Many people use acid-blocking medication to address symptoms of heartburn, acid reflux, and stomach burning. But so often, these symptoms are actually caused by too little stomach acid. Surprising, right?!
Indicators that you may need to increase your stomach acid include:
Constipation (stomach acid helps keep your intestines moving)
Low Vitamin B12 or Iron (stomach acid is necessary for your body to absorb B12 and Iron)
Gut dysbiosis or infections (stomach acid helps make your gut environment unfriendly to infections
This week, I made a video for you, explaining how to increase your stomach acid to reduce symptoms and improve your digestive health.
Bloating is one of the most common symptoms of IBS and SIBO, and one of the most uncomfortable. Along with frequent diarrhea or constipation, bloating is probably the symptom that drives most clients to seek help.
Luckily, with some concerted effort, bloating is one of the symptoms that responds well to dietary and lifestyle habit interventions. In today’s post, I’m going to share my top 6 tips for natural bloating relief to reduce bloating due to IBS or SIBO.
What Are the Primary Causes of Bloating?
There are really just a few primary causes of bloating. A huge one is bacterial overgrowth in the intestines. Bacteria eat and excrete, just like we do. Their excretion is gas.
Some bacterial gases that can cause bloating include methane, hydrogen, and hydrogen sulfide. This last one can cause rotten egg farts, and bad breath.
Bacteria generally like to feed on sugars or starches, and this is why a diet like the Low FODMAP diet, that reduces the amount of certain fermentable starches, often helps you feel better if you suffer from bloating. Another microbiome culprit of bloating is yeasts, like candida.
The other main cause of bloating is constipation or slow gut motility. When your gut slows down, this can make it more likely for gases to build up before they are released, and this can make you feel super uncomfortable!
Some people have bloating so severe that they look pregnant by the end of the day.
Therefore my natural bloating relief tips are going to address these root causes.
Natural Bloating Relief Tips
Natural Bloating Relief Tip # 1: Stress
The first thing I want to talk about is stress. You might roll your eyes at me, but stress is a huge trigger for digestive symptoms of any kind. Stress puts your body into fight or flight mode. When this happens, your digestion slows or stops. To keep your digestion moving well, you want to be in the “rest and digest” state. To tame stress, identify your triggers, address the things you can, and create a plan to manage the stress from things you can’t control. Managing this type of stress includes meditation or mindfulness practices, physical activity, laughing regularly, therapy, and doing things you love. You owe it to yourself to handle this first.
Natural Bloating Relief Tip #2: Identify Your Food Triggers
You can make a lot of forward progress with bloating by investing time to identify your food triggers. This helps you get your symptoms under control relatively quickly. One of the easiest ways to figure out your food triggers is to work closely with a Food-Symptom Diary. (If you don’t already have mine, you can grab your free copy here and get right to work.)
Once you are feeling a little better, you can turn your attention to healing deeper layers of gut dysfunction, and hopefully expand your food choices again to a more normal template. Here are some food types that may be contributing to your symptoms to consider:
FODMAPs: FODMAPs are types of carbohydrates that feed bacteria, and may lead to a symptom flare. The goal is not to avoid ALL high FODMAP foods, but to identify the particular ones that flare your symptoms. Check out my video Low FODMAP Diet for IBS and the blog Your IBS Diet Plan in Context for instructions on how to do this.
High Carb Diet: Too much carbohydrate, sugar, and starch may be your issue. Most of this may be covered by considering FODMAP foods, but in some cases, it may be more broad than that. See if reducing your carbs while increasing your proteins and fats helps.
Too Much Fiber:Too much fiber, especially too much too fast can lead to bloating. You can reduce your intake of fiber (or prebiotics), or back off entirely until you work through other root causes.
Too Much Fat: Some people experience bloating if they eat too much fat. Some are sensitive to animal protein, while others are sensitive to industrial seed oils like canola, soy, and cottonseeed, which can easily become rancid. And for some of you, no matter what the fat is, your gall bladder is struggling to produce enough bile to help break down your fats. Figuring out which situation applies to you can help you make the right choices.
Natural Bloating Relief Tip #3: Support Basic Digestive Function
No matter your digestive troubles, you should always be supporting your basic digestive function. For a more in depth discussion of how to do this, check out my video Digestion Tips for IBS and SIBO. But here are the top three to get you started:
Stomach Acid: Stomach acid greatly helps your digestive tract keep moving, and so helps with bloating. You can support stomach acid by using a little apple cider vinegar or lemon juice in water before meals, or by using betaine hydrochloric acid (HCL) capsules.
Enzymes: Enzymes help your food break all the way down, which may reduce the symptoms of bloating. If carbs are a problem, look for enzymes with amylase. If fats are a problem, make sure you are getting lipase or ox bile. And if proteins aggravate your bloating, make sure there is some protease in there (and you did follow the previous step of stomach acid, too, right? This helps protein break down fully.)
The RIGHT Probiotics (usually no histamine producers): Probiotics are important for good digestive and immune function, but the wrong kinds can aggravate bloating. This is especially true if you are struggling with methane-dominant SIBO or histamine intolerance. Make sure to choose probiotics that don’t have histamine producing strains. Check out my video Probiotics Guide for IBS and SIBO for more information.
Natural Bloating Relief Tip #4: Get Your Gut Moving
Oftentimes bloating is closely related to how quickly your food is moving through your intestines. The more slowly it is moving through, the more bloating you are likely to have. Check out these tips for helping your digestion move along at a normal pace.
Exercise: The physical jostling of exercise helps move the bowels, and it also creates beneficial biochemical changes. At least a daily walk helps keep things moving.
Stretching and Yoga: My colleagues and friends, Ben and Rupali Brown, owners of Pali Yoga in Eureka, CA shared this with me about yoga poses that are beneficial for bloating (You can read their whole post with photos of the poses over on their blog here):
“Simple yoga poses can go along way towards helping to relieve the symptoms of belly bloating. By practicing a range of asanas, we get our bodies moving, which increases blood flow and aids in the expulsion of gas and excessive fluid retention. There are both physical and mental results of these poses that will positively effect belly bloating.
Simple inversions, such as headstand and handstand, calm the nervous system and give gas an easy pathway out of the body. Twisting, like in Supta Matsyendrasana (reclined twist pose) stimulates your internal organs and helps you move internal stagnation. Forward folds, such as uttanasana (standing forward fold), apasana (knees to chest pose), malasana (yogic squat), balasana (child’s pose) can also put direct pressure on the abdomen to help expel gas. More poses that can help include Setubandhasna (Bridge Pose) and Marjariasana Pose (Cat Pose) can be helpful as well.
Additionally, breathing in a way that encourages abdominal contraction on the exhale and dilation on the inhale will increase peristaltic motion. Lastly the benefits of calming the nervous system and reducing anxiety will have perhaps the greatest impact on the healthy functioning of our digestive system, discouraging the over-production of gases in the first place. We encourage practicing these poses and holding each for approximately thirty seconds, and repeating as needed.”
Prokinetics (ginger, LDN): Certain herbal or pharma consumables help encourage intestinal motility. These include Ginger, and low-dose naltrexone (LDN). A few commercial products that help include MotilPro by Pure Encapsulations, and Iberogast by Iberogast, and Motility Activator by Integrative Therapeutics. (You can find these products in my online supplement dispensary at FullScript.)
Massage: Loving up your belly with a little massage oil every now and then can encourage your motility. And come on, this isn’t so hard! It feel’s nice! The main thing is to always work in a clockwise direction, because this is the direction of flow for your large intestine. Try small circles all around the perimeter of your belly.
Adhesions: If chronic constipation and slow motility are a huge contributor to your bloating, you may have abdominal adhesions or scar tissue physically pulling on your intestines and slowing their flow. The gold standard for this work is the Clear Passage Clinics. There are several around the country, and they have had amazing success treating abdominal adhesions in their patients. Or look for a massage therapist or physical therapist in your area who specializes in working with adhesions.
Enemas: Regular enemas can help keep things moving. This particular tip has been a HUGE help for me. If you make a mistake with a trigger food and you’re really uncomfortable, a simple water enema, or enema with some medicinal components can relieve the pressure and allow the gas to move out quickly.
Vagus Nerve Support: The vagus nerve is the super communication highway between your brain and your gut. It is a major contributor to gut motility, so encouraging vagus nerve function can keep your gut moving. Check out my video Digestion Tips for IBS and SIBO for more information about how to stimulate the vagus nerve.
Natural Bloating Relief Tip #5: Correctly Identify Infections and Treat, In the Right Order, for a Long Enough Time
Gut infections and dysbiosis can be a significant contributor to bloating. Parasites, bacteria, and yeasts can aggravate the lining of your gut, produce excess gas and toxins, and blow you up like a balloon, especially the bacterial infections. For more information on this topic, check out my video Gut Microbiome Testing for IBS and SIBO.
Parasites: Parasites, if present, must be addressed first. To skip over this step will usually render any other attempts to deal with bacterial or yeast infections ineffective. Parasites are also somewhat difficult to find with culturing or microscopy stool samples, DNA-PCR analysis can find parasites much more reliably.
SIBO: A very frequent underlying cause to ongoing bloating is SIBO, or Small Intestinal Bacterial Overgrowth. Testing is relatively simple, and treatment includes many of the things I’ve discussed here. If you are having trouble locating a practitioner who offers SIBO testing, please schedule an assessment session with me to discuss.
Yeasts: Yeasts like Candida may be aggravating your bloating, but can only be addressed after any parasites or bacterial problems have been cleared up. Stool testing with a DNA-PCR analysis, like the GI-MAP really helps to identify the level of yeast, and is superior to stool testing that attempts to culture the microorganisms. Yeasts are very difficult to culture.
Natural Bloating Relief Tip #6: Absorb Gases
One last possible way to help is to use binders or herbs that help to absorb the excess gasses that are causing pressure. You may not want to choose this route if you struggle with constipation, as binders may slow things down. Here are two options.
Atrantil: A product designed by a gastroenterologist, this three-herb formula can really help reduce bloating. (I don’t have any affiliation with Atrantil, I’ve just used it and found that it worked).
Binders like clay and activated charcoal: These can also be really valuable, but must be taken on an empty stomach and away from food. The one I use is called GI Detox, by Bio-Botanical Research (also no affiliation).
Conclusion
I hope that all these bloating tips can help you find some relief from your bloating, no matter the cause. Now that you know what to try, where will you focus your attention first? Leave me a comment or a question below.
If all this information feels overwhelming, know that you don’t need to stress about it. I’m here to help you! If you need some extra help sorting out how to make sense of this for your unique situation, I encourage you to do one of two things:
Histamine is a naturally-occurring compound in your body. It is an essential part of your immune system, and is also a neurotransmitter and helps regulate your digestive system. One of the possible root causes of digestive challenges, such as diarrhea and nausea, along with a host of other symptoms, can be caused by histamine intolerance. In today’s post, I want to explain histamine intolerance, help you determine if histamine intolerance may be part of your symptom picture, and help you understand what to do about it.
Histamine Metabolism
Histamine is naturally produced in your digestive system, in brain synapses, and by immune lymphocytes called basophils as well as MAST cells. There are high concentrations of these types of cells in your tissues that are prone to exposure or injury, especially mucous membranes). When a basophil or MAST cell is exposed to the right type of antigen (allergen), the cell “degranulates” and releases histamine to try to destroy the invader.
Histamine also helps regulate your daily body clock, stomach acid secretion, blood vessel dilation, appetite, body temperature, endocrine balance, and itch perception.
So histamine is an important regulator and player in your body!
Excess histamine is broken down by two primary pathways in your body: with the DAO (Diamine oxidase) enzyme and the HNMT (Histamine n-methyltransferase) enzyme and is supported by the methylation process (see What the Heck is Methylation https://confluencenutrition.comwhat-the-heck-is-methylation/). DAO is responsible for breaking down excess histamine in your digestive tract, while HNMT degrades histamine in the nervous system.
Usually, these enzymes break down excess histamine, and you don’t even notice. But if one or both of these enzymes aren’t working properly, or the intake or creation of histamine overwhelms your ability to clear it, you can start to experience histamine intolerance symptoms.
Histamine Intolerance Symptoms
Excess circulating histamine can cause a wide range of symptoms. To complicate matters, the severity of the symptoms can vary widely, and reactions may be delayed making pinpointing the offender difficult.
The classic signs of histamine intolerance include flushing skin or rashes (including hives), itching, and headache, but may also include itchy throat or eyes, fatigue, anxiety or heart palpitations, eczema or rosacea, nasal congestion, dizziness, shortness of breath, and tinnitus or hearing problems.
As always, these symptoms can also indicate other issues as well, so it’s important to create a holistic picture of your case, and to place the symptoms in context to make sure that we are fully understanding what’s involved in your picture, and to make sure we are focusing on the correct things. (See the blog How to Use These 2 Functional Medicine Tools to Clarify Your Path to Healing.)
Histamine Intolerance Root Causes
There are multiple possible reasons that histamine intolerance could be an issue for you, and creating the appropriate solution requires getting clear on your unique root causes.
The first place to always begin is with the food you are putting in your mouth each day. Foods can contribute to the problem if they are high histamine foods, if they are histamine liberator foods, OR if they impede the function of the DAO enzyme.
Some of the most common histamine problem foods include: fermented foods or beverages (kombucha, kefir, sauerkraut, miso, tofu, tempeh, etc.), processed or cured meats (salami, prosciutto, bacon, bologna, ham, luncheon meat, etc.), bone broth, alcohol, vinegars, avocado, tomatoes, and really ripe or overripe fruits.
Another reason for histamine issues can be dysbiosis or gut damage. This impacts your gut’s ability to produce the DAO enzyme that breaks down histamine.
If you also happen to have high amounts of bacteria that produce histamine, you may have histamine flares when you eat foods that encourage these bacteria. Candida toxins may also flare histamine symptoms.
Additionally, if you have a leaky or permeable gut (See video on How to Fix a Leaky Gut below), immune triggers may be sneaking through your gut lining and triggering a histamine response.
Or the problem may be that you are deficient in some of the nutrients that support methylation, which helps break down your histamine. The most important co-factors, which I find many people are deficient in, include vitamin C, vitamins B6, B12, and folate, as well as magnesium.
Finally, some people may have genetics that reduce their efficiency at breaking down their excess histamine. This includes people with certain MTHFR mutations.
How to Tell if Histamine Intolerance is a Problem for You
If you suspect that histamine intolerance may be part of your symptom challenges, here is a step by step way to expand your awareness and build understanding of what your body is doing.
With these broad lists of foods high in one particular food element, the goal isn’t to remove ALL the foods. This isn’t possible, and generally isn’t advisable, because we want to keep you eating as wide a variety of foods as possible. The goal is to clearly identify YOUR unique symptoms triggers and to focus your attention there.
Take a look at the Histamine Handout and mark the histamine foods that you regularly eat (daily or very frequently). Using your Food-Symptom Diary to track your food for a few days, taking particular note of the histamine foods, and how your body responds (there are instructions for how to use the Food-Symptom Diary inside it).
Can you see any correlation between when you eat the histamine foods and your symptoms flares? Make sure to note any and all signs or symptoms in the Symptom column of your diary.
If you DO notice a correlation between eating the histamine foods and your symptoms, try reducing or removing that food for a short while, 1-2 weeks. Keep note of your symptoms, and see if they decrease.
After you’ve completed the elimination exercise, eat a trial serving of one of your suspected foods, and keep your eyes on your symptoms for a few days afterwards. Did your symptoms flare up again? If so, that food may need to come out of your diet for a period of time, or you can experiment with dosage or timing to see how you can tolerate it. For example, you may be able to eat tomatoes once a week, but more frequently causes a flare.
Other Steps to Support Histamine Intolerance Symptoms
The food changes are only one part of the process of resolving a histamine imbalance, and there is more you can do to resolve the root causes. Here are some other places you can focus your investigations to get to the bottom of your histamine issue.
Consider gut testing to see if SIBO or other gut infections are a factor, and address what you find. Sometimes these infections can really aggravate a histamine situation, particularly SIBO, candida, or other bacterial overgrowth. (See Gut Testing for IBS and SIBO for more info).
Add methylation support supplements. Because the methylation process helps break down excess histamine for eliminiation, supporting methylation can help. These nutrients include vitamin C, vitamin B6, B12, methylfolate, and magnesium.
Natural antihistamines can help with symptoms while you address underlying causes. Options include quercetin, vitamin C with bioflavinoids, and DAO enzyme.
Reduce or eliminate alcohol: Alcohol is a histamine double-whammy because it is very high in histamine, but also reduces the effectiveness of your available DAO enzyme.
Should you feel that you’re on the right track, but the details are confusing, or you need some more help getting gut testing, or interpreting your Food-Symptom Diary, please schedule a free 30-minute assessment session with me, to find out how I can help you work through this process.
This week is Endometriosis Awareness Week, and as I had my own journey with Endometriosis (see my latest YouTube video where I talk about it HERE), I wanted to share what I learned about eating a proper endometriosis diet with you.
Endometriosis is a complex condition that is largely misunderstood. But like every complex health challenge, diet and lifestyle factors are significant contributors to your ability to manage and cope. In today’s blog, I’d like to share what I’ve learned about how to eat an endometriosis diet to minimize symptoms.
Endometriosis 101: What Is It?
Endometriosis is an inflammatory, possibly autoimmune disease, where tissue like the inner lining of your uterus, or endometrium, is found outside your uterus. The misplaced endometrial tissue responds to your monthly hormone cycle just like your uterus lining, and this causes inflammation, swelling, scar tissue build up, pain, and adhesions.
The most root-cause resolution approach for treating endometriosis is wide-excision surgery, which removes all of the visible endometriosis tissue with a wide margin of healthy looking tissue. Though there is some recurrence rate, it is much lower than more conventional laproscopic cauterization surgery, and is certainly far more effective than hormonal or other pharmaceutical treatments.
However, these treatments are only one side of the coin. Endometriosis, especially long-term endo, often causes secondary problems, which need to be addressed in addition to surgery for best long term success. Many of these secondary problems are manageable with diet and lifestyle. These include things like: IBS, SIBO, generalized gut dysbiois and leaky gut and the downstream nutrient deficiencies this can lead to, adrenal fatigue, underlying hormone imbalances, food sensitivities, interstitial cystitis or other bladder problems, and internal structural problems due to scar tissue.
Though it can be tempting to try to “attack” all these issues aggressively, the most real, lasting effects are gained by drawing your attention back to the basics, and to create a nourishing, supportive environment, where your body’s cells fundamentally get what they need.
What to Eat and What Not to Eat on an Endometriosis Diet
As with most other inflammatory conditions, an endometriosis diet template reduces or removes inflammatory foods like gluten, rancid vegetable oils, dairy, sugar, and processed foods as a starting place for eating. But here are few specific considerations that may help you find your way to the least symptom-tiggering endometriosis diet.
WHAT TO AVOID on your Endometriosis Diet
Dairy products
No matter whether your sensitivity or dairy source, all dairy products come from a lactating or pregnant cows, and therefore all contain hormones. Because endometriosis is generally hormonally mediated, naturally-occurring hormones from dairy can aggravate the mixed up hormonal messages your body is already experiencing or sending. Avoid dairy products or evaluate each type to see if they affect your symptoms.
Industrial Seed Oils and Trans-Fats
As Americans, we generally over consume industrial seed oils like canola, safflower, sunflower, soy, and cottonseed oils. These oils are easily oxidized, or turn rancid, and this rancidity causes inflammation in your body, especially when not balanced by an abundance of omega-3 fatty acids, like those from fish and seafood.
Reduce or eliminate these seed oils, and replace with olive, coconut, or avocado oil for cooking, and sesame or flax oils for cold uses. You can also increase your consumption of fatty fish or consume a fish oil supplement.
Red meat and Farm-Raised Fish
Many women with endometriosis find that red meat or farmed fish aggravates their endometriosis. For some people, red meat consumption increases inflammatory cytokines, which leads to more pain. Meanwhile, farm-raised fish is raised in toxic, chemical-laden ponds, and is often given antibiotics.
If you can, purchase organic, grass-fed or pasture-raised meat, and wild-caught seafood. Avoid seafood that accumulates toxins like mercury, such as mackerel, merlin, shark, tuna, bluefin, and orange roughy. Commonly farmed fish include tilapia, catfish, and salmon. Choose short-lived fish and seafood species such as wild-caught salmon, cod, shrimp, and pollock.
Oxalate Foods
Oxalic acids naturally occurs in some foods. With certain gut conditions, oxalic acid can deposit into any body tissues and form sharp, jagged crystals. Oxalate crystals are the most frequent cause of kidney stones, and can often be involved with body pain.
Some common foods high in oxalates include spinach, chard, sweet potatoes, chocolate, almonds, peanuts, wheat, chia, and rhubarb. But before you run out and remove all foods these foods (please don’t do this!) you need to know that if you suspect oxalates to be a contributor to your pain, you must slowly reduce the oxalate content of your diet over a period of weeks. This prevents an episode of oxalate dumping, which can lead to a major pain flare. If this is you, I suggest working closely with someone who can guide you through this process. You can start by downloading my Food-Symptom Diary and doing a little tracking to see if you notice a correlation between your symptoms and oxalate foods.
Caffeine and Alcohol
Both caffeine and alcohol can increase the severity and incidence of endometriosis pain, and they can also affect your estrogen metabolism, which is also involved with endometriosis. Reduce or eliminate these from your diet, except for an occasional treat. Green tea is a wonderful substitute for caffeine, and is generally anti-inflammatory.
Sugar
Sugar is generally an inflammatory food, and depletes your body of important nutrients, including magnesium, vitamin D, calcium, chromium (which helps your sugar metabolism), and vitamin C. Since several of these nutrients support your immune function, sugar reduces your healthy immune response. Eliminating sugar can make a significant difference in your level of endometriosis pain, and your body’s ability to manage the inflammation and swelling.
WHAT TO INCLUDE on your Endometriosis Diet
Though it’s easy to say what you should avoid, I also want to take a moment to share a few foods that may be helpful for you to include to modulate your endometriosis. These foods help balance hormones, support proper hormone detoxification, keep your balanced blood sugar, and reduce inflammation.
Green Tea
Green tea contains powerful antioxidants that help clean up inflammatory damage in your body. A cup or two of green tea per day, or using supplemental ECGC can help.
Red Veggies and Fruits
These contain lycopene, another naturally-occuring antioxidant, which may reduce adhesion formation.
Cruciferous veggies contain a relatively high amount of sulfur compounds, which aid your liver in detoxing estrogens and other compounds.
Flaxseed
Flax has a reputation for being estrogenic, but it actually helps bind up the “bad” estrogens and eliminate them. Daily ground flax seeds are helpful to keep estrogen in check.
Fermented Foods
Sauerkraut, pickles, kombucha, and more are a wonderful source of beneficial and diverse good bacteria. Keep in mind that if you already struggle with IBS or SIBO, probiotic or fermented foods may not be the right thing until you handle this because increasing your intake of these foods may exacerbate your bloating or belly pain.
Evening Primrose Oil
This supplement may help with estrogen metabolism and to reduce pain.
Water
Drink plenty of clean, filtered water.
Conclusion
Changing your diet and taking a few supplements won’t likely make your endo go away, but it can make your symptoms largely manageable, and make your other treatments or pain management more effective. And these same dietary changes can help you manage the conditions downstream of your endo as well. By working methodically to shift your life terrain, you can expect to find your cycles less painful, as well as improved pain management, sleep, moods, and immune function.
If you are feeling confused about how to navigate all these choices to manage your endometriosis, I encourage you to reach out to me and schedule a free 30-minute assessment session. I can help you set a course for success.
If you’re not ready for that yet, I invite you to download my free guide, Roadmap to Recovery, where I share the how you can make sense of what your body is telling you so you can experience relief from your most pressing symptoms.
Having an IBS (Irritable Bowel Syndrome) flare is no fun.
To illustrate, imagine this scenario:
I live a 90-minute drive over remote mountain roads from the nearest city, and I make the trip once a week, to resupply my groceries and other necessities. It’s an all-day affair. I leave after I drop my kids off at school, and I return around 5:30 pm. It’s challenging on the best of days, but even more so on one of the days when I used to have an IBS flare.
One January day, I found myself pulled over on the side of the road in the pouring rain, frantically digging a hole, trying to keep out of sight, while my belly cramped. I knew I was in for a crappy day when that happened (pun intended!).
Later that day, I had trouble finding a decent public restroom. Belly rebelling, I managed to make it into a not-so-clean bathroom in a local grocery store.
On this day, I felt not only crampy in my belly, but exhausted, stressed, and fed up with this process! Unfairly, my IBS flare days often seemed to happen on my town days. I was pretty motivated to figure out not only how I could prevent these flare days, but also how to stop them from ever happening! Because, you know, life happens, and I had things I wanted to get done!
So to help you have less frequent and less severe IBS flares, I want to share how IBS patients and practitioners work through an IBS flare, and some bigger picture strategies for unraveling their root causes.
What is an IBS flare?
IBS, or Irritable Bowel Syndrome is a broad, non-specific digestive disorder. IBS typically waxes and wanes, much to the chagrin of sufferers. Sometimes it’s quiet, and not causing much trouble. But other times, it decides to rear its ugly head. In general, IBS symptoms may include:
Bloating
Gas
Constipation OR Diarrhea
Alternating Bouts of Constipation and Diarrhea
Urgent need to use the bathroom, or stool is difficult to pass
Clear, white mucous in the stool
The specifics can look different for each of us, but an IBS flare is an increase in the frequency or intensity of the symptoms. For me, this looked like frequent stool (up to 5-6 times in a day, though it might be even more for you), cramping, pain or soreness, along with fatigue, dehydration, and general malaise. As a practitioner, I have found that a food allergy flare looks quite similar, which suggests to me that IBS symptoms are likely to be connected with food sensitivities or allergies (more on that in a minute).
What Causes IBS?
If you’ve been given a diagnosis of IBS, it’s likely you have these symptoms. But this doesn’t mean that you or your doctor know what’s causing them. The IBS diagnosis is usually given when other digestive pathology, like Crohn’s, Colitis, or other diseases are ruled out.
But from a Functional Medicine or Nutrition perspective, there are a lot of possible causes, and you owe it to yourself to try to uncover them.
One of the main causes of IBS that is well within your control is food allergies or sensitivities. Many of you with IBS are already aware that certain foods flare your symptoms and you avoid them like the plague. But clearly identifying all of those trigger foods can be a game changer. (To read more about how to figure out your particular food triggers, check out Food Intolerance Primer: What I Wish I Had Known here.) Another commonly overlooked cause of IBS is Small Intestinal Bacterial Overgrowth, or SIBO. Some studies suggest that as many as 85% of IBS cases are actually caused by SIBO. In SIBO, bacterial overgrowth in the small intestine can cause malabsorption issues, diarrhea OR constipation, bloating, gas, and many other symptoms. (Sounds like IBS, right?) In addition to SIBO, other potential root causes of IBS are underlying, previously hidden infections, including parasites, fungus, bacteria in the large intestine, or things like Lyme disease. Other potential players or contributors include mold, stress, environmental toxins, or poor water quality in your home.
How to Repair IBS and Restore Normal Gut Function
As tempting as it is to want a quick, easy fix for a problem like IBS, restoring normal gut function is more of a long-game. But even in the worst cases, there is hope for a more normal life. The first step to repairing your gut function isn’t to dive into every possible solution you can think of. Instead, you want to zoom out, and really understand what you’re seeing in context. Gathering information about your story, family history, the triggering events that may have started your problem, your collection of test results, understanding when, where, and how often your symptoms occur, and your current diet and stool habits can really help in creating the right solution. Once you have this information, you can begin to adjust your current diet and habits that are likely to lead to a change in your symptoms. This can often mean adding digestive supports like stomach acid, enzymes, or probiotics, removing foods that may be aggravating your gut lining, adding in nutrients that appear to be deficient, or even focusing on stress management. After you have adjusted these parts of your life, if you still have symptoms, now is the time to consider testing for deeper dysfunction, like infections or SIBO. (If you’d like to see all this mapped out, with some suggested action steps you can take on your own, I invite you to download your free copy of Roadmap to Recovery. I go into a bit more detail about what this looks like in real life, and provide you with some things you can do right now to get started.)
What to Do When You Have An IBS Flare
Even when you are diligent, and work really hard to avoid an IBS flare, they sometimes happen anyway (Damn it!). So what then? In a lot of ways, living with IBS or other bowel disorders is about learning how to minimize your flares. You may never be able to completely eliminate your symptoms, but you CAN certainly minimize them and live well in spite of them. I do want to make sure to say that not ALL of these tips is likely to help you. Choose two or three to test next time you have a flare, and see how you respond. If your body doesn’t like what you’ve chosen, now you know to move on to something else. You can keep a running list that details what works for your body and what doesn’t. This list is GOLD, because you now have a personalized tip sheet to turn to when symptoms get out of hand. If you have already created a Functional Nutrition Matrix, you can note these details in the “Mediators” section. These are important clues that help detail what your body is doing and why. This is at the heart of the Functional method of practice. I asked around my community of chronic illness bloggers and Functional Nutrition professionals to find out what they do themselves, or what they recommend to their clients when they experience an IBS flare.
Here is the list of tips they shared to quickly work through an IBS flare:
#1: Simplify Your Diet and go back to your known safe foods:
I find my flares often happen when I decided to get a little more adventurous on purpose. The first thing I do in response is to try to identify what the food trigger may have been, and return to foods I absolutely know to be safe. And I add a “note to self” to continue avoiding that trigger food while I work on my gut repair.
Here are some other SIMPLIFY tips from IBS patients and practitioners:
Jessica Donces, FDN, Owner Optimize to Thrive: “I suggest basic, easy-to-digest animal proteins. They are broken down and digested earlier on compared to veggies, therefore “easier” on the gut in terms of symptoms one may be experiencing with IBS. Also, elemental diets can be a great tool, there are several different types.”
Amber Blackburn, IBS patient: “My biggest tip when I have a bad flare up is I start eating basically only from the BRAT (Bananas, Rice, Apples and Toast) diet. And I do that for a few days at least until my gut feels better.”
Marya Mesa, IBD patient, blogger atChronic Mom Life: “I had IBS for years and now IBD – ulcerative colitis. When I flare I keep it very simple… stock, yogurt, smoothies, eggs, bananas, avocados.”
Candace Mantle, IBS patient: “I’ve also got Crohn’s disease. When I flare I just eat chicken, white rice and mashed potatoes. This allows my digestive system to rest.”
Collin Wong, IBD patient, blogger atCollin’s IBD Chronicles: “When I have a flare with IBD, I just avoid fried foods and spicy foods and keep it to steamed foods, and soluble fibers.”
Nicole NIckley, FDN Practitioner with The Health Mission: “Fasting with bone broth, chamomile tea, homeopathy (Ignatia Amara, or Nux Vomica remedies), and digestive essential oils blends, topically.”
Natalie Gardner, IBD patient and blogger atThe Spoonie Mummy: “I have IBD (Crohns) and an Ileostomy. One of the first things I turn to when I feel like I’m starting to flare is the Low Residue diet (also known as a low fiber diet).
#2: Add binders
Binders, such as activated charcoal, bentonite clay, or citrus pectin, can bind up toxins or inflammation in your gut.
Nicole Nickley, FDN Practitioner at The Health Mission: “I had a flare up from my Thanksgiving feast and took GI Detox (you can get it here) and that took care of symptoms.”
I do want to add the caveat about binders: If you already trend toward constipation, you may want to skip these, or try them carefully and assess your reaction. Binders may cause or increase constipation. Here are a few specific products to explore (you can access most of these inside my online supplement dispensary at FullScript):
In addition to these shared tips, here are a few more than I have used myself for my flares, and might suggest for you if you are experiencing a flare.
#3: Plain water enemas, or coffee enemas, 1-2 x per day
I’ve found this practice greatly reduces the length of my IBS flares, especially since I generally trend toward constipation. Plus it allows my body to detox a little bit more thoroughly. I only recommend this frequency of enemas for a short period of time, maybe 1-2 days. To do enemas more frequently may lead to nutritional deficiencies and dehydration. Here are instructions on how to perform an enema. Here is the enema kit I prefer.
#4: Return to your tried and true stress-reduction techniques
Stress has a huge impact on the digestive system. Any kind of stress can slow down (or speed up!) your digestion and appetite. If stress is part of your symptom flare, be sure to think about stress-relief techniques as part of your solution. For me, this includes:
You can also use any other stress relief methods you have found work. This might include yoga, or walks outdoors, dancing, a hobby you enjoy, singing, time with people you love. Whatever feeds you and helps you feel happy is stress relief!
Rachel Romaine, FDN Practitioner with Present Day Wellness, recommends belly massage and a hot water bottle to relieve belly stress and pain. If you’re not too sore, massage in slow, small circles, moving always in a clockwise direction.
If I missed any stress relief techniques you like, please add yours in the comment.
#5: Include soothing, demulcent, or carminative supplements or essential oils:
This is a very bioindividual recommendation, because while some of these may help soothe your gut, some could irritate your gut. But many people find relief using herbs or botanicals orally, such as:
Kara Louise, Certified Integrative Health Coach, Holistic Health Practitioner, and Functional Medicine Practitioner, and owner ofLife Hub Center says:
“There are several essential oils that can help keep the digestive system in a state of relative calm. These are my favorites:
DiGize (Young Living brand) is an essential oil blend that includes Fennel, Tarragon, Ginger, Peppermint, Juniper, Lemongrass, Anise, and Patchouli. DiGize can be used internally (either via a couple drops in a capsule), rubbed on the lower belly, or via under the tongue. DiGize also helps relieve digestive problems like indigestion, heartburn, gas, and bloating to name a few. It is also known to help fight off candida and intestinal parasites making it an all-in-one essential oil blend that’s a must-have for every at-home medicine cabinet.
Marjoram, Basil and Peppermint are three single essential oils that when added to Epsom salt baths (3 drops each to a cup or more of Epsom salts) help relieve the cramping that is associated with irritable bowel. (Peppermint happens to be a great oil to keep with you at all time to help relieve stomach upset and nausea. It’s also great on the roof of your mouth to relieve headaches.)
Oregano is a “hot” oil that has strong anti-bacterial qualities. Many individuals have found it to be beneficial as part of their anti-candida therapy and to balance their microbiome. It’s best to work with a health coach trained in essential oil usage when it comes to using oregano.
Essential oils are powerful, strong and therapeutic. My two tips when it comes to essential oil usage are: (1) find the right company who can track your oil from Seed to Seal to be the best quality; (2) work with someone who is trained on aromatic medicine and can help you with an individualized approach to using essential oils as part of your healing journey.”
For some people, especially if SIBO is an issue, probiotics may aggravate symptoms. Back off on probiotics for a few days while you restore balance and calm inflammation.
#7: Increase antioxidants
Vitamins A, C, & E, CoQ10, or glutathione will help repair the inflammatory damage in your guts, whatever the cause. Give your cells the nutrients they need to do repair work! One simple way you can do this is by eating a rainbow of foods, if you can tolerate them, or by using herbal teas, which contain plant phenols which are natural antioxidants. While a nutrient-dense diet is always the preferred way to get these nutrients into your body, you can also include nutritional supplements to meet your needs.
#8 : Hydration
The body needs adequate hydration to do all it’s tasks. If you’ve had diarrhea as part of your flare, you may also be dehydrated. Be sure to drink plenty of fresh, clean water.
#9: L-glutamine
L-glutamine is an amino acid that your gut cells use to do repair work. Taking L-glutamine (1-5 or more grams per day) may help repair your gut lining during a flare. L-glutamine is generally well tolerated, but it’s always a good policy to start at a low dose and slowly increase to your tolerance to avoid any negative reactions.
Conclusion
You don’t have to simply wait out your IBS flare. With some attention and care, you can reduce the length and severity of a flare by trying out some of the methods shown here. If your IBS flares and attacks are an ongoing, regular occurrence, it may be time to get serious about investigating your root causes. When a client comes to me with symptoms resembling IBS, I always do a full case history, to try and identify when and why the symptoms first started. I help them do some dietary clean up and support their digestion first. If we’re not able to resolve symptoms that way, I suggest running a stool or breath test, to find out whether infections are involved. I’ve used this approach with myself as well as my clients. I’ve done so well with my IBS approach that I can’t remember the last time I had an IBS flare, let alone on my town trip day. What a relief! And though I do occasionally have a flare, they are no longer anywhere near as bad as they once were, and I’m able to resolve them quickly with a minimum of disruption of my life. My kids and my family need me, and I’d rather spend my time with them than be on my toilet. Wouldn’t you?
Let’s get you free from symptom flares, and back to comfortable belly function! When you’re ready to dig into your underlying reasons for your IBS flares, and are ready to see the length of time between your flares increase, grab your free copy of Roadmap to Recovery, and get started right away with some easy, accessible tasks.
One of my personal missions with Confluence Nutrition is to help you become your own health care hero. By this, I mean that you are 100% in charge of your health. And one of the most important ways you can do this is by learning how to be an effective symptom tracker.
Symptoms are your body’s S.O.S. signal. I’m not talking about the kind of symptoms you have when you’re sick with a virus. I’m talking about persistent symptoms that continue, month after month. These are your built-in warning system that something isn’t right, and needs attention.
But figuring out which symptoms to pay attention to and how to organize this information can be confusing. This is especially so if you have A LOT of symptoms. In this blog, I want to share what to note on your symptom tracker, what to use for your symptom tracker, and some of the results that are possible with effective symptom tracking.
My Own Symptom Tracker Story
Years ago, I first reached out to my doctor because I was concerned about my lower abdominal pain. By the time I made the appointment, I was having pain a few days every month, and saw the symptoms getting worse.
I went in for an ultrasound, and it showed I had ovarian cysts. No follow up was recommended.
My symptoms paused while I was pregnant with my second child, but my symptoms returned with a vengeance with the hormonal changes that happened when I weaned him. At this point in my life, I only had 5-7 good days each month. The other days, I had some combination of pain, anxiety, digestive problems, insomnia, acne, and more.
The first important piece of information I gathered from my loose symptom tracking was that my symptoms were obviously getting worse. Over months and years. And this rightfully concerned me.
Symptoms that are worsening over time are a clear sign from your body that it is time to pay attention and seek some help.
From my perspective as a Functional Nutrition Practitioner, your symptoms are pure gold. Even if your doctor seems unconcerned with your symptoms, I want to teach you what symptoms I believe are important to track, how you can track them, and why you would want to.
How to Start Being A Symptom Tracker
For me, the purpose of tracking symptoms isn’t only to note them, it’s to begin to ask WHY they are happening. Because I am working to help resolve problems at their roots, I want to place your symptoms in a context.
For example, if you have a headache, I want to know what you ate earlier that day, how much liquid you had to drink, how your stress level was, how well you slept the night before, and so on.
But to have this information feel useful, it’s necessary to organize it on a day-to-day basis, and to connect food intake, symptoms, stool changes, hydration data, and sleep. It’s best to write down your observations at least once a day, as it can be hard to remember the details much beyond that.
The tool I prefer to help my clients keep track of everything and become a master symptom tracker is a Food-Symptom Diary (You can download your copy here). This tracks food, symptoms, and stool frequency and consistency. If my client needs to track other layers, I will have them note the results on this same form, for consistency and organization.
You could also use a calendar, an app, or any other method you like to collect your information. Just make sure that you can easily see what you’re trying to look at, and generally keep your results to one page per day.
What to Track on a Symptom Tracker
So what kind of symptoms am I talking about here? Well, just about any symptom you can experience is important, though severely uncomfortable symptoms are the most obvious.
Certainly, if your symptoms feel potentially life threatening, like shortness of breath, you should get yourself checked as soon as possible by a qualified medical person.
But if you’ve been checked, and your provider can’t see anything “wrong” on the surface, this doesn’t mean your symptoms should be ignored. On the contrary, this is an invitation to see what you can learn from them.
You will want to track things like:
headaches
migraines
pain in the muscles or joints
digestive symptoms like diarrhea, constipation, gas, nausea, vomiting, or heartburn
brain fog
itching
skin breakouts of acne, eczema, psoriasis, or other rashes
fatigue
insomnia
shortness of breath
rapid heartbeat
anxiety attacks
mood symptoms, like irritability, anger, sadness, anxiety, frustration, or depression
frequent illnesses
There are, of course, many more possible symptoms. This is just a partial list. Note the ones that are most present for you.
In addition to this list of signs or symptoms, there are additional metrics I like to encourage my clients to track, depending on the situation. These include:
blood sugar throughout the day
medications and supplements
menstrual cycle and related symptoms for my female clients
seasonal and moon cycles
daily waking temperature (basal body temperature)
Other metrics people sometimes look at include activity levels, as with a FitBit or similar device, or heart-rate variability and sleep cycles, as with the Oura Ring.
To get the most value out of this tracking, use the Food Symptom Diary or similar log, and note foods along side symptoms and poop type. The longer you can track this data, the better your results. A good place to start is with one week of tracking.
Here are 5 additional metrics you can add to your symptom tracker to try and make connections about WHY your symptoms are happening.
Blood Sugar Levels
A high percentage of symptoms people experience are rooted in food sensitivities, or eating a combination of macronutrients (protein, fat, and carbs) that leads to blood sugar swings.
Paying attention to this one single piece can truly rebalance many many symptoms. Keeping your blood sugar stable keeps your moods and energy levels constant.
If you are eating too many carbs, or are skipping meals, you may feel more stressed, anxious, tired, irritable, or angry, and you may experience energy slumps, as well as difficulty sleeping. And this can lead to hormonal imbalances downstream. So just by tracking blood sugar and the relative balance of protein, fats, and carbs in your meals, we’ve addressed sleep, moods, fatigue, and hormones.
If you’re not sure if blood sugar is an issue, you can track this too with an at-home glucometer. You can buy one at your drugstore or over on Amazon (make sure you buy test strips too.) You want to check your values at :
• Immediately after waking, first thing in the morning (functional range: 78-88 mg/dL)
• 40 minutes after breakfast (functional range: <135 mg/dL)
• 40 minutes after lunch (functional range: <135 mg/dL)
• 20 minutes before dinner (functional range, if >2 hours since last food: 78-88 mg/dL)
• Just before bed (functional range, if > 2 hours since last food: 78-88 mg/dL)
Add these values to your food-symptom diary or other tracking tool.
If your sugars are higher than the suggested values, begin to track that backwards to your previous meal or two. Which foods may be triggering your elevated blood sugar?
Make sure that you are taking note of your medications and supplements on your tracking sheet as well, as their side effects can be responsible for symptoms.
Menstrual Cycle Symptoms and Rhythms
If you are a woman, tracking your monthly menstrual cycle can also be important and can shed some light on your symptoms. Do your headaches correlate? How long are your cycles? Do any of your symptoms connect to your ovulation, or your bleeding time?
In Toni Weschler’s book Taking Charge of Your Fertility, she explains the method of tracking your monthly cycle, either for pregnancy achievement or avoidance. She uses a method of tracking daily waking temperature (basal body temperature) and cervical fluid quality.
I used this method to plan both my kids’ births, and avoid pregnancy until my hysterectomy during the first 15 years I was married.
Seasonal and Moon Cycles
Another interesting data layer to add to the equation is moon cycles and seasonal cycles if you have noticed changes during the month or year. Tracking these may be best done on an annual or monthly calendar.
Basal Body Temperature
Basal body temperature can be useful not only for tracking menstrual cycles, but also for tracking thyroid function. A basal body temperature of 97.1 or less can indicate an underactive thyroid gland, and would suggest a need to investigate.
The biggest trick is putting all your symptom tracker data together. This is why shorter periods of tracking with one sheet of data per day is what I recommend.
After you have a collection of days, you can look back over your record and take note of when your symptoms appeared. Can you see any patterns connected to the foods you ate? Did your acne flare after eating a particular food, or after you stayed up really late? Does your afternoon fatigue relate to what you ate for breakfast? Review your data and begin asking questions.
So often, the symptoms or clusters of signs you are experiencing are a consequence of one or more of your behaviors or choices, and you can make good headway against them by changing your behaviors.
Tracking this way has helped me solve many of my health mysteries. One story I like to tell involves my previously chronic constipation.
Though there were many actions I took to help resolve this problem, when I started using a food-symptom diary, I finally figured out that broccoli was a significant constipation trigger for me. Every time I ate broccoli (one of my favorite vegetables), I would stop pooping 1-2 days later, for a day or two. It was an easy enough thing to forego broccoli temporarily while I sorted out the other factors (which included SIBO, but that’s another story!).
A few years later, I was confused after my partial hysterectomy. Because I was no longer bleeding, I couldn’t exactly tell what my cycle was doing. I knew that I needed some hormonal support, but my other symptoms didn’t make it clear.
By taking my basal body temperature, I found that I WAS still cycling, but that my cycles had become irregular. So I learned that I was entering peri-menopause, which helped me craft my best support strategy. It also helped me understand some symptoms I was seeing on the outside, like acne flares.
I had a client who was able to figure out that the reason they had chronic, daily diarrhea was because of a melatonin supplement they were taking in order to help with sleep.
I had another client who learned through food-symptom tracking that tomatoes, a high histamine food, were contributing to their frequent hives.
One more client could clearly see that gluten and dairy were causing her bloating and extra morning trips to the bathroom.
Conclusion
Sometimes the solutions to your health problems don’t involve fancy protocols or pills, just some common sense changes that address what’s true for your very own body. If you are willing to take the time to look a little deeper, and learn to be a symptom tracker, you may find the root causes, which save us a life of worsening symptoms and increasing medical costs.
Now it’s your turn…if you’re confused about the source of your symptoms, download the Food-Symptom Diary and try your hand at tracking your symptoms. See what new information you can learn about your symptoms.
Tracking your symptoms to learn about your body’s non-negotiables is only one stop on the Road to Recovery. To see what else is needed to find your way to your personal remission or long-term plan, grab your free copy of Roadmap to Recovery here.
If you find you have more questions than answers after completing your Food-Symptom Diary, I invite you to schedule a free 30-minute Assessment Session with me, and I’ll help you make sense of what you found.
