), targeted mineral support, and more.
This is an important part of the healing journey, because even though the foundations make a huge influence on how we feel, it may take something like H. pylori, or mold, or candida eradication (or whatever) to resolve symptoms.
To give you a sense of what this could look like, here’s a mini-case study of a client of mine.
This client came to me with complaints of diarrhea, undigested food in stool, cramping, urgency, acid reflux, heartburn, elevated thyroid antibodies & goiter, and weight loss resistance, among some other things 🤠
We ran a GI MAP stool test for her, and went through the whole process I’ve covered here (health history and lifestyle audit, establishing foundations (especially liver support, strategic nutrition, blood sugar management, nervous system support) and symptom relief support). We also had blood work from her PCP to work with!
As it relates to the targeted protocols we developed for her, here’s what we found and what we did about it:
This is part of the H.Pylori panel on the GI MAP, showing elevated levels (correlating with a number of this clients symptoms).
This is part of the panel on the GI MAP showing commensal microbes in the gut microbiome. Some are overgrown, which may be related to the H.Pylori and low stomach acid output, and some are depleted (or so low, they weren’t even detected, like the Akkermansia muciniphila!), which may indicate a stressed or inflammed gut mucosa, and potentially gut barrier dysfunction (aka possibly a “leaky gut”).
This panel is showing some mild overgrowth; it’s not uncommon to see this patten with H.Pylori and low stomach acid output.
Elevated Anti-gliadin IgA showing an immune system reacting to a protein (gliadin) found in gluten.
Based on her GI MAP results, and her symptom presentation, we developed phased protocols including:
Microbiome Support: targeted nutrition and lifestyle strategies to promote a healthy microbial ecosystem, including targeted specific strains such as Akkermansia muciniphila and Faecalibacterium prausnitzii
H.Pylori Eradication: it’s likely the HP we found here was driving her upper GI symptoms, and her loose stool and poor digestion (it can also lead to downstream impacts like overgrowth of beneficial flora, and its common to see overgrowth in Strep like we did here)
Digestive Function Support: H.Pylori infections can hinder stomach acid production, which can create an environment further down the GI tract more susceptible to overgrowth and dysbiosis (like we saw a little bit here), as well as poor digestion. We focused on really leveling up her digestion via short-term supplemental strategies, and establishing good mealtime hygiene and lifestyle tools
Gut Barrier Repair: a few of the beneficial flora on her lab that came back low (or below detected limits), are important for the gut mucosa and integrity of the gut barrier (think “leaky gut”), so we implemented nutrition, lifestyle and supplemental support here
Gluten Free: We also trialled gluten removal based on her anti-gliadin IgA marker (showing an elevated immune response to the protein gliadin, found in gluten), which may have played a role in how much her thyroid antibodies came down!
These we’re broken down into ~4-5 phased protocols over the 6 months or so that we worked together.
(As an aside this client was able to overcome almost all her symptoms during our time together, with the exception of her thyroid stuff that was still to be worked towards!)
📈 ONGOING MAINTENANCE
I always tell my clients: it’s important, yes, to address & resolve symptoms bothering them now, but it’s also critical that we establish sustainable foundations that’ll help maintain good gut health LONG term — do they don’t end up back in the same spot in the future.
In this final step, we focus on two things:
Re-evaluating the foundations to make sure the fundamentals are dialed in — this is what’s really going to support long-term gut health and wellness.
Having toolkits available to clients for when life happens (ie. in the case of flare-ups, antibiotic use, food poisoning, when clients need a “reset”)
This looks different for everyone — and it’s all completely personalized based on a client’s health history and circumstance and lab results.
Looking for Help with Healing your IBS?
If you’d like to learn more about my 1:1 programs, and you’re interested in whether or not this method could be the right one for you, you can apply to work with me 1:1 via this application form.
If you seem like a good fit based on your application, I’ll reach out about booking in a 📞 free 25 minute connection call, where we can meet virtually on Zoom, chat through your case, and which options I have available to you that may be best suited to help you reach your health goals 👋
