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Pt. 3 IBS Awareness: IBS Solutions: Ways to have a #goodgut without the #gutguilt!



What kind of food can I eat if I have IBS?

For those who have severe symptoms, it may feel like there are no foods that can possibly help. As said in part two of our IBS blog series, the FODMAP diet can work for initial remission within some individuals. For those who don’t respond to the low FODMAP diet, a reverse-elimination diet may be helpful to identify which types of foods are causing symptoms.


Even with these dietary protocols, you might still be asking yourself, “what can I actually eat?” Research has shown that sustaining a #GoodGut can be done with the consumption of whole-food plants, especially vegetables. Cooking or blending vegetables will further break down fiber and may be easier on digestion, eating fruit that has been frozen, cooked, or blended, and sprouting grains and legumes can have the same effect. Remember, all of these diets are meant to be individualized, and not everybody is able to eat the recommended foods! If one or more of them do not work for you, there is no need to make yourself eat them. IBS symptoms are very personal, and it is important to remember this when going through your own journey!


Why should I work with a Dietitian if I have IBS?

We know you might also be wondering, do I have to do this alone? Absolutely not! IBS is a personalized disease that is impacted, not only by dietary choices, but our microbiota, genetic predisposition, as well as stress and inflammation.


Working with a dietitian and your care team to understand your symptoms and find the right remedies to manage is essential for your recovery. A dietitian experienced in gut disorders is beneficial in navigating this disease because general care practitioners are not specialized enough to tie together the symptoms of IBS and determine a proper diagnosis and treatment. A gut health dietitian will tailor your dietary needs to maintain proper micronutrient content and ensure that symptoms do not worsen. Eliminating foods that trigger symptoms, systematically adding foods back in, and then personalizing the dietary protocol are also some objectives that your dietitian will provide.


Lastly, if you do have IBS and you have gone on a restrictive diet, it is very important to consult a dietitian to make sure you maintain diversity in your diet while simultaneously managing symptoms. Restriction diets can become very narrow, and a dietitian can be extremely helpful when navigating that process. The low FODMAP diet has been studied to be safely used for 6-8 weeks max at a time while in the pure elimination phase. Eliminating a large variety of foods beyond this can come with harmful implications to the gut microbiome.


Please note: These diets are NOT a fix to a problem, but can serve as a temporary symptom relief tool while looking for the root cause of the gut dysfunction and dysbiosis. Even if an individual is prescribed a diet, it is not the full answer to the root cause of their problem.


What recipes are low FODMAP, or good for my gut?

Married to Health has a plethora of recipes on our website, and if you become a patient there are low FODMAP, gluten free, vegan, and other options for your #goodgut to get you on the path to healing with each meal!


Here is a full day of fun low FODMAP meals!


Breakfast: Teff Waffles

Ingredients:

  • ½ Cup Maskal Teff Ivory Flour

  • ½ Cup Gluten Free Baking Flour (Cassava Or Oat)

  • ½ Cup Almond Flour

  • ½ tsp Cinnamon

  • ¼ tsp Cardamom

  • 2 tsp Baking Powder

  • 1 tsp Baking Soda

  • A Pinch of Pink Himalayan Salt

  • 1 Ripe Banana (Or Green Banana If Low FODMAP)

  • 2 Flax Eggs (2 Tbsp Flax Meal + 5 Tbsp Of Water)

  • 2 Pitted Dates (Or Pureed Grapes Or Maple Syrup For Low FODMAP)

  • 2 Cups Unsweetened Coconut Milk (Or Flax, Macadamia, Quinoa, Or Rice Milk For Low FODMAP)

  • 1 tsp Vanilla Extract (No Alcohol)

Directions:

  1. Preheat a waffle iron.

  2. In a medium sized bowl, mix together the baking flour and the almond flour, cinnamon, cardamom, baking soda, baking powder, and salt.

  3. Make your flax eggs by mixing 2 Tbsp of flax meal with 5 Tbsp of water. After mixing well, set aside.

  4. In a blender cup or food processor, add the flax egg, milk, dates, banana, and vanilla extract. Blend until smooth.

  5. Add the wet and dry ingredients. Whisk together until well incorporated with each other.

  6. Let the mixture rest for at least 5-10 minutes before spooning into the hot waffle iron.

  7. Serve with nut butter, fruit compote, and/or unsweetened coconut yogurt. Enjoy!

Lunch: Cassava Quesadilla

Ingredients:

  • 1-2 Cassava Tortillas

  • 4 tsp vegan Cheeze Sauce

  • ½ Cup Kale Or Collard Greens

Directions:

  1. Steam or sauté your greens.

  2. Spread the nacho cheese onto your tortilla.

  3. Add the greens to your tortilla and enjoy!

Note: You can make everything fresh. Or if using leftovers, reheat using a toaster oven, skillet, or microwave.


Beet (Veggie) Burger

Ingredients:

  • ¾ Cup Cooked Quinoa

  • ½ Large Red Onion (Finely Diced) (Or 1 Cup Green Onion Or Leek Tops - Green Part Only For Low FODMAP)

  • 1 Cup Finely Chopped Mushrooms (Shitake, Baby Bella, Or White Button) (Or Oyster Mushrooms Only If Low FODMAP)

  • Pinch Of Pink Himalayan Salt

  • Pinch Of Black Pepper

  • 1 (15 Oz) Can Or Homemade Black Beans, Well-Rinsed And Drained (Or Low FODMAP Bean Such As Lentils, Chickpeas, Lima, Dal, Butter Beans, Or Mung Beans)

  • 1 Cup Finely Grated Raw Beet (or ¾ cup of finely grated pickled beet for low FODMAP option)

  • 1 tsp Cumin

  • ½ tsp Chili Powder (Or Substitute Extra Cumin) ¼ tsp Smoked Paprika

  • ~½ Cup Raw Walnuts, Crushed Or Ground Into A Loose Meal

Directions:

  1. Heat a large skillet over medium-low heat and add vegetable broth to prevent the ingredients from sticking. Once the pan is hot, add the onion. Sauté the onion, seasoning with a pinch each of salt and pepper.

  2. When the onions are soft, (takes about 5 minutes), increase to medium heat and add the mushrooms. Season with another pinch each of salt and pepper, garlic powder, and dried parsley. Cook until the mushrooms and onions are slightly browned and fragrant, (takes about 3 minutes).

  3. Remove the skillet from heat. Add the black beans and mash. If you are looking for a rough mash, you can leave a bit of texture if desired.

  4. Transfer the mixture to a mixing bowl and add the quinoa, beets, and spices. Stir until well incorporated. For even more flavor, add some coconut aminos (optional).

  5. Add the walnut meal, small portions at a time, until the mixture is able to be formed into patties.

  6. Place the mixture in the refrigerator to chill while your oven is preheated to 375˚F. You can also cook the patties in an air fryer.

  7. Cover a baking sheet with a piece of parchment paper. Form the mixture into roughly 8-9 patties, (or as many patties as you want). The thicker the patties are, the longer it will take to cook them through; thinner patties cook faster.

  8. Arrange the burger patties on a baking sheet and bake in the oven at 375˚F for 30-45 minutes, gently flipping the patties at the halfway mark. For crispier burgers, cook longer.

  9. Serve the patties on small buns. (We love the brand Bread Srsly).

We have many more recipes on the Married to Health website and even more available to patients and group members! Be sure to check them out!


What can I do right now to start healing my gut: Call-to-action

  1. Find a dietitian or doctor to consult about diagnosing IBS

  2. Focus on vegetables and healthy plant proteins, while avoiding processed foods and any trigger foods such as saturated fat, gluten, or dairy

  3. Stress reduction and/or time restricted feeding techniques may also be beneficial for management of symptoms.

  4. Be patient and understand that it may have taken years or decades to get unwell, it will take time to get well again.

  5. Having a good care team behind you to support and guide your dietary and lifestyle choices. Whether they’re a dietitian, gastroenterologist, therapist, or endocrinologist, ensure they understand your story and are willing to work with you to find a solution.


Heal with each meal!


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References

Sood, R., Law, G. & Ford, A. Diagnosis of IBS: symptoms, symptom-based criteria, biomarkers or 'psychomarkers'?. Nat Rev Gastroenterol Hepatol 11, 683–691 (2014). https://doi.org/10.1038/nrgastro.2014.127

National Institute of Diabetes and Kidney Disease. (November 2017). Definition & facts for irritable bowel syndrome. U.S. Department of Health and Human Services. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts

Ireton-Jones, C., Weisberg, M. (12 August 2020). Management of irritable bowel syndrome: Physician-Dietitian collaboration. Nutrition in Clinical Practice, volume 35 (issue 5), pp 826-834. https://doi.org/10.1002/ncp.10567

Kennedy, P. J., Cryan, J. F., Dinan, T. G., & Clarke, G. (2014). Irritable bowel syndrome: a microbiome-gut-brain axis disorder?. World journal of gastroenterology, 20(39), 14105–14125. https://doi.org/10.3748/wjg.v20.i39.14105

Martin, C. R., Osadchiy, V., Kalani, A., & Mayer, E. A. (2018). The Brain-Gut-Microbiome Axis. Cellular and molecular gastroenterology and hepatology, 6(2), 133–148. https://doi.org/10.1016/j.jcmgh.2018.04.003

Bennet SMP, Böhn L, Störsrud S, et al. (2018). Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs. BMJ Journals: Gut Microbiota, volume 67, (issue 5). https://gut.bmj.com/content/gutjnl/67/5/872.full.pdf

National Institute of Diabetes and Kidney Disease. (November 2017). Definition & facts for irritable bowel syndrome. U.S. Department of Health and Human Services. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts

Sood, R., Law, G. & Ford, A. Diagnosis of IBS: symptoms, symptom-based criteria, biomarkers or 'psychomarkers'?. Nat Rev Gastroenterol Hepatol 11, 683–691 (2014). https://doi.org/10.1038/nrgastro.2014.127

Kennedy, P. J., Cryan, J. F., Dinan, T. G., & Clarke, G. (2014). Irritable bowel syndrome: a microbiome-gut-brain axis disorder?. World journal of gastroenterology, 20(39), 14105–14125. https://doi.org/10.3748/wjg.v20.i39.14105

Martin, C. R., Osadchiy, V., Kalani, A., & Mayer, E. A. (2018). The Brain-Gut-Microbiome Axis. Cellular and molecular gastroenterology and hepatology, 6(2), 133–148. https://doi.org/10.1016/j.jcmgh.2018.04.003

El-Salhy, M., Hatlebakk, J. G., and Hausken, T). (7 August 2019). Diet in irritable bowel syndrome (IBS): Interaction with gut microbiota and gut hormones. Nutritional Management of Gastrointestinal Diseases and Disorders, volume 11 (Issue 8), https://www.mdpi.com/2072-6643/11/8/1824/htm

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Gibson, P. & Halmos, E. (8 March 2019). Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome. Journal of Gastroenterology and Hepatology, volume 34 (issue 7), pp. 1134-1142. https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.14650

Bennet SMP, Böhn L, Störsrud S, et al. (2018). Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs. BMJ Journals: Gut Microbiota, volume 67, (issue 5). https://gut.bmj.com/content/gutjnl/67/5/872.full.pdf

Fukudo, S. and Kanazawa, M. (2006). Effects of fasting therapy on irritable bowel syndrome. International Journal of Behavioral Medicine, Volume 13, (Issue 3), pp 214-220. https://link.springer.com/content/pdf/10.1207/s15327558ijbm1303_4.pdf

Anton, S. et al (31 October 2017). Flipping the metabolic switch: Understanding and applying the health benefits of fasting. Wiley Online Library, volume 26, (issue 2), pp 254-268. https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22065?casa_token=a6N0GsS09UcAAAAA%3AV45eq6CoL1IxwtWZpVUA-Uy87OYfIq2aoG3j0QSMHze4tuPrB-XzJK9Cgo6TGe-pI_XwSCKXZLbrTA

Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World journal of gastroenterology, 20(39), 14126–14131. https://doi.org/10.3748/wjg.v20.i39.14126

Garland, E.L., Gaylord, S.A., Palsson, O. et al. (2012). Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med volume 35, 591–602. https://link.springer.com/article/10.1007/s10865-011-9391-z

Afzal, A., Gonsalkorale, W. M., Miller, V., Whorwell, P. J. (23 July 2003). Long term benefits of hypnotherapy for irritable bowel syndrome. BMJ Journals, volume 52 (issue 11), pp. 1623-1629. https://gut.bmj.com/content/52/11/1623.short

Ireton-Jones, C., Weisberg, M. (12 August 2020). Management of irritable bowel syndrome: Physician-Dietitian collaboration. Nutrition in Clinical Practice, volume 35 (issue 5), pp 826-834. https://doi.org/10.1002/ncp.10567

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