Q. Is it IBS or coeliac disease?
Coeliac disease affects around 1 in 100 people in the UK, and causes symptoms which are very similar to IBS, such as bloating, gas, loose stools and tiredness. But unlike IBS, coeliac disease does result in damage to the gut, which is caused by an overactive response from the immune system. When someone with coeliac disease eats gluten (a protein found in wheat, rye and barley) the immune system mistakenly attacks the lining of the small intestine, which can lead to problems digesting and absorbing nutrients. If it’s left undiagnosed and untreated, coeliac disease can lead to problems like iron deficiency and osteoporosis. This is why it’s important to get coeliac disease ruled out, even if you feel sure your symptoms are down to IBS. Chat to your G.P. if you’re unsure.
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Q. What are the symptoms of IBS?
Irritable (very irritable) bowel syndrome is characterised by chronic (long-term) symptoms which include;

  • Abdominal pain (30-40% of IBS patients suffer with pain) or discomfort
  • Gut hypersensitivity (people with IBS tend to have an increased sensitivity to pain caused by gas)
  • Bloating or tummy distention
  • Excess wind or gas
  • A worsening of symptoms after eating
  • Change in Bowel Habit – constipation, diarrhoea or both
  • A rumbling or gurgling tummy
  • Passing mucus
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Q. What’s the difference between having IBS and having just a dodgy tummy?
An upset tummy will usually resolve itself after a few days, or in some cases, within a week or two (with something like gastroenteritis). IBS is a chronic or long-term condition – although it can go through periods of being more settled, or well controlled, most people with IBS will experience ‘flare ups’ of their symptoms. In most cases, IBS is diagnosed if symptoms have persisted for 6 months or more. However, it’s important to chat to your G.P. if you notice a change in your poo habits (change in their frequency, consistency, or blood in your poo) that lasts more than a week or two
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Q. How is IBS diagnosed?
Doctors use something called the ROME IV criteria for diagnosing IBS. This is helpful, because it gives a clear guide to the symptoms of IBS and when it should be diagnosed.

Your doctor will ask some questions about your gut symptoms (what sort of symptoms you have and how long they’ve been going on), and will arrange a blood test to exclude other possible causes, like coeliac disease or inflammatory bowel disease.

IBS will be considered if you have recurring tummy pain or discomfort (at least one day a week) which…

  • goes away temporarily when you poo
  • is linked with a change in your poo habits (what your poo looks like, or how frequently you poo)

They might also ask for other signs, like bloating, passing mucus, or symptoms that get worse when you eat

Further tests (like a colonoscopy or endoscopy, where a camera looks into your tummy or colon) are not needed to diagnose IBS. In some cases, your doctor might ask you to have these tests if they need more information, or suspect that there might be another cause for your symptoms.

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Q. Why have I got IBS?
Working out why you have IBS is a bit like trying to find a needle in a haystack – there are lots of potential causes, but we still don’t have a clear answer.

However, as research on gut health continues, there are a few theories as to factors which might contribute to the development of IBS. These include:

  • An extra sensitive colon, which means you feel gut pain more intensely than people without IBS
  • Changes in the gut’s immune defences
  • Changes in the balance of bacteria in the gut
  • Repeated use of antibiotics
  • Lifestyle factors such as diet, stress, eating habits, alcohol intake, and exercise
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Q. I’ve got IBS, what now?
The doctor will diagnose you and may discuss some options to help you manage your symptoms. You might also be given some information around caffeine, alcohol (DAD; day after drinking) and fibre. They might also offer you some medication which can help with symptom relief.

As IBS is a chronic disease there is not a pill or medicine that can cure IBS – but the good news is you can learn how to manage your symptoms – and it doesn’t have to be a life sentence.

You will have flare ups and then times where you have no symptoms at all, but investing time into working out your triggers – and how to manage them – will give you the best chance of spending more time with your symptoms under control.

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Q. Why can’t I join if I have previously had an eating disorder?
We know this might sound a little strict, but we don’t recommend joining TIG if you have an eating disorder, as this requires specialist support which we are unable to provide.

In addition, some parts of the programme require restricting foods, and this approach may trigger unhelpful feelings or behaviours for someone struggling with an eating disorder, or for someone who has recently struggled with an eating disorder. For this reason, we would advise working with a specialist dietitian who can support you.

If however, you have previously had an eating disorder but have recovered, and feel you can comfortably manage the programme you are welcome to join – but we would recommend informing your G.P. before you begin, and checking in with yourself at regular points during the programme to see how you are feeling.

For more information or support around eating disorders, you might find the charity BEAT helpful

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Q. Can my emotions affect my IBS?
In a word, yes! Your gut and brain communicate with each other via your nervous system, so it’s no surprise that your mood and emotions can affect your gut. For example, we know there’s a link between anxiety, stress and IBS symptoms. This is why stress management is such important part of an IBS self-care kit.
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Q. Will I have IBS forever?
IBS is what is known as a chronic condition – meaning that it is something which continues long-term. This doesn’t mean you have to spend the whole time in pain or discomfort though! Lots of people with IBS can go for months or even years with their symptoms well controlled.
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Q. What are FODMAPs?
Put simply, FODMAPs are a group of short-chain carbohydrates (sugars) that aren’t properly absorbed in the gut, which can trigger symptoms like pain, wind, bloating and loose stools in people with IBS.
More specifically, FODMAP stands for:

Fermentable: the process when bacteria consume sugars (FODMAPs) and produce gas.

Oligosaccharides: sugars which are found in chains of two to ten, found in wheat, rye, onions and garlic!

Disaccharides: double sugars, like lactose – found in dairy products like milk, soft cheeses (so sad) and yoghurt

Monasaccharides: single sugars like fructose; found in sweeter foods, such as apples, honey and some cereals

Polyols: a type of sugar alcohol, found in some vegetables and fruit, as well as artificial sweeteners

As part of the TIG, we’ll help you decide whether a trial of the low FODMAP diet is right for you.

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Q. Why do FODMAPs trigger IBS symptoms?
Good question! When we eat carbohydrates they are broken down into individual sugars. Usually these sugars are absorbed in through the small intestine and into the bloodstream, where they are used for energy.

For various reasons, FODMAPs are trickier to break down and absorb, so they end up travelling to the large intestine, where they are consumed (fermented) by the trillions of bacteria that live there. The bacteria turn the sugars into gas, which can result in bloating and pain – remember that people with IBS tend to have an increased sensitivity to pain, so increased gas = more pain. FODMAPs can also attract water in the bowel, which can cause diarrhoea.

As part of the TIG, we’ll help you decide whether a trial of the low FODMAP diet is right for you.

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Q. Are FODMAPs unhealthy?

FODMAPs are found naturally in many foods and food additives, and there’s nothing ‘unhealthy’ about them – in many cases they’re found in healthy foods like fruits and vegetables! What differs between people with and without IBS is the potential of these sugars to cause discomfort. In people without IBS, FODMAPs move through the bowel without much consequence. But, in people with IBS, the malabsorption of these carbohydrates can trigger symptoms  such as diarrhea, constipation, bloating, wind (flatulence) and abdominal pain and discomfort.

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Q. Is it IBS or endometriosis?

Endometriosis is a condition where the tissue that normally grows inside your uterus (called the endometrium), grows outside your uterus. Sometimes, endometriosis can affect the bowel (intestines). When this happens, tissue can grow on the surface of the bowel, or through the walls of the bowel. This can cause symptoms that are very similar to IBS – including tummy pain, cramping, nausea, bloating, diarrhoea or trouble passing stools. For this reason, endometriosis is sometimes misdiagnosed as IBS.  It’s therefore important to get the correct diagnosis before making any dietary or lifestyle changes, as left untreated endometriosis can lead to infertility.

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Q. Is TIG suitable if I have endometriosis?

TIG has been specifically designed to help manage the symptoms of IBS. However, we know that endometriosis and IBS can coexist, so if you have both conditions TIG may well be helpful in managing your bowel symptoms.

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Q. Is The IBS Guide suitable for someone with IBD (Crohn’s or Ulcerative Colitis?)

TIG has been specifically designed to help manage the symptoms of IBS and is not for people with active IBD (inflammatory bowel disease).

However, we know that IBS and IBD can coexist, and some people with IBD continue to have IBS-like symptoms, even when their IBD is well controlled and in remission.

If you have both conditions, and your IBD is currently in remission (there is no active disease or ongoing inflammation), then strategies covered in TIG (such as stress management, mindfulness and dietary changes) may be helpful. We’d recommend having a chat with your doctor before joining the programme.

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Q. Can I start at any time?

Yes you can…after you purchase the programme it will show you the prep week instantly. After a week, week one will be available to access, and then week 2 and so on – but you can repeat any week you like, and take it at your own pace. Each week you will receive 2 emails from us checking in and motivating you on, but you can come back to any week at any time. This is your programme go at a speed which suits you.

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Q. If I have food allergies/intolerances can I follow the programme?

Yes, there is a recipe filter so you can choose recipes that work for you and your diet.

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Q. I am vegan/vegetarian, can I join the programme?

Yes, our recipe filters can be tailored to fit your dietary requirements whether that’s vegan, vegetarian, gluten free and many more.

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Q. I live overseas, can I use the programme?

Yes the programme is accessible from anywhere in the world. However, please note, the content is primarily written for an English audience -mostly in terms of types of foods etc. If you would like to find out more please do email us on happygutguide@gmail.com

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Q. Is it suitable if I’m pregnant?

Congratulations on your pregnancy! Unfortunately Happy Gut Guide is not suitable for mums-to-be as there is a period during which certain foods will be limited – and it’s important to avoid food restriction during pregnancy.

In addition, there are additional nutritional factors to consider during pregnancy, which we do not cover in the programme.

Lastly, some women with IBS note a change in their symptoms when pregnant. Those with IBS-D (diarrhoea) often notice an improvement, whilst those with IBS-C may notice a worsening, as certain supplements and increased pressure on the bowel can cause changes in gut motility. If you do suffer with IBS-C (constipation) making sure you have adequate water and fibre in your diet, and staying active should help. If you need further support, we would recommend seeing a dietitian or chatting with your G.P.  You may also find this leaflet helpful.

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Q. What If I Am Already Taking Medication For My Symptoms?

As part of your IBS treatment plan, your doctor may have discussed medications with you.

Remember that there is no ‘cure’ for IBS – so the goal of medication is to try and help control your symptoms.

If you have diarrhea, a medicine called loperamide (immodium) might be prescribed – this slows down the movement of food through your digestive system.

If you are suffering with constipation you may be offered a laxative – these work in one of two ways. They either draw water into the bowel, helping to soften your poo, or increase the number of contractions in your digestive system, to increase the speed at which food moves through your gut.

If tummy spasms are a problem, something known as an anti-spasmodic medicine might be offered to you.

If laxatives, loperamide or antispasmodics don’t help, your doctor might discuss the option of a type of low-dose antidepressant, known as an SSRI, which may help with tummy pain.

Other option include bowel training, and CBT (cognitive behaviour therapy)

If you have been advised to take any medications, continue to follow the advice from your doctor – but do check in with them if you have improvements in symptoms, as you may find your need for medication changes throughout the programme.

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