Do you often get a belly ache or diarrhea after eating certain foods or when you’re under stress or worrying about something? It happens to most of us every once in a while, but if you deal with it on a regular basis, you might have irritable bowel syndrome or IBS.
Brain in your gut
Health experts believe IBS symptoms are caused by faulty communication between the brain in the head and the brain in the gut. That’s right — your gut has a brain!
About 100 million neurons line the intestinal tract and help control gut behavior independently of the brain. According to Dr. Michael Gershon, a neurobiologist at Columbia-Presbyterian, not only can the head send messages down to the gut, the gut can send messages up to the head. And those messages can make you feel miserable.
Dr. Gershon even wrote a book about it, called The Second Brain. In an interview he did a few years back with Stephen Colbert he said, “You have to have these two brains cooperating with each other to have peace in the body. When this goes wrong, people get to be very disturbed. The gut has a profound way of disturbing the brain. So quite really, people can be made to feel terrible from this organ. If you’re chained by diarrhea to a toilet seat, for example, it can really do you in.”
Being chained to the toilet is something we’d rather not even imagine. But it’s an unfortunate reality for about 58 million people in the United States. A complex combination of factors, including psychological stress, anxiety, hormones, the immune system, or sensitivity to certain foods can interfere with the messages going back and forth. The result — terrible cramping, bloating, gas, and diarrhea.
Patsy Catsos is a registered, licensed dietitian with a personal and professional interest in helping “people with stomach problems get their lives back.” She shares her expertise on her blog IBSFree.net and sees patients at Nutrition Works in Portland.
She points out that, “Differences in gut-brain biochemistry might help explain why people with IBS experience more pain from buildup of gas and fluid in the intestines compared to other people. It’s also likely that events in the gut affect brain biochemistry, so it goes both ways.”
Whatever the causes, IBS can be difficult to manage. Generally, the goal is to reduce symptoms using a combination of approaches such as medication, psychotherapy, and dietary changes.
Food and IBS
While Patsy believes multiple triggers are usually at play, as a registered dietitian her focus is on food. She says limiting FODMAP carbohydrates can control IBS symptoms. “Many of my IBS patients feel much better when they avoid certain sugars and fibers that encourage gas, bloating, and irregularity,” she says.
FODMAP stands for fermentable oligo-, di-, and monosaccharides and polyols. FODMAP carbohydrates include lactose, fructose, sugar alcohols, fructans, and galactans, which cause IBS symptoms because they are both fermentable and osmotically active.
- Fermentable – broken down by intestinal bacteria that produce a lot of gas and cause bloating
- Osmotically active – they pull water into the intestines and cause diarrhea
Some foods that contain FODMAP carbs
- sugar-free gum
As Patsy pointed out to me, “It only takes a few days of experimenting with a low FODMAP diet to find out for yourself if they are causing your symptoms. Once you learn which foods are the problem, you can usually manage symptoms by limiting portion sizes. It’s rarely necessary to give up trigger foods completely.”
An IBS-friendly recipe
This recipe for Smoky Kale Salad with Pumpkin Seeds and Shaved Parmesan was developed by Lisa Rothstein for the book IBS-Free Recipes by Lisa Rothstein, Patsy Catsos and Karen Warman,
- 1⁄4 cup Lemon Vinaigrette (recipe below)
- 3⁄4 teaspoon smoked paprika
- 8 cups thinly sliced kale leaves, ribs removed (4 ounces)
- 8 black oil-cured olives, pitted and finely chopped
- 1⁄2 red bell pepper, seeded and diced into 1⁄4-inch pieces
- 1⁄4 cup shaved Parmesan cheese (1 ounce)
- 1⁄4 cup pumpkin seeds (pepitas) or sunflower seeds
- LEMON VINAIGRETTE
- 1 1⁄2 teaspoons Dijon mustard
- 1⁄4 cup fresh lemon juice (about 2 lemons)
- 1⁄4 teaspoon salt
- 1⁄4 cup plus 1 tablespoon extra-virgin olive oil
- 2 1⁄2 teaspoons granulated sugar
- 1⁄2 teaspoon finely grated lemon zest (optional)
- 2 tablespoons water
- Shake ingredients together vigorously in a tightly covered glass jar. Use immediately or store in the refrigerator for up to one week.
- Yield: ¾ cup
- Whisk vinaigrette and smoked paprika together in a large serving bowl. Add sliced kale, olives, and bell pepper and toss salad to coat with dressing. Hold at room temperature for 30 minutes, stirring every few minutes. Salad will wilt slightly. Top with pumpkin seeds just before serving.
If you have any questions about IBS or other stomach problems, you can contact Patsy directly through her blog.