IBS (irritable bowel syndrome) is the most common diagnosis given by gastroenterologists to their patients complaining of bloating, abdominal pain and abnormal bowel movements. In fact, IBS is not really a diagnosis. It simply refers to a cluster of digestive symptoms. It doesn’t tell you what the problem is or where it comes from. It just confirms that you have digestive problems. And I bet you knew that already.
Many people with IBS see drastic improvements in their digestive health once they ditch the gluten, grains, sugar, dairy and other processed foods eliminated on the Paleo diet. If you aren’t one of these lucky ones, it’s time to dig a bit deeper and see if your digestive troubles could be caused by one of the five following possibilities.
You’re eating too much fiber.
Is there really such a thing as eating too much fiber? Don’t dietitians and doctors recommend that their IBS patients eat more fiber-rich whole grains, fruits and vegetables? Or even suggest supplementing with extra fiber from flaxseeds or psyllium husk? They certainly do, but these recommendations often make people feel worse.
As you know, dietary fiber is not digested in humans and travels through the many meters of your intestines until they reach your toilet. Insoluble fiber, mainly found in whole grains, nuts and seeds, gives bulk to your stools and this is why it is often recommended against constipation. But your intestines are not like pipes that need to be swept. Insoluble fiber can actually be very harsh for your intestines, especially if your bowels are already irritated and inflamed. And you can assume it is the case if you regularly suffer from any kind of digestive problems. Eating insoluble fiber can worsen your digestive issues and prevent your intestines from healing. Just like scrubbing a brush on an open wound.
Soluble fiber, mainly found in the flesh of most fruits and vegetables, is a bit gentler for your intestines, but can also be problematic. This type of fiber has the potential of becoming food for the bacteria living in your intestines. This can actually be a good thing and can help you maintain a healthy gut flora… IF your gut flora is healthy. If you suffer from bloating or abnormal bowel movements, you can almost always assume that you have a form of gut flora imbalance. In that situation, soluble fiber from large servings of fruits and vegetables can lead to excessive intestinal fermentation and trigger your usual digestive issues.
The good news is that the Paleo diet already eliminates grains, but you may also need to cut down on your intake of nuts, seeds, vegetables and fruits to see positive changes in your digestion.
Gluten is hiding in your food.
Celiac disease, the autoimmune form of gluten intolerance, now affects 1 in 133 Americans, but non-celiac gluten sensitivity is thought to touch at least 8 times more people according to the University of Maryland Center for Celiac Disease Research. Gluten-containing grains include wheat, barley, rye and oats (unless specifically labeled gluten-free).
If you are one of the people sensitive to gluten, eliminating bread, pasta, breakfast cereals, couscous and cookies won’t be enough to restore optimal digestive health. Trace amounts of gluten, the equivalent of the size of a breadcrumb, could be enough to perpetuate your digestive troubles. Unfortunately, wheat-derived ingredients are found EVERYWHERE… in gravies, sausages, deli meat, jerky, soy sauce, beer and even seasonings. Always read the ingredient list to ensure gluten and wheat are not hiding in your food.
Even if you’ve already triple checked all of your food labels, you might still be exposed to gluten through cross-contamination. Removing the croutons from your salad, eating the filling of a sandwich without eating the bread or using the same cutting board for your food as the one used for bread by other family members could sneak in enough gluten into your body to negatively affect your digestion if you’re gluten-sensitive.
You have too many bacteria at the wrong place in your intestines.
A healthy gut flora is important for digestive health. But too much gut-friendly bacteria could in fact be at the root of your digestive issues, especially if they are overgrowing in your small intestines. This condition called SIBO (small intestinal bacterial overgrowth) is now believed to be one of the main underlying cause of IBS.
Request a glucose or lactulose hydrogen and methane breath test to find out if it’s the case for you. A diagnosis of SIBO should ideally be followed by a treatment with antibiotics (herbal or regular) to reestablish a normal gut flora. Minimizing your intake of carbohydrates, both in the form of sugars from fruits and starches from starchy vegetables, can also help you starve your SIBO and better control the side effects associated with excessive intestinal carbohydrate fermentation. With SIBO, all carbohydrates can result in gas, bloating, cramping, diarrhea or even constipation.
You are sensitive to FODMAPs.
No, this is not the name of a new band. FODMAP is the “sexy” acronym they found for Fermentable Oligo-, Di-, Mono-saccharides, And Polyols, which comprise fructose, lactose, fructans, galactans and polyols. If your gut flora and intestinal health are impaired, consuming high-FODMAP foods could result in the same IBS symptoms you’re already well too familiar with.
Eliminating high-FODMAP foods like wheat, grains, legumes and high-fructose corn syrup by going Paleo can make a big difference, but some people need to be even stricter and limit their intake of specific vegetables and fruits rich in these fermentable carbs. Try avoiding high-FODMAP Paleo foods, including vegetables like onions, garlic, cabbage, broccoli and Brussels sprouts as well as fruits like watermelon, apples, pears, peaches and dried fruits for a few weeks to see whether it could make a difference for you.
You forgot to heal your gut.
Implementing all the suggestions listed above may not be enough to make your digestion work normally again, especially if you’ve been dealing with digestive issues for a while. When you get a splinter in your foot, you need to remove it first and then let the inflammation subside and the wound heal. Removing irritant fiber, gluten and fermentable carbs and FODMAPs is the first step to eliminate many of the problematic compounds that could trigger your digestive problems, but your intestines still need time to heal.
You can facilitate and speed up the healing process by making sleep and stress management a priority in your life, adding a cup or two of homemade bone broth to your daily routine and possibly looking into using supplements like gut flora-restorative probiotics and gut-healing L-glutamine.
Still experiencing digestive issues?
If you still experience digestive problems despite experimenting with the five tweaks described above, you might have a gastrointestinal infection, other types of food sensitivities or a digestive condition other than IBS. If your doctor is not willing to look under the hood, find a Paleo-friendly doctor or naturopathic physician using the Paleo Physician Network.
It is NOT normal to feel bloated, experience abdominal discomfort or suffer constipation or diarrhea. Abnormal digestion is a sign that your health is not optimal. Health starts in the gut, so make sure you get your digestion in order if you want to achieve optimal health.
If you need extra help to get there:
- learn everything you need to know about digestion in my book and get inspiring easy-to-digest and gut-healing recipe in my cookbook “Digestive Health with REAL Food“
- get support in my online “Digestive Health with REAL Food Community“
- work directly 1:1 with me to really get to the bottom of your digestive issues.
* Article originally published in Paleo Magazine.