🌟 Struggling with that dreaded flare-up again?

Highlights:

• Decoding your gut's signals during an IBS attack.
• Learn top-notch strategies to ease the pain, reduce cramps, Quick relief tips and tricks,
• Insights on what to eat during a flare of diarrhoea or constipation
• Discover the low FODMAP heroes, from soothing teas (think peppermint, ginger, and fennel) to gut-friendly foods.
• Over-the-counter aids, from laxatives to anti-diarrhoea meds.

Links

• Work with me individually - https://www.goodnessme-nutrition.com/consultations/
• Join the Group Gut Reset - 3 months of IBS support - https://www.goodnessme-nutrition.com/group-course-ibsc/

Episode links

• Ep 17 - the low FODMAP diet
• Ep19 - FODMAP reintroductions

Do you feel like your stomach bloats

up when you even look at a pizza, or

2

you even smell a glass of Prosecco?

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Maybe you spend a few days a month,

or even a few days a week, feeling

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rubbish because of your IBS.

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Could be that you're in a flare up right

now, and you're searching for answers of

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how to calm down my gut, or what to eat in

a flare up, and how to get back to normal.

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In this episode of the Inside Knowledge

podcast, you'll find out my top tips

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for what to do in a flare, what to eat,

and what supplements might be useful.

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You'll also learn my key longer

term strategies that you can employ

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to start avoiding the frequency

of all of those flare ups.

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Welcome to episode 20 of the Inside

Knowledge with me, Anna Mapson.

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This is a podcast for people

who have IBS, and I couldn't...

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Carry on without focusing

on what to do in a flare up.

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This is going to be some helpful

advice and things about what you

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can do, what you can eat, and...

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Just some tips, really, based on

things that I've found help my

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clients, to try and get yourself back

to normal as quickly as possible.

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If you've got Irritable Bowel Syndrome,

it's not always possible to completely

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eradicate flares, but what you can

do is try to manage them and try

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to understand your triggers so that

you can live the best life that you

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can without spending too many days

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curled up with a hot water bottle

watching Netflix on the sofa.

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I thought it might be a good place to

start talking about what is a flare of

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IBS, what does it feel like, and how

would you know if you're having one?

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You may feel like you're constantly in

this kind of state, but really an IBS

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attack is normally something that's

an increase of your digestive issues.

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IBS typically does come and go, it's

quite normal for it to flare up,

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or it's, I shouldn't say normal,

it's common for it to flare up.

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But it could be that a flare is

like a sudden rise in your bloating,

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gas and diarrhoea, or sudden

flare up of constipation, that...

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That could be triggered by something

you ate, it could be anxiety, it could

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be stress, it could be medication,

or, you know, you've had a big

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night out and had some alcohol and

a few days later you get a flare up.

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Or it could just be that you've changed

some of the foods that you've been

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eating and they have not agreed with you.

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This can be so confusing because

that's basically everything.

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It's like...

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What you do, how you live, how you

eat, and how you digest the food.

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Any of those things could be a

trigger and that is what is so

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challenging to identify the cause.

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The most frustrating thing is that

even if you feel like you're doing

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everything right, you're eating in

the right way, you're exercising,

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you're sleeping well, you're trying to

pay attention to your stress levels.

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These are all things that help and

even if you're doing all of that.

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There could be something that's

happened that will cause a flare up

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and sometimes it's not actually related

to what you've been eating at all.

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I find the most common thing that

people will do is to blame the last

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food that they ate and of course this

seems to make sense that the most recent

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food was the cause of the symptoms or

that dash to the toilet that you had.

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But there are things that are not food

related that could also be suddenly

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triggering these kind of symptoms.

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And we must also think about

how long digestion takes.

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It's very rare that food

you've just eaten will cause

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immediate symptoms in diarrhoea.

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It's much more likely to be food that

you ate last night that is now reaching

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the colon and triggering the symptoms.

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It is possible that sometimes this

gastrocolic reflex, that's when we

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eat, it triggers the body to move

food along the pipes, like get rid

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of some food to allow more food in.

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So this is called a gastrocolic

reflex, and if it's very strong on

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high alert, and that can be down to

anxiety, stress, or nervous system

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disorders, then you may find that

food, as soon as you put something

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in, that nervous system kicks in.

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So that is possible.

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We also know that when we are

stressed, our body has less energy

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for digestion, which means foods won't

be broken down as well by the process

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of digestion, and that can cause more

bloating, more sensitivity, and pain.

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So, Stress and anxiety are definitely key.

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It might not be something that's

immediately happened and caused a

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flare up, but it's something that's

been building over a couple of

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days, and that is really triggering.

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For women who have periods, you may

find that IBS symptoms are worse just

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before or after your period, and this

is because of the hormones that make the

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uterus contract to release the lining.

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These hormones can also affect...

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The gut, which are obviously very close

to the uterus, all in your same torso.

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And this can lead to more cramps,

pain, and just high sensitivity

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in your large intestine.

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So this is also really key, is

thinking about the time of the month.

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And then, in terms of food, it could

be that you've had, too much fibre.

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Maybe too much coffee, alcohol,

high level of sweeteners.

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Maybe more dairy than you're

used to, or very greasy foods.

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Any of those things could potentially

be triggers, but it doesn't mean

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they necessarily are your triggers,

but just things to be aware of.

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I know when you have a chronic condition

that you can spend hours thinking

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about what was the problem, what was

the thing that tipped you over this

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time, and trying to find out that one

trigger that you can now eliminate so

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you never have to go through this again.

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I know how tempting it is to

spend all that time thinking

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about it, researching online.

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Sometimes you just don't really

know, and you have to just move on,

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and it is frustrating not to know.

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But at the same time getting

yourself worked up about it is also

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counterproductive because it can feel

like you're very stressed searching

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for this thing which is very elusive.

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So now I'm going to move on to talk about

what you can actually do in a flare up

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in that acute situation, some little

tips that might help you feel better

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and then what you can eat to try and get

over the flare as quickly as possible.

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And then I'll also focus on what

over the counter Medications may

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be helpful in those situations.

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You're probably doing a

lot of this stuff anyway.

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But, I suppose my top bit of advice is

to really try to be kind to yourself

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and to allow yourself to recover.

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It's so common to push on

through, keep going, and...

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Generally, we want to think about what

is going to reduce pain, reduce the

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cramps, and help you feel more relaxed.

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So, a couple of things.

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One is, warmth.

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And you can get that either through a heat

pack or a hot water bottle that you put on

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your stomach and can just ease any cramps

and pain and that feeling of sensitivity.

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Maybe a warm bath might help you relax

and just soothe your stomach a little bit.

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Or just getting a blanket

and curling up on the sofa.

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And just trying to keep warm.

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Because when you're cold you

feel tense and you tend to

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hold your body more tightly.

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So, just trying to relax

as much as possible.

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Then, in terms of relaxing your

body from the inside, something

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that can be helpful is drinking

soothing herbal teas for digestion.

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And these can be Sipped

throughout the day.

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You can have them cold if you don't like

hot drinks, but the warming liquid is

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actually quite soothing on your stomach.

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Peppermint tea is good because it

helps you to release gas back up.

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So it helps you to burp because it

relaxes the sphincter at the top of your

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stomach which can increase your burping.

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This means gas doesn't travel

down the digestive system.

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So this is why it's best not to

drink peppermint tea if you're

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lying down or before you go to bed,

especially if you are prone to reflux.

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But peppermint oil is traditionally

used as a digestive aid, and

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you can get capsules, actually,

which I will come back to.

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But peppermint tea is useful because

it's an antispasmodic, so it helps

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to relax painful stomach cramps, and

it helps to just soothe your stomach.

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Ginger tea might help

with feelings of nausea.

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It's often used in anti sickness

sort of supplements, and it can

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reduce inflammation as well.

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So if you're more diarrhoea predominant,

in some studies, ginger's been shown to

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sort of reduce water being drawn into

the bowel and also reduce inflammation.

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So ginger is also really

helpful, ginger tea.

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The other one that's less well known,

I feel like ginger and peppermint

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you might have heard of, is fennel.

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You can just soak some fennel seeds

that you get in the supermarket in hot

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water or chew on them after a meal.

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And if you don't know much about fennel,

it has a licorice y kind of taste, so.

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It's quite pleasant for some people,

some people don't like licorice, but

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It is soothing and it is, been shown

to, like, relax gas and cramps and

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bloating, so can be very helpful.

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The last one I wanted to

mention was lemon balm.

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It grows really easily in the garden

and it's a little bit like peppermint

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tea, but it's also quite calming

and it may help feelings of, like,

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anxiety, sleeplessness, and lemon

balm is sometimes used in anxiety

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supplements and that sort of thing.

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So it may help to reduce down

sort of hypersensitivity.

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So yeah, give it a go.

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Other teas that might be helpful include

chamomile, turmeric, maybe lemon,

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anything really that's nice warm liquid.

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That is going to be

soothing on your stomach.

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I would stay away from things like

hot chocolate, lattes, like a huge

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amount of high lactose, milky drinks.

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And also reducing down your caffeine

and tea intake because they can

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make you feel more sensitive and can

also really trigger bowel cramps.

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Now, you may feel...

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Like, you just want to lie down

when you've got an IBS flare, and

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you don't feel like doing anything.

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However, gentle movement

is really helpful.

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Not only will getting outside for a

little walk help you to sleep better,

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because you've got a bit of fresh air,

a bit of outside exposure, and just can

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help you sleep better, which will then

help you to recover from this flare up.

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But also, little bit of things

like..., anything where you are putting

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yourself into an inverted position.

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So basically your bum's up in

the air and your head is down.

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So like a downward dog or child's pose,

or anything where you're lying on the

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floor putting your bum in the air,

that will potentially help to release

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a little bit of gas and may help you to

soothe any bloating and, Trapped wind.

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So if you're doing all of those

things, you know a little bit of

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gentle movement trying to rest Trying

to take time to recover keeping

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yourself warm and cozy And comfortable.

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Oh, the other thing I meant

to say was a soft waistband.

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So don't wear any tight clothing,

stay away from really tight yoga

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leggings or tight skinny jeans, that

sort of thing, because that is going

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to constrict your stomach and may

add to bloating and trapped gas.

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So let's move on to what

to eat during an IBS flare.

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This will be slightly different

depending on your symptoms.

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If you are somebody who has more

constipation predominant symptoms and your

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flare up involves not going to the toilet

for a few days, feeling bloated and heavy

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and just very stuck, one of the things you

want to do is to really focus on fibre.

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And also things that are going to

help to draw water into the bowel

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to try and get a softer stool.

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If you're not already doing this, I

do suggest eating two kiwis a day.

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They have been shown to really

improve constipation and with

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the least amount of bloating.

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So things like psyllium husk, which

you can take as a supplement, may be

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beneficial, but may, in some people, lead

to a little bit of bloating and cramps.

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Where, in a study, where they compared

psyllium husk, prunes, and kiwi.

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Kiwi had a similar kind of result in

terms of bowel frequency but had less

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side effects like bloating and the cramps.

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So two kiwi fruit a day is really good for

constipation and can be used in a flare

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or just as a preventative type measure.

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I would also really focus on soft

warming foods, well cooked because

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they are easiest to digest and try

to Also eat things like porridge,

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so oats, really good because they

include a lot of soluble fibre which

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can help to draw water into the bowel.

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If you don't find a lot of bloating

problems with stone fruit, then they can

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also be really good in a constipation

flare because they do help, have

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good levels of fibre, but can also

help to draw water in and that can

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be really helpful in softening your

stool and just keeping you going.

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With constipation I...

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definitely suggest walking as

well, or even if you can manage it,

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running, because that action will

often help to stimulate a bowel

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movement and can be so helpful.

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So for people who have constipation,

remember you want to try to increase

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the variety in fiber because you

want some bulk forming fiber and

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you want some viscous gel forming

fiber to try and create a soft stool.

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So really focusing on fiber, but

juicy fruits, that kind of thing.

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Kiwi as I mentioned, citrus fruits

like oranges, um, and then lots of

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root vegetables, things like sweet

potato, butternut squash, carrots,

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as well as grains like oats and rice.

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These would be great foods for you to

eat if you have constipation flare up.

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If you have more...

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of a diarrhoea type flare up, and

you're getting bloating, gas, and

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a lot of frequent stalls, then you

might find going low FODMAP for a few

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days will help to remove some of that

fermentable starches out of your diet.

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If you need a reminder on what the FODMAP

foods are, please go back to episodes 17

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and 18, where I dive into the low FODMAP

diet and give you a little overview.

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But typical high FODMAP foods would

be things like onions, garlic,

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wheat, mushrooms, red pepper and

cherry tomatoes, beans and lentils,

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stone fruits and also dried fruits.

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So these are like common healthy foods

that you might be eating lots of that

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may have triggered a symptom flare.

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What I would suggest is doing a

low FODMAP few days and that would

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be really focusing on protein.

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So chicken, you can have tofu, eggs maybe.

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Fish as well would be great, as well

as some fruits and vegetables that tend

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to be lower in FODMAPs, like, again,

kiwi, you can have berries, blueberries,

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raspberries, broccoli, and potatoes.

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Don't forget potatoes.

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A good, cheap, and relatively

easy to digest food.

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So, generally, those

are really useful foods.

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To have when you have got a flareup.

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As well as thinking about what

you can eat, what you can do.

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You might also be interested in some

products and things that you can just take

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in the short term to help you feel better.

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If you have got constipation and

your problem is that you haven't

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been for a few days, it's quite hard

and you're feeling very bloated.

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Don't be afraid to use

laxatives if you need them.

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Laxatives encourage you

to have a bowel movement.

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Some of them work quite quickly and some

of them will take a few days to get going.

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There are different types of

laxatives and so you need to find

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a solution that works for you.

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Some of them, for example, draw water in.

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They're called osmotic laxatives and that

will soften the stool and create more of

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a need to go and make it easier to pass.

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Some laxatives add bulk, like

extra fibre, to your stools

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and some are more gel forming.

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So, it's best to find the one that will

work for you and your particular symptoms,

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but do go and check with your pharmacist,

if you're not sure, and trial them.

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There's no harm in trying laxatives, and I

know people are often very scared of them.

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often really avoid them.

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But if it can clear this backlog and

just enable you to feel better, then

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you can spend a bit more energy and time

getting to work on your diet and longer

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term changes when you're feeling better.

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It's very hard to do that

when you're feeling so stuck.

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If your problem is the opposite and

you've got lots of frequent bowel

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movements, um, you might actually find

anti diarrhoea medication helpful.

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So this is something

like loperamide, Imodium.

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This is fine again to

use in the short term.

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If you're having a flare up and

you need to go to work or you need

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to sit in the car for an hour to

drive somewhere, then you need to

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make sure that you're not going to

have an urgent diarrhea explosion.

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So It's fine to take this in the short

term to help yourself feel better

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in terms of like gas and cramping

There are supplements and things

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that you can take to ease the gas.

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You can get peppermint capsules.

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That's one thing that is useful for

helping to disperse the gas a little

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bit and relax It's like an antispasmodic

and that can be helpful sometimes.

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Do make sure with peppermint capsules

though that you're getting an enterically

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coated capsule, or it might say sustained

release, and that is in order for

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To avoid the capsule opening in your

stomach, you do not want to have a

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load of peppermint oil in your stomach.

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It will potentially cause reflux,

and these enterically coated ones, so

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things like colpamine or boscomint,

sometimes they're called, these are

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only going to open in the more alkaline

environment of your small intestine,

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and that is where you want them to open.

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You don't want it in your stomach.

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Other things that help to disperse

wind and gas, there are products

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sometimes, like, Cimeticone, which

is like an anti foaming agent.

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So it, you know, like if you have

bubbles of gas, it's basically changing

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the surface area of the gas bubbles

to help them move through the gut.

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Um, this medication doesn't get absorbed.

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It just goes straight through you.

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And it can be helpful, just

to disperse gas a little bit.

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Sometimes you can do a similar

thing with activated charcoal.

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You can take it for a short period

of time, to see if it helps you.

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I wouldn't take it longer term because

it can interfere with mineral absorption.

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But again, just in the short term,

just for the flare up, it's okay

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to take activated charcoal tablets.

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Something else you might have heard

of is like another antispasmodic,

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which is buscopan, useful for when

you're getting a lot of cramping

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and pain and like, urgent diarrhoea,

and they get to work quite quickly.

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But, I wouldn't take something like

that when you have constipation,

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because it can, for some people,

slow down the motility of your gut.

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If you have thought you'd like to try

the low FODMAP diet and you don't know

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what to do, what to eat, you can download

a low FODMAP meal plan from my website.

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It's 10.

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It's not available to anybody in America

or Canada unless you work with me one

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to one, but you can download it from

elsewhere in the world and that will

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give you a selection of breakfast, lunch

and dinner recipes that can help you to

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eat in a low FODMAP way that hopefully

is doable and not, too challenging.

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And then if you want help longer term

to try and minimise these flare ups, do

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get in touch, I work with people on a

one to one basis, over three months in

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my one to one gut reset, or of course my

group gut reset, which is where I take

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groups of people through the same gut

reset process, but in a group situation.

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Right, that is it for this week,

I will see you next week, goodbye!