The IBS Q and A with Priya Tew

Priya is a dietitian who specialises in irritable bowel syndrome (IBS) and eating disorders. She runs her own private practice (www.dietitianuk.co.uk) and has written a book specifically on IBS called “The Complete LOW FODMAP Diet Plan”. She is an expert in all thing’s gut health, which is why we asked her to share her knowledge in our latest Q&A.

The relationship between gut health and IBS

What is the gut microbiome and why is it important?

The gut microbiome is made up of the bacteria, fungi, viruses and other microbes (known as the microbiota) plus the genetic material of these microorganisms. These micro-organisms vary from person to person and are influenced by the food you eat, the environment you live in, your mental health and your physical health too.

These microorganisms are involved in many functions critical to our health and wellbeing, such as digestion, metabolism, immune health and even brain health. Although it is established during infancy, we can modify the balance of our gut microbiome at all stages of life through our diet, exercise, sleep and the environment we live in.

Disruption to the gut microbiome can lead to digestive conditions such as IBS, as well as many other disorders including anxiety. Therefore, looking after our gut health is very important.

What is IBS?

Irritable bowel syndrome, or IBS as it is more frequently referred to, is a functional gut disorder where the gut is more sensitive and the balance of bacteria in the gut is altered. It is a common condition with 5-12% of the population suffering, but it is often undiagnosed or just seen as something to cope with. Symptoms can include:

· Bloating

· Excess wind

· Diarrhoea and/or Constipation

· Nausea

· Gurgling tummy

· Tiredness

· Feeling full quickly

· Abdominal pain

This can be very uncomfortable and debilitating, stopping you from enjoying social occasions and enjoying life to the full. There can be a number of causes or triggers including tummy bugs, having an over-sensitive gut or what we eat in our diets. Stress and anxiety can also play a key role in the development and worsening of symptoms, as our guts and brains are in close communication with each other, and are connected via the gut-brain axis.

Tell us more about the gut-brain axis

IBS is also known as a disorder of the gut-brain axis. The gut-brain axis (GBA) is a two way means of communication between the brain and the gut. You could think of it like a telephone, with the vagus nerve that connects the two together being the telephone wire that the messages are being sent through.

The main role of the GBA is to maintain a happy digestive system. One example of this is as you see, smell and get ready to eat food the brain tells the digestive system to get ready and make digestive juices (gastric acid). This message is sent via the vagus nerve. The cells in the gut wall also release hormones that communicate via the vagus nerve, with the brain, to feedback on fullness and hunger.

So how exactly does stress impact IBS?

Stress and anxiety are well-known factors that can disrupt the digestive system and affect IBS via the gut-brain axis. Think about those butterflies that you get when you are nervous or how some people need to rush to the toilet before a big event. These are both examples of how the gut-brain axis has an impact.

Stress can lead to a slowing down of the digestive system, leading to food passing more slowly. It can also increase the permeability of the gut, allowing substances such as toxins to cross over – which we do not want! Overall, stress can lead to poorer digestion, increased inflammation, more wind, abdominal pain and bloating. For some people this can cause the speeding up of bowel movements, leading to diarrhoea, whilst others may feel more constipated. Stress and anxiety can also influence appetite and the types of foods we choose to eat, and for some, these foods can trigger symptoms of IBS.

There is some evidence showing that interventions such as yoga, meditation, cognitive behavioural therapy and gut-related hypnotherapy can help with IBS symptoms. Anything that calms our minds, can calm our guts too.

How can we support gut health?

Dysbiosis is an imbalance of the gut microbiota and it is one cause of IBS. This altered balance of gut bacteria can alter speed of digestion, the movement of food through the digestive tract and the sensitivity of the gut as well as the serotonin levels in the body.

Incorporating live bacterial cultures, such as a probiotics supplement, and prebiotic foods into your diet are two ways you can try to help restore your gut microbiome to healthy levels. Prebiotics are the foods that feed your gut bacteria, whereas live bacterial cultures, otherwise known as probiotics, are live micro-organisms that are beneficial to our bodies. A balance of both of these is needed for a healthy gut microbiome.

Some live bacterial cultures have been shown in research studies to reduce the stress response in our bodies and brains. Having the right microbes present can affect the levels of the mood.

stabilizing chemical serotonin in the brain and reduce the leakiness of the tight junctions of the gut. However these live bacterial cultures do need to be strain specific which means you need to take the right culture for the right condition.

Written By: Priya Tew, Dietician