Month: March 2025

Everything you need to know about Bowel Syndrome

"If you've searched for phrases like "I have a tummy ache after eating, is that normal?" or "I have gas all day, what can I do?", you may have heard of Irritable Bowel Syndrome (IBS). But what exactly is it? And more importantly, can it be cured or improved? What is IBS? IBS is a functional digestive disorder, which means that there is no visible injury to the digestive system, but there is a disturbance in its functioning. It is characterised by the presence of abdominal pain or discomfort associated with changes in the frequency or consistency of bowel movements. It is a diagnosis of exclusion, i.e. for a doctor to diagnose it, other digestive diseases such as coeliac disease, inflammatory bowel disease or SIBO must first be ruled out. What are the symptoms? Everyone experiences it differently, but the most common symptoms include: Abdominal bloating (feeling like your tummy "explodes" after eating). Pain or cramping in the abdomen that gets better or worse with bowel movements. Alternating periods of constipation with periods of diarrhoea. Feeling of incomplete emptying after going to the toilet. Excessive flatulence and/or belching. Fatigue, anxiety and even mental fogginess What are the causes? There is no single cause of IBS, but the most common triggers are: Food: A diet high in ultra-processed food (pastries, biscuits, cereals, salty snacks, etc.) and/or saturated fats (very fatty meats such as bacon, chops, black pudding, sobrassada, pâté, sausages, etc.) can alter the composition of our microbiota, increasing our predisposition to develop this digestive pathology. High stress in our daily life: Our intestine and brain are connected through the intestine-brain axis, so anything that affects our brain can have repercussions on our intestine and vice versa. This can include altered microbiota and altered gut motility and sensitivity. For this reason, psychological disturbances such as anxiety disorders are often a predisposing factor. Menstrual cycle: hormones also influence our intestinal transit, for example shortly before menstruation when progesterone levels fall (stimulates intestinal muscle contractions) can increase the symptoms of diarrhoea or facilitate evacuation if we are constipated. Altered gut microbiota: scientific evidence shows that IBS patients have a higher proportion of pro-inflammatory bacteria (such as Firmicutes) and a reduction in anti-inflammatory bacteria (such as Lactobacillus and Bifidobacterium). This may explain the digestive sensitivity and low-grade inflammation associated with IBS. How is Irritable Bowel Syndrome diagnosed? The diagnosis of IBS is based on the Rome IV Criteria, which state that you must have had recurrent abdominal pain at least once a week for the past 3 months, along with altered bowel movements (diarrhoea, constipation or both). Before reaching this diagnosis, it is essential to rule out other digestive pathologies, with which it can be confused, by means of tests such as: - Coeliac disease test (anti-transglutaminase antibodies in blood) - Breath test (to rule out food intolerances: lactose and fructose) - SIBO test (bacterial overgrowth in the small intestine) - Blood tests to rule out endocrine diseases. - Stool analysis to rule out intestinal hyperpermeability and Inflammatory Bowel Disease. - Colonoscopy if there are warning signs such as blood in stool or other. Do I really have to have all the tests? Some tests can be expensive and are not always covered by public health or insurance. However, it is often not necessary to do all of them. With proper assessment and a well thought out nutritional strategy, other diagnoses can be effectively ruled out without the need to spend on unnecessary tests, and the most appropriate tests such as SIBO tests, blood tests and stool tests can be performed. Treatment for Irritable Bowel Syndrome: How to improve symptoms? There is no "miracle cure", but the good news is that IBS can be managed with the right strategy. In fact, many patients return to normal and regain their digestive function. 1. Personalised nutrition It's not about eliminating senseless foods, but identifying what's affecting you. Some key changes are: Low FODMAP diet: a strategy based on temporarily removing certain fermentable carbohydrates and gradually reintroducing them. Some people do not need so many restrictions, be careful with this. Improve gut microbiota composition once digestive function has improved. Control fibre: too much fibre can worsen bloating and gas. Drink enough water: dehydration makes constipation worse. Chew well and eat slowly: key to avoid air intake, reduce bloating, reduce stress and avoid disruption of the gut-brain axis. 2. Stress reduction As mentioned above, stress can trigger symptoms, so strategies such as exercise, yoga or diaphragmatic breathing can make a difference. Scientific evidence supports that short-term high-intensity interval exercise (HIIT) can help to improve symptoms. 3. Professional support Trying to manage IBS without guidance can be frustrating. Working with a specialist nutritionist will help you find what works for you without over-restricting, structure your meals, improve your nutritional status and improve your quality of life. If you have been feeling that your digestive system is not working well for some time and you can't seem to get it back on track, the first step is to seek professional help. Irritable Bowel Syndrome can be greatly improved with a strategy tailored to you. If you don't know where to start and need help with your diet, write to me or visit my website! Together we can find the best solution for you.