I’m an independent gal so I get it – you’re thinking you can figure this IBS stuff out yourself. Surely that’s doable, what with all the info online and Dr ChatGPT at your fingertips. But it’s easy to get lost in the weeds, overwhelmed by all that info, and led astray by inaccurate or out-of-context online advice.
This is where an IBS dietitian comes in.
What is an IBS Dietitian?
Simply put, an IBS dietitian is a registered dietitian who specializes in irritable bowel syndrome.
Because IBS is influenced by many factors, IBS dietitians help clients control their digestive symptoms in numerous ways:
- Dietary change (no surprise there!)
- Fibre therapy
- Evidence-based supplements
- Gut-brain axis strategies to calm the nervous system
- Over-the-counter medications
You can’t specialize in IBS without knowing A LOT about the gut, so IBS dietitians are also well versed in other digestive conditions:
- Chronic constipation and diarrhea
- Reflux and GERD
- SIBO (small intestinal bacterial overgrowth)
- Histamine intolerance
- Diverticulitis
- Gluten-related disorders
- Inflammatory bowel disease
More than simply providing education, IBS dietitians assess their clients’ diets, collaborate with clients on personalized interventions, coach clients through the difficult process of change, and provide emotional support.
Now let’s explore the nitty gritty of exactly how an IBS dietitian can help with frustrating gut symptoms.
Emotional Support and Partnership
IBS and other digestive conditions can be really stressful, frustrating and debilitating health issues. I’ve seen the mental and emotional toll IBS can take on people.
As an IBS dietitian, I have the privilege of getting to spend more time with my clients compared to many other health care providers. This extra time gives clients the breathing room to talk about their digestive symptoms and related confusion, frustrations, and fears.
Even though dietitians are not mental health counsellors, I firmly believe that listening, validating, empathizing and reassuring are some of the most powerful tools a dietitian can use with their clients.
Many clients find that the combination of practical guidance and meaningful support that a dietitian provides improves not just their digestive symptoms, but their overall wellbeing.
Thorough Assessment of Your Diet and Lifestyle
The devil’s in the details and IBS is complex, so IBS dietitians ask A LOT of questions to understand their clients’ gut health. In addition to helping identify both food and non-food symptom triggers, this deep dive helps dietitians get to know their clients’ knowledge base, health goals, and preferences.
Common topics discussed in an initial assessment with an IBS dietitian:
- Health history – existing medical conditions, medical tests (eg. blood work, abdominal x-ray, colonoscopy, etc), allergies, mental health issues including history of eating disorders.
- Current use of supplements, over-the-counter medications, and prescription medications.
- Diet, food intolerances, fluid intake, and eating patterns.
- Common symptoms, triggers, timing, severity.
- Bowel movement habits.
- Exercise, stress and stress management efforts, sleep quality.
- Interventions the client has tried before.
With a greater understanding of their clients diet, health, lifestyle and goals, dietitians can recommend targeted and personalized interventions that are more likely to improve gut symptoms.
Exploring and Implementing the Best Interventions
After a thorough assessment has pointed towards potentially helpful interventions, the dietitian can give you the support and education to implement them. This can look like:
- Education on why certain symptoms are happening (eg. frequent diarrhea in the morning being driven by a strong gastrocolic reflex).
- Education on IBS treatment options – both diet and non-diet interventions.
- Brainstorming meal and snack ideas that fit the client’s preferences, restrictions, lifestyle, and goals.
- Tips and tricks on how to take supplements or over-the-counter medications for best results.
- Recipes and meal planning.
- Providing lists of therapeutic foods (eg. soluble fibre, laxation foods, GI-gentle diet, etc).
- Suggesting helpful food products and supplements.
- Troubleshooting challenges the client faces in implementing interventions.
- Coaching clients though change via motivational interviewing that helps draw out intrinsic motivation.
Personalized Guidance on the Low FODMAP Diet
A Monash FODMAP trained IBS dietitian will be skilled in assessing whether the low FODMAP diet would be beneficial for a client, and if so, tailoring it to the client’s needs.
To give an example, some clients can’t or don’t want to do the full low FODMAP diet but are open to modified versions such as reducing only certain FODMAPs that the dietitian can recommend based on the clients’ diet.
If the low FODMAP diet isn’t a suitable option for a client, such as in the case of a concurrent eating disorder or a busy lifestyle, then the IBS dietitian can provide guidance on alternative interventions such as supplements, gut-brain axis strategies, and lifestyle modification.
Supporting A Better Relationship with Food
People with gut health issues are at high risk for having a poor relationship with food. This manifests as being fearful of food, avoiding lots of foods, developing strict food rules, and skipping social gatherings.
Sadly, disordered eating and eating disorders are common among people with poorly managed digestive symptoms.
IBS dietitians create a supportive environment where clients can talk openly about food fears, food rules, and past struggles with food — without shame or blame. We don’t label food as “safe” or “unsafe”, “good” or “bad” because doing so can foster fear, anxiety, unnecessary restriction, disordered eating and malnutrition.
Food isn’t good or bad, it just is. When we understand all the factors that influence IBS symptoms, we learn to unsee food as the villain.
When focusing on food isn’t the healthiest option, the IBS dietitian supports clients in implementing non-food interventions that can improve digestive distress.
Referring to Other Health Care Providers Who Can Help
Sometimes diet, lifestyle tweaks, supplements and basic gut-brain axis strategies aren’t enough.
When people with constipation-predominant IBS don’t respond well to diet, supplements or over-the-counter medications, an IBS dietitian can screen for pelvic floor dysfunction and refer clients on to a pelvic floor physiotherapist for a full assessment.
Similarly, dietitians can help re-direct clients back to their physician for further assessment when folks with diarrhea-predominant IBS don’t respond well to interventions. Some cases of IBS-D end up actually being bile acid malabsorption or SIBO, two issues that need medical management.
IBS dietitians can also spot when a client may need extra mental health support and in collaboration with the client, discuss a referral to a therapist.
Team work makes the dream work!
Thanks for stopping by!
xoAndrea, RD
