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April 2021 Diet & Digestive Health (DDHChat) Twitter Chat with IFFGD, and Niki Strealy, RDN, LD

Niki April Twitter Chat

2021 April DDHChat: Eating with IBS

IFFGD – introductory tweets and remarks: The views and experiences shared by our participant are their own and do not reflect the official positions of IFFGD. Each patient is different. Always consult with your healthcare provider or a registered dietitian (RD) on a diet treatment plan that is right for you. Information and resources shared during today’s chat should not replace medical care that you are receiving. And reminder, be sure to include #DDHChat in each of your tweets.

IFFGD – welcomes everyone to the chat and introduces co-host Niki Strealy, RDN, LD:

Welcome to our April #DDHChat on eating for IBS in recognition of IBS Awareness Month host Niki Strealy. First designated by IFFGD in 1997, IBS Awareness Month is nationally recognized to raise awareness of this common but often misunderstood condition. IBS affects approximately 10-15% of the population globally and occurs in men, women, and children. IBS is defined as pain associated with a change in bowel habit, such as diarrhea, constipation, or mixed. Many people with IBS associate their symptoms with what they eat, and treatment may include specific dietary and lifestyle changes. When you notice changes in your symptoms, it is important to communicate these changes with your healthcare provider. It is natural to have some concerns about finding the right treatment plan for you. For some, seeking support from a registered dietitian could help. During the next hour, we’ll discuss eating with #IBS and how to overcome challenges. 

We’re joined today by registered dietitian Niki Strealy to share her unique insights on Eating with IBS. 

IFFGD and Niki Strealy, RDN, LD Q&A:

Q1: Thank you, Niki Strealy, RDN, LD for joining us today. In recognition of #IBSAwarenessMonth, can you share with us why you became a #RD to help those living with IBS? #DDHChat

Niki Strealy, RDN, LDI was diagnosed with IBS at 13 after testing negative for #crohnsdisease or #ulcerativecolitis. GI doc said, “We can’t find anything wrong. You probably have IBS,” and sent me home with no resources. My personal quest for answers led me to a career as a #GIdietitian #DDHChat

Q2: What symptoms are commonly associated with #IBS? #DDHChat

Niki Strealy, RDN, LDCommon symptoms of #IBS: abdominal pain, gas, bloating, diarrhea, constipation, or alternating diarrhea/constipation. Criteria for #IBS is abdominal pain at least 1day/wk in last 3mo + at least two of the following symptoms: abdominal pain related to defecation, change in bowel frequency, change in form of stools (#diarrhea #constipation or alternating). #romeIVcriteria #DDHChat

Q3: What are some of the most common foods that might trigger #IBS symptoms? #DDHChat

Niki Strealy, RDN, LDIBS triggers are different for all! Simple changes, like reducing caffeine or alcohol, may be enough. #Lactoseintolerance is very common. Also consider intake of #FODMAPs; natural sugars and fibers which are not completely digested or absorbed in our intestines. #DDHChat

Q4: What approach(s) do you take when working with a patient who has been diagnosed with #IBS? #DDHChat

Niki Strealy, RDN, LDWith new diagnosis of #IBS, obtain medical and nutrition history. Make sure #IBD & #celiacdisease ruled out. Also ask about other diagnoses, #BMs, GI symptoms, stress, sleep, exercise, medications, past surgeries, #foodallergies #foodintolerances. Assess diet for high intake of #FODMAPs, found in common foods: some fruits (e.g. apples, pears) & veg (e.g. asparagus, cauliflower), beans, onions, garlic, wheat, dairy, honey, and sugar alcohols (e.g. sugar-free gum & mints). Consider a 2-6 wk FODMAP elim diet #DDHChat

Q5: For someone who might have #Crohns, #IBD or any other GI disorder but also has #IBS, what dietary modifications might you suggest? #DDHChat

Niki Strealy, RDN, LDIBS commonly overlaps with other GI conditions, like #Crohns #ulcerativecolitis #celiacdisease or #SIBO. The #LowFODMAPdiet can help control symptoms of gas, bloating, #diarrhea #constipation. Many also feel better with foods that are natural and less processed. In addition to diet, gut-brain therapies like #gutdirectedhypnotherapy, gut-focused cognitive behavior therapy and #meditation can also reduce symptoms of IBS. #DDHChat

Q6: For individuals who enjoy exercising and going for a run occasionally, what do you suggest they do before exercising to help with symptoms like diarrhea? #DDHChat

Niki Strealy, RDN, LD#Runnerstrots are common! Many foods/ingredients consumed by athletes are high in FODMAPs (cereal bars, wheat, dairy, inulin, fruit, fructose), worsening symptoms. Limiting #FODMAPs before hard workouts and competition may help. Work with a #GIdietitian #DDHChat

Q7: Bloating, pain, and discomfort are common symptoms of #IBS. With the support and guidance of an #RD, what dietary modifications would you suggest? #DDHChat

Niki Strealy, RDN, LDModerate intake of foods which contribute to gas/bloating/pain: sugar alcohols, dairy, beans/pulses, nuts, fresh fruits (e.g. apples, watermelon), dried fruit, veggies (asparagus, cauliflower). Limit beverages like beer and apple juice. Common habits which can cause gas/bloating: drinking thru a straw, mouth breathing, gulping air while eating/talking, drinking carbonated beverages, and skipping meals #DDHChat

Q8: How can fiber help improve gut symptoms, and what types of fiber are beneficial for those living with #IBS? #DDHChat

Niki Strealy, RDN, LDFiber can be great for #IBS, but not all tolerate it! Try increasing fiber from food, like chia & flax seeds, oats, whole grains, blueberries, raspberries, small amounts of nuts & seeds. Resistant starch is good too: green bananas, cooked & cooled potatoes. Insoluble fiber often not as well tolerated as soluble. Fiber supplements are also an option: partially hydrolyzed guar gum, acacia gum, or ground psyllium fiber (whole psyllium husk for constipation). If fiber doesn’t agree with you, try another type. #DDHChat

Q9: Outside of the food, could caffeinated drinks or any other beverage trigger #IBS symptoms? #DDHChat

Niki Strealy, RDN, LDCaffeine speeds up GI motility; everything moves thru faster. Would limit for those with abd pain & diarrhea. Less of an issue with bloating/constipation. Some teas and coconut water contain #FODMAPs. Recommend limiting sodas with high fructose corn syrup (FODMAP) #DDHChat

Q10: What recommendation do you have for patients who may experience #IBS symptoms while working in the office due to something they may have had to eat or drink? #DDHChat

Niki Strealy, RDN, LDIBS can be unpredictable and isolating. It’s hard to maintain privacy when tummy symptoms affect your work. A two-week #FODMAPeliminationdiet can help you determine personal dietary triggers so they can be avoided at work. Stick to food from home! Keep a hot water bottle or heating pad at work to soothe stomach on the bad days. Peppermint oil capsules can calm symptoms of #gas #bloating #stomachpain #DDHChat

Q11: While traveling, what recommendations do you have for patients who may experience #IBS symptoms due to something they may have had to eat or drink? #DDHChat

Niki Strealy, RDN, LDI suggest bringing your own food when traveling, so digestion will be more predictable. Test different remedies and foods to find what minimizes your symptoms. Limit alcohol intake. Traveling suggestions for #diarrhea: take loperamide tablets or bismuth subsalicylate, drink pediatric electrolytes or ginger tea. For #constipation: drink extra water or coffee/tea, take stool softener or magnesium citrate to facilitate BMs, light exercise #DDHChat

Q12: As we begin to wrap things up, can you provide our followers with some cool food swap examples for #IBS to keep in mind the next time they go grocery shopping? #DDHChat

Niki Strealy, RDN, LDLow FODMAP swaps! Sourdough instead of wheat bread, rice instead of pasta, almonds instead of cashews, chickpeas instead of black beans, maple syrup instead of honey. More swaps! Garlic-infused oil (no garlic), scallion greens instead of onions, broccoli not asparagus, raspberries not blackberries, lactose free instead of reg cow’s milk, cheddar instead of cott cheese #DDHChat

IFFGD – final tweets and remarks:

Remember that April is IBS Awareness Month. It is important to understand that some foods may trigger #IBS symptoms, but with help and support for your health care team you can begin to enjoy food again. To learn more about this topic from Niki Strealy, RDN, LD, click here

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