In my extensive research on IBS, I’ve come across all kinds of information and claims on the topic. The cause of IBS seems especially debated, some doctors agreeing with me in that stress can cause IBS, while others believing stress has nothing to do with it.

The title of this post is an argument made by a doctor against the idea that stress causes IBS. He felt that stress makes everything worse, so if you have IBS, the symptoms just get worse when you are stressed out, just like how all your health issues would.

I agree that stress makes everything worse. But I do believe stress can also cause IBS.

In short:

1. There is much evidence to show that a large proportion of people with IBS have trauma in their past (extreme stress)
2. The IBS diagnosis was made right after a period of severe stress in many, if not most, cases. I’ve seen this with my clients time and again. 
3. Stress can lead to all the classic IBS symptoms. This is a fact.

Furthermore, scientists agree that stress can cause a whole host of symptoms, NOT ONLY digestive problems and all the classic IBS symptoms of bloating, diarrhea, constipation and abdominal pain, but also headaches, muscle tension, hives, high blood pressure, dizziness…. 

Everyone has stress (at least sometimes), then why doesn’t everyone have IBS? 

It’s a matter of stress manifesting in different ways in different people. I don’t know why someone gets migraines from stress and someone else horrendous bloating, it’s probably a sum of many things that are different between individuals.

It seems most of us have experienced gut symptoms from stressful episodes, especially when feeling nervous from having to perform in front of people, be it a speech or a sports competition. Me included! The symptoms just don’t reach the severity or frequency to qualify for an official IBS diagnosis every time.

"Everyone has IBS"

I recently chatted with a gastropsychologist (a psychologist specializing in IBS and other digestive disorders), and it was her thought that “everyone has IBS”. It's an interesting way to think of it, and essentially it speaks to the stress reaction being a universal mechanism. Then, if stress is severe enough and passes a certain individual threshold, everyone will get GI symptoms of some kind! 

So, don’t believe when someone even of authority says that stress doesn’t cause IBS. Sure, there are many things at play, and stress might not be the only ingredient needed to “make” IBS, but to say it has no role at all in IBS to me is impossible. 

If you are serious about taking charge of your IBS, talk to me. I offer free 30-minute consultations (no strings attached!) to give you a chance to talk to an expert about your situation. You’ll gain valuable advice on your next steps toward IBS freedom, and a chance to have expert guidance going forward, if you so choose.

How are your stress levels these days? It’s hard to remain centered in this tumultuous world!

Could the answer to IBS lie in the ancient practice of meditation?

IBS is a world-wide problem and the most common gastrointestinal disorder.

For a long time, irritable bowel syndrome has just been thought of as a functional problem: there’s nothing measurably, or visibly wrong with the intestines, so labeling IBS as a functional problem is almost like a shrug from the experts. 

Now, IBS has earned a new classification: a disorder of gut-brain interaction. So, instead of IBS being a functional problem, there’s actually something physical that becomes disrupted – it’s just not visible to the naked eye. 

What is gut-brain interaction? It is the two-way communication highway between your brain and your gut. It’s also called “gut-brain axis”. When the connection is disrupted, there are misunderstandings and overreactions that lead to IBS symptoms. You can read more about the gut-brain axis in this blog post.

What disrupts the gut-brain interaction? Many things, but a big culprit looks to be stress (1). Stress causes stress hormones to surge in the body, which turn digestion off. With a lower digestive “fire”, food digests poorly, leading to abdominal pain, diarrhea/constipation and/or bloating. 

To make matters worse, the brains of people with IBS are wired in ways that make them more sensitive to stress, triggering a stress response more easily, which causes a difficult situation to turn into gut symptoms more easily as well. (2)

Solution? To mend the gut-brain interaction through stress release practices and mindset shifts. 

And what I’m really excited about, is meditation’s ability to change the brain to withstand stress better (4). This means that while stress is not going to go away, you cope better with stress, and a stressful situation less easily leads to IBS symptoms. Naturally, these effects come from a long-term practice. But, even a one-time practice of a few minutes of meditation can measurably reduce stress. (5)

Personally, after 15 years of practice, daily meditation has become my secret weapon. Not only do I feel great while meditating (though not always, sometimes my brain is just too restless), I’ve noticed in general feeling calmer, more empathetic, and having a better emotional control than I used to. It feels like my brain gets triggered less easily.

One of the meditation techniques I particularly love is Hong Sau (Sau pronounced “saw”). It’s a technique of attentive focus on the breath. Since the breath is always there, it becomes an excellent object for meditation (no, meditation is not about blanking the mind). A focused mind is a calm mind, and a calm breath leads to a calm mind and vice versa. Or how do you breathe when you are reading a book with deep focus? 

I’m teaching the Hong Sau meditation technique live online starting today on Wednesday January 8^th 2025. There’s still time to sign up! Even if you miss the first class, you can still participate live in the remaining four. All the sessions will be recorded, so you’ll get the recording of the first session, and they will be made available for purchase as a full course after the live course is finished. Go here for more info. Sign up by emailing me at [email protected]

Questions? You got my email address.

Let’s make the year 2025 the best one yet! Let’s start by taking up meditation, or some other stress release practice, and cultivating the belief that improvement is possible – I really do believe that. Even if you feel like you’ve tried everything, something will help you, if you keep working at it.

References

1. Cryan JF, O'Riordan KJ, Cowan CSM, Sandhu KV, Bastiaanssen TFS, Boehme M, Codagnone MG, Cussotto S, Fulling C, Golubeva AV, Guzzetta KE, Jaggar M, Long-Smith CM, Lyte JM, Martin JA, Molinero-Perez A, Moloney G, Morelli E, Morillas E, O'Connor R, Cruz-Pereira JS, Peterson VL, Rea K, Ritz NL, Sherwin E, Spichak S, Teichman EM, van de Wouw M, Ventura-Silva AP, Wallace-Fitzsimons SE, Hyland N, Clarke G, Dinan TG. The Microbiota-Gut-Brain Axis. Physiol Rev. 2019 Oct 1;99(4):1877-2013. doi: 10.1152/physrev.00018.2018. PMID: 31460832.
2. Mayer EA, Ryu HJ, Bhatt RR. The neurobiology of irritable bowel syndrome. Mol Psychiatry. 2023 Apr;28(4):1451-1465. doi: 10.1038/s41380-023-01972-w. Epub 2023 Feb 2. PMID: 36732586; PMCID: PMC10208985.
3. Baboș CI, Leucuța DC, Dumitrașcu DL. Meditation and Irritable Bowel Syndrome, a Systematic Review and Meta-Analysis. J Clin Med. 2022 Nov 2;11(21):6516. doi: 10.3390/jcm11216516. PMID: 36362745; PMCID: PMC9658118.
4. Taren AA, Gianaros PJ, Greco CM, Lindsay EK, Fairgrieve A, Brown KW, Rosen RK, Ferris JL, Julson E, Marsland AL, Bursley JK, Ramsburg J, Creswell JD. Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: a randomized controlled trial. Soc Cogn Affect Neurosci. 2015 Dec;10(12):1758-68. doi: 10.1093/scan/nsv066. Epub 2015 Jun 5. PMID: 26048176; PMCID: PMC4666115.
5. Mandlik GV, Siopis G, Nguyen B, Ding D, Edwards KM. Effect of a single session of yoga and meditation on stress reactivity: A systematic review. Stress Health. 2024 Jun;40(3):e3324. doi: 10.1002/smi.3324. Epub 2023 Oct 11. PMID: 37822096.

The low FODMAP diet is a relatively well researched diet for IBS. Studies show that the low FODMAP diet can ease symptoms in about 2/3 of cases in varying degrees (1). But that’s just it – this diet is not a true treatment for IBS as it can only manage symptoms and not the cause of IBS. But more on that later.

The idea behind the diet is that FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), which are naturally more difficult for the body to digest, are minimized in the diet and then brought back one FODMAP group at a time. This is because you want to only avoid those FODMAP groups that trigger symptoms – it’s not usual that all FODMAP groups are the problem. Because these fibers don’t digest well, they attract water into the intestines and are fermented (digested) by your gut microbes, both of which can cause bloating, discomfort and potentially diarrhea/constipation. 

The thing is, this happens to everyone eating FODMAPs, especially in large amounts. The reason why people with IBS so often find these fibers problematic is that they have visceral hypersensitivity - they feel everything going on the intestines more strongly. Even normal things in the gut can cause bloating and pain, when normally you wouldn’t feel anything at all. 

It’s important to know that FODMAPs are not bad for you. They feed the healthy gut bacteria in the large intestine, which is actually very good for your health. Avoiding FODMAPs gives the gut bacteria less food to process, which reduces their gas production and in turn gut symptoms. Unfortunately, studies have noticed that some beneficial bacteria species are reduced on the low FODMAP diet probably for this reason. 

This is one reason I’m not the biggest fan of the diet. Other reasons are:

• The potential for food fears: there is a risk that you begin labeling high FODMAP foods as bad, which can lead to fear toward these foods. Fear is not helpful for gut function.
• Increased stress: the low FODMAP diet is not the easiest diet to follow. If you want to try the diet, always make sure you understand what you are doing, and even better, get guidance from an expert dietitian. Even then the diet tends to cause stress, and stress causes IBS symptoms, so following the low FODMAP diet can be counterproductive from this standpoint. 
• It doesn’t treat the underlying cause: a problem in the gut-brain interaction. Perhaps, if your symptoms improve on the diet and you feel relief and reduced stress from the improvement, this can help mend the disrupted communication between the gut and the brain. But it’s not the diet change that truly did it, it’s the feelings and thoughts that followed that made the difference.
• Nutrient deficiencies: if you only cut foods out and don’t bring the right low FODMAP foods in, there is a risk of not getting enough of all the nutrients you need. Malnutrition is never supportive of gut health. 
• Often there are bigger fish to fry than your diet when it comes to IBS management. If your lifestyle is not supporting your gut health, diet changes likely have a very limited impact on your symptoms. If you don’t sleep enough or if you are very stressed out for example, IBS symptoms may not be affected in any way by the low FODMAP diet. 
• The low FODMAP diet asks you to avoid healthy foods, like whole grains and certain fruits and vegetables. 
• Potential negative effects on your gut microbiome as mentioned above

How do you do that? You need to think about yourself as a whole – everything that is going on in your life and your body is affecting everything else. It’s not just about food. 

My best advice? Get in touch with me to see what might be the most important diet and lifestyle changes for you. Book your free session here.

Or, if you prefer to work on your own, I have the perfect self-care program for you: IBSwise. It goes over everything worthy of knowing about IBS, with many tools that you can try right away to ease your symptoms – tools that focus on mending the gut-brain communication to achieve real results. It’s an awesome program and I highly recommend it. The price is going up on 1/1/2025, so get enrolled now! 

You can get started on calming the real problem behind IBS by practicing a breathing exercise like box breathing at least once daily. Go to Instagram to my account @ibsandstressdietitian and find there a short instructional video on box breathing pinned at the top of my posts. My clients are benefiting so much from practicing breathing exercises, so this tip is my gift to you. 

Wishing you all the best,

PS. Did you get my free “5 Easy Ways to Beat the Bloat” ebook? If not, go here to get it!

References:

1. Manning LP, Yao CK, Biesiekierski JR. Therapy of IBS: Is a Low FODMAP Diet the Answer? Front Psychiatry. 2020 Aug 31;11:865. doi: 10.3389/fpsyt.2020.00865. PMID: 33110411; PMCID: PMC7488954.

I’ve recently noticed a diet that is trending – the carnivore diet – not just among people in general, but also among people with IBS. Being a dietitian makes me very interested in all diets, but I must say this takes the cake. This diet seems to be completely counterintuitive, as it goes against all dietary guidelines out there, so why do people try it anyway?

It's because some people who follow the carnivore diet report feeling much better after switching. They feel more energetic and lighter than before. They report that their IBS symptoms get better, even disappear in some cases. As a registered dietitian, this is hard hard for me to believe, so let’s dig in and see what is going on here.

The Carnivore Diet: A Closer Look

Let’s first find out what this diet is. This diet is almost exactly as it sounds: it is all meat, fish and chicken. You are also allowed a little bit of cheese, heavy cream and eggs. Fat sources are lard and tallow, although some allow plant oils in the diet also. You can drink unsweetened coffee and tea and add spices that contain no carbs. 

Basically, this diet is an extremely low carbohydrate diet, very high in protein, and high in fat. It is not possible to get all the nutrients your body needs from this diet, especially vitamin C, B vitamins, vitamin K and calcium, unless you include a variety of organ meats in your diet every day, like liver, kidney, and brain. For omega-3 fatty acids, it’s important to eat fatty fish, like salmon. Unless you drink coffee or tea, this diet contains hardly any antioxidants - these are highly beneficial for your health as they fight free radicals that damage your tissues. Animal foods contain no fiber that are needed to support the health of the gut microbiota. 

To sum up, the carnivore diet is a highly restrictive eating plan that consists of 99% animal-based foods and carries with it a high risk of malnutrition. It’s not a diet that any dietitian or doctor can recommend to be followed. How is it possible then, to feel better with this diet?

Why you might feel better

There are no objective studies done, so I can’t say anything for sure, but I have a few theories why someone might feel better.

1. You eat hardly any processed food and no sugar. Processed food is a big problem in today’s world. These foods usually contain additives, sugar, and hardly any vital nutrients, and so they are harmful to health. People who follow the carnivore diet are likely to eat a lot less processed food, perhaps even none, unless they choose deli meats and sausages etc. on their plate.
2. Ketosis. The carnivore diet contains close to 0 grams of carbohydrate, which means the body must go into ketosis to survive. People on a ketogenic diet report feeling more alert (though not always!). Ketogenic diets also increase fat loss in the body, which helps lose weight and may help make you feel better (at least in the short term).
3. Placebo effect. It is a big dietary change, and if you are expecting to feel better, the placebo effect can help you achieve this. At least for a while. Placebo effect tends to lose power long term.
4. No carb fermentation. Gut symptoms may improve as there is no fiber for the gut microbes to process and make gas from – bloating and flatulence improve. However, a diet with no fiber, and without green/herbal tea no polyphenols either, cause negative changes to the composition of the gut microbiota (=dysbiosis).  The lack of fiber tends to lead to constipation, and some people might even experience diarrhea caused by the dysbiosis.

The risks involved

• Who knows what this does in the long term! There are no studies, and objective studies are not possible because of ethical reasons as mentioned above. Researchers would have to rely on a small group of volunteers, and so there would be many biases that come from a non-random study groups making results untrustworthy.
• In the long term, you will very likely get nutrition deficiencies without supplementation.
• No fiber in the diet leads to gut microbiota dysbiosis, which leads to health problems 
  • Gut microbes will need to process proteins and amino acids instead, leading to production of potentially harmful compounds.
• High meat consumption is linked to a host of health problems, like gout, osteoporosis, and kidney stones, and even colon cancer, whereas plant rich diets are linked to longevity and lower risk of chronic illnesses.
• No antioxidants at all, unless tea/coffee is added to the diet. Antioxidants fight free radicals and tissue damage.
• Humans are not actually carnivores, we are omnivores. Just compare the digestive systems of a wolf and a human. It’s not built to process only animal protein.
• Very high protein content. Excess protein will be turned into carbs and other molecules, and getting rid of protein waste products is very tough on the body. Kidneys will be taking a hit in the long term.
• The diet is not sustainable, you’ll get cravings eventually and it will be hard to maintain the diet. Resuming to your normal diet after being on a carnivore diet can cause you to regain all the weight you had lost, and sometimes gain even more.
• Following the diet increases the risk of disordered eating for people prone to them.
• Constipation from no fiber / diarrhea from changed microbiota.

Who absolutely should not try this diet

But what about the Inuit?

The carnivore diet (or any meat-heavy diet for that matter) is against the dietary recommendations of any given country in the world. But then we have Inuits who mostly eat fish and meat. They seem to do well on this diet. So why shouldn’t others do the same?

This is an excellent question! Here’s what I found.

However, it’s important to note that the traditional Inuit diet is not a carnivore diet, it also includes local plant foods, studies are estimating 8-50% carbohydrate. Also, the Inuit eat lots of marine mammals and fish, including their internal organs, which helps provide more of the nutrients the body needs. 

It has been thought that heart disease doesn’t exist among the Inuit population, but this might not be the case. Another problem with this diet is also that it doesn’t promote bone health - the Inuit have been found to have very poor bone health and early onset osteoporosis. 

What to do instead

If you have IBS, and are seeking a diet that minimizes symptoms, it shouldn't be the carnivore diet. It might not be the low FODMAP diet either. What you need is a balanced, highly individualized diet that takes into account much more than just your gut symptoms, such as your age, gender, background history, habits, skills and so on. This is what dietitians do – they look at your diet from all angles and recommend changes to support your gut health, your overall health and your wellbeing.  

If you are considering trying out an extreme diet like the carnivore diet, it is a sign to talk to an IBS dietitian and get real solutions that bring you real results, without risking your long term health. Book a free gut health review with me to kickstart your journey to finding your very own, best possible IBS diet.

PS. If you haven’t yet, download my free “5 Easy Ways to Beat the Bloat” guide packed with actionable tips that you can start applying in your day to day life right away.

PPS. Let’s chat! There is a right IBS diet for you out there. Book your free gut health review now!

References:

1. LeWine, H. E., What is the carnivore diet? Harvard Health Publishing. 2024. Accessed 11/20/2024 
2. Eagle, R, medically reviewed by Seitz, A. Carnivore diet: What it is and how to do it. 2020.  https://www.medicalnewstoday.com/articles/carnivore-diet accessed 11/20/2024
3. Campbell, T. Masai and Inuit High-Protein Diets: A Closer Look. NutritionStudies.org. Accessed 11/20/2024
4. Fumagalli M, Moltke I, Grarup N, Racimo F, Bjerregaard P, Jørgensen ME, Korneliussen TS, Gerbault P, Skotte L, Linneberg A, Christensen C, Brandslund I, Jørgensen T, Huerta-Sánchez E, Schmidt EB, Pedersen O, Hansen T, Albrechtsen A, Nielsen R. Greenlandic Inuit show genetic signatures of diet and climate adaptation. Science. 2015 Sep 18;349(6254):1343-7. doi: 10.1126/science.aab2319. PMID: 26383953.
5. Oliphant K, Allen-Vercoe E. Macronutrient metabolism by the human gut microbiome: major fermentation by-products and their impact on host health. Microbiome. 2019 Jun 13;7(1):91. doi: 10.1186/s40168-019-0704-8. PMID: 31196177; PMCID: PMC6567490.