DIY or with dietician - IBS?

I don't know if a dietician would be useful for IBS.

I am a DIY type and have for many years been health food focused. When it comes to my IBS-C. I finally got relief when I discovered the Monash University food app for FODMAPs and did a lot of Googling on IBS and FODMAPs.

Try to find an appropriate dietician if you are curious and go to one appointment to see if it has value.

Also, remember, stress can play a part. There is an app called Mahana. The first segment is extensive, useful, and free. My gastro recommended it and it was put together by a doctor. Very useful.

It is a journey. Regardless, experiment in some way and keep at it until you find what works for you.

I have the Monash app and have had a free consultation with a dietician who is trained in the Monash U protocol - but it’s expensive! I’ve had a persistent flare up and fell I need a more systematic regimen to eliminate and then reintroduce because I feel as if my episodes are becoming more frequent and prolonged. I am waiting for SIBO test results - took my first test ever yesterday. So I may wait and see what the results are.

I have combined the Institute of Functional Medicine elimination diet with the Monash Low Fodmap diet, plus only low or no histamine producing foods since May 10th. It is now June 16th. I will continue for 3 more weeks before reintroducing food one at a time. I am experimenting on myself. Two years ago, I became a Functional Medicine Coach in order to apply this medical approach and knowledge to myself. If I find substantial, meaningful change, I will have my own personal experience to share. After 5 weeks of these food plans, I feel much better and will continue another 3 weeks. Two years ago, my BMI was in the morbidly obese category, Now I'm in the obese category and hopefully this year, I will be in the overweight category. In the hospital and under anesthesia, I had a colonoscopy/endoscopy and found out I have a redundant/tortuous colon. My gastritis symptoms have gone down to mild (no medication nec,) and I'm awaiting biopsies from both ends. After 5 weeks on these combined diets, I still experience extreme constipation with no urge. I take Digest Tone (Triphala and Rose, an Ayurvedic formula). I get a Xolair injection (a monoclonal antibody that inhibits IgE production) eve. 2 mos. for an autoimmune condition. I'll keep you posted as to the benefits of this regime and what I find out after reintroduction of foods.

From my light readings on SIBO, a periodic antibiotic "cure" is recommended. I can't remember if there is a diet change recommendation. I was tested for SIBO and came up negative; the doc wants me to do another, perhaps more sensitive (and expensive) SIBO test, but I just don't have any SIBO symptoms (I have IBS-C and the "C" doesn't seem to be SIBO at all).

I feel for you -- a persistent flare up is no fun at all. I didn't go into it at length, but I have to eat the Monash App-listed zero or trace FODMAP foods to get relief, and not too much of any one thing or too much food at once. Overlay that with no lactose and no grains (even rice bothers me), enough sleep, and reduced stress -- then I do just fine, which is better than no path to that outcome.

I would love a solution that doesn't require me to limit my food so much but I haven't found one yet.

Consider if the extreme constipation (I had that recently) is caused by one or more supplements.

I had made two supp changes at about the same time - adding in Melatonin and ground psyllium husk.

I added in the Melatonin based on a study of healthy-gut people (so not me) and the psyllium husk based on reports it is good for "C" and weight loss. However, the husk slows down digestion and that may not be good for a redundant colon.

I don't know which one, both, or neither of these supps slowed my bowel down to complete inaction, but I am better now and I am no longer experimenting with these supps.

What did you take for your constipation? I also am on meds and get constipated. Finally did a magnesium stratagem drink which cleaned me out but would prefer other options

candidough47
I have found adding a probiotic has helped with my severe constipation: Seeking Health Probiota 12. I take it every other day as well as Magnesium Citrate 110mg 2x/day; one w/lunch at one dose at bedtime. So far fibers are not working for me as they cause digestive upset in the tiniest amounts.

Antibiotics do not cure SIBO. Antibiotics kill good and bad bacteria. You need the good. You may feel good after taking the antibiotics but symptoms return. If you have SIBO, learn about the causes of SIBO. There’s a great book called Super Gut by Dr. William Davis, especially if you’re a DIY person. If not read it anyway-shares foods to eat, recipes, etc.
Find a good doctor that not only tests for SIBO but knows how to treat it without prescription or OTC drugs. Those are just a band aid and not chemicals you want to be on for years. Our bodies were not made for chemicals. Yes some are necessary for some terrible diseases like cancer. And yes, hormone balance is important and sometimes those meds are necessary.
I had 3 endoscopies and all treated with prescriptions. Symptoms always returned. Finally the last GI after my 3rd endoscopy told me to never take a PPI again as my intestinal cells were enlarged.
I turned to functional medicine and never looked back.
Good luck to you, wishing you the best to heal.

My exteme, dead-in-the-water bowel? Colace itself wasn't enough, so Colace 2 in 1 (with a stimulant). At bedtime. Max recommended dose. Way back when, I had a gastro doctor I trusted who said that brand was gentle yet effective. As my gut gets more sensitive, it is now a bit harsh, but I was in an emergency situation.

Now, to mitigate the risk of constipation, and all the way to when constipated, I have three tools in my toolkit right now.

Proactive: I just started this but have had good success so far. Practicing good morning bowel habits. It seems too easy or silly, but it helped a lot. See paragraph 3. https://www.kentcht.nhs.uk/wp-content/uploads/2019/08/Bowel-emptying-techniques-00946-v5.pdf

Stepping it up: This massage regime. I lay down with my left side on the bed or floor for the end of the regime; it can really has helped move stool that feels stuck. Again it may seem too easy to work, but it does for me.
https://www.wchc.nhs.uk/content/uploads/2019/12/Self-abdominal-massage.pdf
Final step: Mineral oil. I first tried one Tablespoon after lunch as recommended. It seemed to make me more comfortable and it worked the next morning. The dose was too harsh for me and I now take it at night if I need it. My dose is 1/2 teaspoon or 1/4 teaspoon close to bedtime. It does seem to get the job done and is more gentle than what I have tried to date.
https://www.health.harvard.edu/diseases-and-conditions/dont-bomb-the-bowel-with-laxatives
(I also mitigate constipation risk by really chewing my food thoroughly (first stage of digestion) and sipping water throughout the day. Don't discount these two measures -- basic but important.

I feel like this is one of those things where the immediate instinct is to go without a dietician because it seems deceptively simple (I did it too!) and there are so many blogs and resources, including the blog itself.

But I’ve done it both ways—on my own and eventually with a GI dietician and let me tell you I wish I would have done it with a GI dietician out of the gate.

By the time I got to her, I still had symptoms; my diet was needlessly restricted; I developed food anxiety/stress/confusion (which research shows is a very high risk of restrictive diets and GI conditions)—which was probably making my symptoms worse; and I was at risk of disordered eating. I never would have thought I would be susceptible to that, and honestly I probably wouldn’t have listened to someone if they told me what I’m saying now…

But I learned from my GI RD and GI psychologist (after very, very long wait times) that these are very common “side effects” of the low FODMAP diet, so much so that the approaches at academic medical centers are changing so that they don’t recommend it to every patient, and if they do, it’s not as strict and more targeted at the most likely problematic foods, and always with an emphasis on having the most diverse eating pattern possible with the least restriction. But that’s rarely reflected on blogs and the internet and might not make it out to providers who aren’t able to keep up with the current research or perspectives.

That’s my two cents… I know it’s a privilege to even have or find a GI dietician, but I feel it’s worth it, because I’ve made more progress and more quickly, and without as much stress. Sadly, I’ve had to put in the work to overcome the food stress/confusion and disordered or unhelpful thoughts around food (though I do not have an eating disorder), because so many people and providers bandied about worksheets and flippant remarks about restrictive diet that I felt like I “should” be able to fix myself (spoiler alert: it’s not our fault, and food isn’t always medicine). I learned the hard way that the low FODMAP diet is a medical intervention, and like any medical intervention, it has benefits and risks and a potential placebo effect.

Some people still do really great with it though, and on their own too. But it’s worth looking into finding a GI dietician and how hard it may or may not be where you are. Hope you feel better soon.