(Image: Tina Tiller)
(Image: Tina Tiller)

SocietyJanuary 25, 2021

The bad sh*t: My search for a solution to irritable bowel syndrome

(Image: Tina Tiller)
(Image: Tina Tiller)

What’s it like to have your life governed by your gut? It’s crap, frankly.

On my birthday last year I was given a bottle of fancy Aesop post-poo drops which clear the air after rigorous bowel activity – though on reflection, it may have been more of a gift for my flatmates. I’m not offended, I’m willing to admit my faults.  

Irritable bowel syndrome is uncomfortable, annoying and painful. It’s characterised by a range of symptoms including bloating, gas, cramping, constipation and diarrhoea. And while IBS is hardly just shits and giggles, it differs from illnesses such as inflammatory bowel disease, coeliac disease or bowel cancer in being a non-life-threatening condition.  

My IBS flares up depending on a lot of infuriatingly random factors – the foods I’ve eaten, my stress levels, period cycle, the alignment of the stars. On a good day, I forget about it. On a bad day, I’m running relays between my desk at The Spinoff office and the loo down the hall.

So what is IBS, exactly? Registered dietitian Rebekah Jones describes it as a disorder of the gut/brain axis. “The communication is out of whack, and with a sensitive intestine, it creates this exaggerated response.

“It goes back to evolution. If a lion was coming at you, your blood rushes to your extremities so you can run away. But if you are always in that state, your stress hormones mean you won’t be able to digest well.” It’s the difference between being in rest and digest mode, or in fight or flight response. 

Around 15% of the population, or one in seven people, struggle with IBS (Photo: Getty Images)

Monash University, regarded as a pioneer in IBS research by dietitians, found 15% of the population, or one in seven people, struggle with IBS.  

Kate Collins, also a registered dietitian, says there’s a variety of reasons why IBS is becoming more common in the developed world. “In the past we were eating the same things for breakfast, brunch and dinner. But now with new sugars and carbohydrates, we’re eating a much wider variety of foods.” 

Collins says it’s just as likely that figures are on the rise because we’re getting more comfortable talking about gut health. 

There are a number of factors that could play a role in someone developing IBS, including gut sensitivity, altered gut mobility, bacterial imbalance or a leaky gut. Some people develop the condition after a gastric infection. “It’s more about a displacement of bacteria in the gut than something you’re born with,” says Collins, who notes that stress can also be a contributing factor. 

This might be underlying stress due to work, or something more long term. Collins says her team of dietitians at Nutrition and Life noticed a flare-up of symptoms during Covid-19 lockdowns. 

There’s no cure for IBS, but symptoms can be managed. “We can take the right steps and our gut health might shift and get to a point where we can introduce more foods.”

A low-FODMAP diet is recommended by dietitians to help determine the gut’s reaction to various foods. However, Collins is careful to warn against people self-diagnosing. “If you suspect you might have IBS, go to your GP first. They’ll look at your symptoms, and might refer you to a gastroenterologist to make sure there isn’t anything more sinister.” 

The FODMAP diet isn’t a new fad version of the bizarre trends such as lemon water and cayenne pepper master cleanse. Collins sees it more of a human experiment more than an actual sustainable diet. “Many people get stuck on these restrictive diets, but that’s not the point of it as it can lead to worse off gut health. The goal is to be able to slowly reintroduce these foods.” 

The low-FODMAP diet is pretty foul. I was put on it at 17 years old, after a few late night trips to the emergency room for intense stomach pains. My GP gave me a glossy pamphlet containing a long list of foods I was supposed to avoid. 

The acronym FODMAP represents certain kinds of short-chain carbohydrates that are difficult to digest, such as sorbitol in some fruit and artificial sweeteners, and oligosaccharides in garlic or onion. While I’m intolerant to these two carbohydrates, the trigger foods may be different for other sufferers. 

“I don’t want people to read this and think to put themselves on a low FODMAP diet. It’s really hard to manage by yourself, and it’s not as simple as cutting out a whole food group,” says Collins. 

Monash University found three out of four people felt their symptoms improved on the diet. But for the one in four who find no difference, alternatives such as stress reduction or gut-guided hypnotherapy is suggested. 

Once my flatmate had to piss in the garden because I locked myself in our one and only toilet. PAIN (Photo: Getty Images)

That’s how I find myself getting hypnotised over Zoom by Tony Yuile in The Spinoff’s podcast studio. I go in sceptical and somewhat terrified; I’ve seen Derren Brown do his thing. But Yuile seems normal enough. He’s an accountant-turned-certified hypnotherapist specialising in stress and anxiety management. 

“Hypnotherapy is a communication process that focuses imagination on a specific idea. It’s a way of learning rapidly but requires an open mindset, in that you want to follow suggestions,” he tells me.

“A misconception with hypnotherapy is that you’ll sit in the chair and it’ll cure you. But it’s 80% in your head. Hypnotherapists have no magical powers, we just guide and pull the levers through suggestions at the right time. You have to do your best.” 

Assuring me that I’m aware and conscious the whole time, and there’s no way he could steal my PIN number, we set off on a short intro session. I lift my arms up and down, imagining a heavy bucket and light helium balloons. No chicken clucking yet.

According to Monash University research, gut-directed hypnotherapy can improve symptoms by 70-80%. Personally, I can see how hypnotherapy can help with stress and anxiety management. It was nice to let go and imagine walking down some steps into a safe place in my mind. But it also costs around $600 to participate in the full programme. 

I know it’s hard to tell after just after half an hour of hypnotherapy, but I don’t think I’m ready yet to eat a whole clove of garlic, one of my most triggering foods. Maybe after completing Yuile’s programme of four IBS-specific hypnotherapy sessions I would. But then again, maybe my mind just wasn’t open enough. Too many constipated thoughts. 

I also found the first session of hypnotherapy not dissimilar to practices I’d do in physical theatre, such as imagining balls of light flowing through my body and letting my imagination play. 

“Sleep, stress and movement tend to be the big ones that affect IBS,” says Rebekah Jones. She suggests a holistic approach to managing symptoms. And she’s probably right, but a part of me wishes I could just pop a poo pill to cure my gut. Faecal transplant, anyone?

Of course food is more than just fuel. “It’s enjoyment and celebration, especially culturally,” says Jones. For the longest time, my Chinese family refused to believe I could actually be intolerant to garlic. Blasphemy!  

I’m still figuring out my IBS, hopefully in time for Chinese New Year. But it might be easier to eat the garlic, and have some fiery poops later, than disrupt my extended family’s entire menu. 

Because what’s some strange poops and stomach pains compared to the prospect of only eating plain rice for the rest of my life? As both a hedonist and a masochist, I know which future I’m picking. 

Keep going!
Dr Ashley Bloomfied, director general of health (Photo: Hagen Hopkins/Getty Images)
Dr Ashley Bloomfied, director general of health (Photo: Hagen Hopkins/Getty Images)

SocietyJanuary 24, 2021

Live updates, January 24: Probable new Northland community case went through MIQ in Auckland

Dr Ashley Bloomfied, director general of health (Photo: Hagen Hopkins/Getty Images)
Dr Ashley Bloomfied, director general of health (Photo: Hagen Hopkins/Getty Images)

Welcome to The Spinoff’s live updates for January 24.

4.05pm: Northland community case went through managed isolation

The probable community case in Northland is a 56-year-old woman who has recently been through isolation at the Pullman Hotel in Auckland after returning from Europe, Covid-19 response minister Chris Hipkins told media this afternoon. The woman’s PCR test and genome sequencing is under way, he said, noting it can take 24 hours for results.

The woman lives just south of Whangārei and is currently still there. Accompanied by her husband, she has recently been travelling in Mangawhai, across to Dargaville, and as far south as Helensville, said Bloomfield. The ministry has identified 30 locations the woman visited during the course of her travels, he said, but she didn’t go to any mass gatherings. “They were just spending time together,” Bloomfield said of the couple. He said the two were travelling because the woman had been overseas for four months.

The locations she visited include cafes and restaurants, retail outlets and tourist attractions. She was assiduous with checking in on the Covid Tracer app and the ministry is in the process of contacting these locations.

The list of locations, potential exposure dates and times will be published and push notifications will be sent to people who may have come in contact with her.

The government will post information about the 30 locations the woman visited only once business owners are notified of the coming public disclosure, Hipkins said, citing privacy concerns. Push notifications to the Covid-19 app would come out “in a drip fashion” as affected businesses are contacted, said Bloomfield.

“We will know a lot more in 24 hours than we know now. Genomic sequencing is a big part of the puzzle,” said Hipkins, in response to questions about what risk the woman’s movements pose to Northland.

The woman had travelled in Spain and the Netherlands late last year. While in the Netherlands she was with family members, all who were well at the time, but one or two have tested positive for Covid-19 since, said Ashley Bloomfield. She travelled to New Zealand from London via Singapore and arrived in Auckland on December 30.

The woman tested negative on January 2 and 10 in managed isolation, and was released on January 13, after which she went home. She lives with one other person, her husband, who has been tested and is isolating while waiting for results.

The woman started to have mild symptoms on January 15 which got progressively worse. She did not associate the mild symptoms with anything that could be Covid, Bloomfield said. Once they got worse she was tested at a community facility and the test result came back late last night. CCTV footage from the Pullman Hotel is being reviewed, said Hipkins, and those who have stayed there since January 1 – just over 600 people – have been contacted and asked to be tested.

The Ministry of Health doesn’t yet know origin or strain of infection but genome testing is under way to determine any connections to other cases in MIQ. Bloomfield said it was possible but unlikely the woman was infected before arriving in New Zealand and the virus had a long incubation period, indicating that transmission within the MIQ facility was more likely.

Bloomfield said the ministry was working on the assumption that this is one of the more transmissible variants of Covid-19. A number of the 13 or 14 people who have tested positive at the Pullman Hotel in recent weeks were infected by the faster-spreading UK or South African variants.

Hipkins said it is too early to speculate on possible response options including changes to alert levels. The new case won’t have an impact on the country’s vaccination schedule. “We will vaccinate as soon as we can get vaccines into the country,” he said.

4.00pm: Media conference on Northland case

Chris Hipkins and Ashley Bloomfield are about to address the media regarding the Northland case. Watch here:

1.15pm: Suspected community case in Northland

Health officials are investigating a suspected community case of Covid-19 in Northland, related to someone who was recently released from managed isolation and quarantine, the NZ Herald is reporting.

A spokesperson for Covid-19 response minister Chris Hipkins said the case was being treated as “probable”.

The last case of community transmission in New Zealand was on November 18.

Hipkins and director general of health Ashley Bloomfield will hold a press conference at the Beehive at 4pm today, and we’ll have more updates then.