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.
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.
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.
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