I was very lucky to attend the free lecture by Monash University in conjunction with the Alfred Hospital in Melbourne recently. Monash University have been doing some amazing work in the world of digestive discomfort, IBS and FODMAPs. Many times on this site I have referred to their work and I freaking LOVE their FODMAP guide app so my inner nerd was very excited to go and learn.
The whole talk was delivered by Professor Peter Gibson and primarily related to Irritable Bowel Syndrome, what causes it, how you can potential control it and how a low FODMAP diet can help. I was extremely excited when Professor Gibson kicked off his talk discussing the Gut/Brain Axis. Sounds wacky but it’s not and to hear a conventional medical practioner discussing it made me want to do a little fist pump. The easiest and most basic description is that your body almost has two brains – obviously the main guy in your head but your gut almost like it’s own brain itself, with more nerves that your entire spine it has a memory controlling your gut rhythm (bowel movements) and all the muscles of your digestive system. If one ‘brain’ is out, it can throw your whole body out which is why IBS is such a huge problem. There were some crazy stats such as 20% of the community has IBS, 10% of GP clientele suffer from IBS and all this comes at a high economic cost with IBS symptoms being the second biggest cause for people taking a sick day behind the common cold.
Professor Gibson used the analogy that IBS is when your gut brain gets out of tune. When the gut brain is over stimulated resulting in the classic symptoms of pain, bloat and change of bowel movements. The technical term is visceral hypersensitivity.
So we know what it is, we know the sympthoms and so many of us know what it feels like but WHAT THE BLOODY HELL CAUSES IT. It comes down to the following list of possible triggers…
- Genes – one of your parents probably as a dodgey gut and they believe is has around 30-50%
- Gut infection – some super nasty bug which has caused some sort of trauma and then probably wiped out with some killer antibiotics completely upset your gut brain. How often have you heard of people who have picked up a bug overseas and never been the same since.
- Gut Microbiota/Bacteria caused dysbiosis (basically bacterial imbalance)
- Food Hypersensentivity
- Psychological – pent up childhood anxiety, depression, stress all have a role to play. In the Q&A session at the end a woman got up and said “I have done the low FODMAP diet and I am not fixed so what could it be?” Well lady, did you just listen to this presentation? Other triggers include stress and potentially you stressing about your own diet is a trigger for your symptoms.
Just as complicated as the potential list of triggers, the potential list of remedies and cures
- Drugs – not ideal for many many reasons, this requires no explanation
- Changing the gut bacteria to restore the balance
- Psychological therapies including hypnotherapy, meditiation and cognitive behaviour therapy
- Changing your diet to eliminate potential triggers
Gut microbiota/bacteria was briefly discussed and it is such a huge broad spectrum and the research (from his perspective) and the range of clinical studies hasn’t been done throughly enough to prescribe a particular therapy. But he did say that there is lots of exciting new information in this area including fecal transplants. This excited me that they were interested in this sort of wacky health science as well. If you are interested in looking into your gut bacteria as potential solution I really recommend you work with a proper holistic practitioner. I know I benefit hugely from a regular dose of probiotic goodness in my diet and I ingest it in a myriad of forms through foods, drinks like kombucha and supplements. But this is what works for me so don’t go off self diagnosing.
One of the most successful ways to manage IBS is reduced the stimuli which is where the FODMAP diet comes in. If you are not familiar with FODMAPs I have written a post here – but the short summary is that FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Basically these are short chain carbohydrates that some people unfortunately are unable to properly digest and breakdown which then upsets their digestive system triggering IBS symptoms. It is rare for people to be sensitive to all FODMAPs. The majority of people are just sensitive to a couple so it is recommended that you firstly adopt a low FODMAP diet eliminating all and then reintroduce individual FODMAP foods at a time to figure out what is your trigger. The clinical study results through Monash have shown incredible improvement for IBS sufferers through adopting a low FODMAP diet and is something that people really should consider if they are suffering from a heap of digestive problems. If you are Melbourne based there is great clinic specialising in diets for IBS sufferers run by Sue Shepherd.
The discussion around hypnotherapy and psychological therapies to help manage IBS symptoms was pretty light as there is limited research at this point in time. Excitingly Monash University have employed a hypnotherapist and are undertaking some controlled studies to see the effects. There is definitely lots of anecdotal evidence that stress and anxiety can really exacerbate your symptoms. Plus Professor Gibson warned about people becoming what he called an ‘Dietary Cripple’. You are so paranoid about what you eat, even if you do eat a low FODMAP diet you are probably so stressed about everything you are partially undoing your good work.
Finally the talk ended with a bit of discussion about gluten free diets. Professor Gibson doesn’t advocate a gluten free diet unless you are a celiac as the low FODMAP diet is wheat free but not gluten free. Monash Uni had done several studies and clinical trials of people with IBS on a gluten free and then low FODMAP diet. They found that people had much more relief on a low FODMAP diet with some gluten as opposed to gluten free diet diet leading them to believe that particular FODMAPs are more of trigger than gluten itself. He also warned that so many gluten free products that are coming into the market are so full of crap. The concern people perceiving them as healthy because they are gluten free but in actual fact, they are terrible for you and contain minimal nutritional value. This sentiment I wholeheartedly agree with – people just need to get back to basics and enjoy unprocessed real foods.
As you can see it was a pretty interesting discussion. I highly recommend that you check out Monash Uni’s site here and download their app if you want more information. If you have any questions – leave me a comment below – would love to hear your thoughts on this.