Do you find yourself telling others you have a “sensitive stomach”? Skipping out on invitations where meals are involved? Locking yourself in the office bathroom in agony every day after lunch? If so, you might be one of the millions of Americans suffering from IBS. Irritable Bowel Syndrome is an extremely common condition that affects 10-25% of our population. According to Danielle Capalino, MSPH, RD Registered Dietition and Nutritionist, it particularly affects young women. Danielle has dedicated her career to studying the relationship between the brain and the gut, and loves nothing more than helping people suffering from digestive issues reclaim their bodies (and their social lives.) She’s also the author of the new book, Healthy Gut, Flat Stomach.
If you suffer from common upset stomach, read on to discover Danielle’s insight on what causes IBS and her tips for steps you can take to take control of your body and start feeling better every day.
What special training or experience do you have that makes you an expert in your field?
I completed my undergraduate studies in Brain and Cognitive Science at MIT, because I’m fascinated by the brain. I continued my graduate studies at Johns Hopkins Bloomberg School of Public Health where I delved into the science of the digestive health, the microbiome, and the deep connection between the gut and the brain. I sought out every opportunity to work and learn more about the gut. After graduating, I started a private practice specializing in helping people attain digestive wellness. Since then I’ve continued to work with this population and have written two books on the topic as well.
What do you love about what you do?
I love the combination of staying on top of the latest science of the microbiome, figuring out new ways to communicate this complex information to people, and of course I love the satisfaction of changing people’s lives for the better. It’s very gratifying to be able to help someone — particularly when they suffer from digestive issues that alter their daily lives. Many of my patients avoid social activities out of fear or embarrassment when I first meet them, and then are able to return happily to their social lives.
In your experience, how common are chronic digestive problems in young women?
Very common! Statistics show that within the US population, 10-25% of people suffer from IBS (which is the most common chronic functional digestive issue.) Even if the low end is most accurate, that’s still 1 in 10 people, which is a lot! My clients tend to skew toward women in general, and young women in particular. I think there are several reasons for this.
We’ve heard a lot about IBS (Irritable Bowel Syndrome) on TV from pharmaceutical companies promoting prescription medicines meant to treat chronic upset stomach. Is IBS a real thing? How do you know if you have it?
Yes! IBS Is very much a real thing. I think some people are dismissive of the label because they hear it so much — but if you think about it, the reason you hear it is because it’s so common. IBS is a functional digestive disorder, which means that it’s not something you can see with your eyes. The way it’s diagnosed is if your symptoms meet a specific criteria rather than seeing something on a scan or in your blood. Your doctor might want to rule out other potential causes for your discomfort before landing on IBS as a diagnosis.
So, what causes chronic upset stomach? And what are the best first steps to treating it?
There are many potential causes of chronic upset stomach, but one that’s very common and tends to get overlooked is food sensitivities. Food sensitivities are different than allergies (which can be tested in your blood.) Elimination diets are a very effective tool in identifying foods that trigger chronic digestive issues. I spend most of my time working with people on the low-FODMAP diet, which is a specific type of elimination that takes out certain carbohydrates (but not all carbohydrates!) temporarily, and then guide my clients through reintroducing them to figure out what specific foods are bothering them.
Is it true that all adults are somewhat lactose intolerant since our bodies stop producing the enzymes required to break down milk after infancy?
No, not all adults are lactose intolerant. It’s difficult to estimate a real statistic for this because of inconsistencies in testing and self-diagnosis, but lactose intolerance is quite common. Lactose is made up of two sugars and it requires an enzyme to break it apart in order to be digested. Some people (either genetically or due to illness) will become deficient in the enzyme (lactase,) which is needed to break down lactose. For example, it’s possible to be temporarily lactose intolerance after a bout of a stomach virus or infection.
For those of us who suffer from frequent stomachaches, there are certain types of food that almost always spell disaster (specifically: greasy, spicy, and diary-rich). Do we have to just cut out fun things like crawfish boils and milkshakes forever? Or is there a way to teach our bodies to tolerate those foods better?
If you have a sensitive stomach it really is best to avoid greasy, spicy, rich foods — though our tolerances do change over time to some extent. There are things you can do like take over-the-counter digestive enzymes (including lactase) to help digest foods, but it’s not a surefire way to eat whatever you want.
That’s great news. What else can we do to naturally battle IBS?
1. Write it down!
Keep a food and symptom log so that you can begin to notice trends between what you are eating and how you are feeling. If you work with a Registered Dietitian like myself this is very useful information to help us.
2. Try a FODMAP elimination diet.
If you’ve been to a doctor and ruled out other causes for your symptoms, you may have a food sensitivity. FODMAPs are specific types of carbohydrates that can be difficult to digest. You can work with a Registered Dietitian like myself to help you identify high FODMAP foods in your diet and take them out temporarily to see if it helps to relieve your symptoms. You may be surprised by the list of high FODMAP foods which include things like apples, mangoes, honey, onions, beans and garlic.
3. Avoid artificial sweeteners.
Many foods that are advertised as sugar-free are loaded with sugar alcohols which can really wreak havoc on your gut. Cut out artificial sweeteners, particularly those that end in the letters “ol” from your diet.
4. Eat more fiber.
Making sure you’re eating foods with sufficient fiber is a big part of making sure that your system is running on track. Whole grains, fruits, and vegetables are all good sources of fiber.
5. Experiment with probiotics.
Healthy bacteria that is good for your gut is a key part of a healthy digestive system. You can get probiotics in fermented foods like yogurt, sauerkraut or kimchi, and also by taking probiotic supplements.
You can book an appointment with Danielle on her website here, and be sure and check out her new book Healthy Gut, Flat Stomach!