Caitlin Whyte (Host): Welcome to Hally HealthCast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic important to your health and well-being, bringing in doctors, specialists, and other health experts who offer advice and answer your most pressing questions.

Today's episode is all about irritable bowel syndrome, or IBS. And April is IBS Awareness Month, so it's the perfect time to learn more about this widespread health concern. Here with us is Katie Rudin. She's a dietitian at Carle Diabetes and Nutrition Services in Champaign. Welcome, Ms. Rudin, and thank you so much for being with us today and sharing your knowledge.

Let's begin with an understanding about our topic. IBS, of course, stands for irritable bowel syndrome, which is a pretty descriptive name as far as medical conditions go. But what exactly is IBS, Ms. Rudin? It certainly sounds unpleasant, but how serious is it?

Kati Rudin: IBS is a chronic disorder of gut-brain interaction. So, the main symptoms are reoccurring abdominal pain or discomfort associated with a change in bowel habits. So, examples of these are like constipation, diarrhea, alternating bowel habits, excessive flatulence, bloating, and abdominal distention. And these symptoms can certainly vary in intensity and change over time.

If you have a diagnosis of IBS, know that you're not alone in that. The American College of Gastroenterology reports that about 5% of the U.S. population has IBS. That's about 1 in 20 people in the United States. Now, the good news is IBS is not a life-threatening disease. However, the symptom severity can diminish an individual's quality of life. A study in the American Journal of Gastroenterology showed that a majority of patients with IBS would give up 10-15 years of life expectancy just for an instant cure for their condition. This statistic really emphasizes the day to day impact that IBS symptoms have on a person living with IBS.

Host: Well, thank you for that thorough explanation. We really appreciate it. So, with 5-10 percent of people worldwide affected by IBS, but every IBS experience being unique, is there just one kind of IBS that affects so many of us, or are there multiple varieties of this condition?

Kati Rudin: Yeah. IBS is broken down into four different subtypes. The subtype is determined by the individual's most common stool consistency when having abnormal bowel movements. Using a set criteria called the Rome IV criteria, a patient's IBS is categorized as diarrhea, constipation, or mixed predominant.

Host: Wow, I had no idea there were so many different kinds of IBS. Thank you, Ms. Rudin. So, do we know what causes it and what kind of factors impact the symptoms of IBS?

Kati Rudin: Examples of factors that may trigger IBS symptoms are certain foods, so think foods high in FODMAPs or foods high in fat like fried foods; certain beverages, so thinking like caffeine or carbonated beverages; and stress level. But the exact causes of IBS is not known, and there may be multiple causes. So, possibilities for these causes include dysmotility or problems with the speed or strength of the contractions of the GI muscles, visceral hypersensitivity, so specifically having like extra sensitive nerves along the GI tract, abnormal levels of gut bacteria, severe infection along the GI tract, and childhood stress.

Host: Thank you, Ms. Rudin. That really brings home the seriousness of this topic we're discussing today. So, you've told us IBS is chronic, sometimes severe, but not necessarily life-threatening, yet often lifelong and so far incurable. That certainly sounds serious enough to me, though. What are available treatments for IBS right now, such as antibiotics? And does diet have any impact on relieving those IBS symptoms?

Kati Rudin: Current treatments for IBS include diet, medications, and gut-directed therapies like hypnotherapy. Medications may be over-the-counter or prescribed. Examples are anti-diarrheal medications, laxatives, smooth muscle relaxants, or antibiotics. Diet treatments often include adequate soluble fiber intake and a trial of the low FODMAP diet. It has been seen that diet can impact IBS symptoms. Food triggers really vary from person to person. Common culprits that may cause IBS symptom flareups include foods high in FODMAPs, foods high in fats, spicy foods, caffeine, or alcohol. Also staying hydrated and consuming adequate fiber intake is recommended, specifically soluble fiber, that's as opposed to insoluble fiber. Sources of soluble fiber include like psyllium husk, oat bran, barley, and oranges.

Host: Terrific answer. Thank you. Now, speaking of a dietary approach to treating IBS, you've mentioned FODMAPs a couple times. I've actually been on this diet and it is really rough. But for our listeners, what is the so called low FODMAP diet? You know, I've heard it's sometimes recommended for people like me to treat and help with irritable bowel syndrome, but only for short periods. So, tell us again, what is the low FODMAP diet and how exactly does it help people with IBS?

Kati Rudin: Absolutely. So, the term FODMAP is an acronym that stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. So, these are short-chain carbohydrates or sugars and fibers that lead to an increased water secretion in the intestine and increased fermentation, which can cause more IBS symptoms like gas and bloating. So, following the low FODMAP elimination diet allows an individual to identify which groups of FODMAPs may be causing those symptoms. It's recommended to work with a registered dietitian like myself through this is three-phase elimination diet

. The first phase is the elimination of high FODMAP foods for two to six weeks, and a registered dietitian can really help ensure that you are getting all the nutrients you need during that restricted phase. The second phase is reintroduction. So over a period of six to eight weeks, the different groups of short chain carbohydrates are challenged to determine which group is causing those symptoms. The last phase is the personalization phase where we take what we learned in the reintroduction phase to really liberalize the diet.

There are lots of benefits, but also some limitations. The benefit to following that low FODMAP diet is finding what foods may be triggers for increased IBS symptoms. And avoiding those foods can decrease overall symptoms and really improve quality of life. But there are drawbacks, which includes the decreased ease and convenience of choosing and preparing foods, and a possible increase of food costs. But that's where a registered dietitian can be really helpful.

I would also like to note, though, that the low FODMAP diet would not be appropriate for all individuals, especially an individual with a history of disordered eating.

Host: Absolutely. Well, it's good to know that there is some hope of relief for those with IBS, if not yet an outright cure. So, we've definitely established the seriousness and occasional severity of IBS symptoms, but it probably bears asking, what about when it's something other than IBS causing these symptoms, something potentially even worse? How do we know when to be concerned that the problem is maybe more than IBS?

Kati Rudin: Watching for those red flag symptoms or warning signs, those would include like blood in the stool, fever, unexplained weight loss, an older age of onset of those symptoms, waking at night for bowel movements, or a family history of intestinal conditions. Those red flag symptoms may indicate serious intestinal conditions like celiac disease, colon cancer, inflammatory bowel disease, or ovarian cancer. It's always important to consult with your physician if you're experiencing any sort of altered GI habit.

Host: Of course. Well, thank you, Ms. Rudin, for that potentially life-saving information. So, my last question for you today. If you could convey one essential message about IBS Awareness Month, what would it be? What would you want everyone to be aware of about IBS?

Kati Rudin: I think the answer to your last question really sums it up best. Always consult with your medical provider if you're troubled by any GI symptoms or have altered GI habits. Do not self-diagnose. Once you have a diagnosis from your medical provider, they can connect you with resources to really support you, and they may even connect you with a registered dietitian like myself.

Host: Excellent answer, Ms. Rudin. You've truly given us a lot to digest. And you've certainly been a pleasure to have on our podcast. Thank you so much for joining us and for all that you do every day at Carle Diabetes and Nutrition Services for so many people and families.

That concludes today's Hally HealthCast. Tune in next time as we tackle yet another topic important for your health and well-being. And remember, Hally Health is your partner in helping you live your healthiest life. Visit hally.com, that's H-A-L-L-Y.com, for resources, information, tips, and much more.

Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in again.