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Kirsten Jackson Consultant BSc Hons PG Cert RD

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Probiotics for IBS

by Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert 2 Comments

Introduction 

Probiotics are a hot topic when it comes to gut health, so you’ve probably already heard of probiotics for IBS.

But what is a probiotic and should you take probiotics for IBS? AND which one should you take when there are so many to choose from? 

This post will explain some of those questions you may be asking yourself when thinking about probiotics for IBS.

probiotics for IBS

What is a probiotic?

When you think of consuming bacteria, you may instantly think of having a tummy bug. However, our gut is full of microbes which have a range of benefits for gut health and overall health. 

The term probiotic refers to live microorganisms (bacteria, yeasts, etc) that have a positive effect on your health or on a symptom you may have. Probiotics are not the same as prebiotics.

You can find probiotics in lots of different forms and brands. They can come in powders, capsules, sachets, fermented food products and more.

Different probiotics will contain different species and strains of bacteria that will increase the levels in your gut microbiome. 

It is the specific strains that can help you choose what probiotic is right for you. 

There are also other factors to consider when looking into taking a probiotic:

  • Count of live bacteria (colony-forming units aka CFU)
  • Ensuring you store them as instructed
  • Not taking them past the expiry date, as the count of live bacteria decreases 

Benefits of probiotics for IBS

There are currently no officially approved health claims for probiotics to date. This means that official guidelines for IBS management are currently unable to make recommendations on specific probiotics.

This does not mean that you definitely won’t benefit from one – the research is there. It just isn’t considered strong enough by some organisations to make sweeping recommendations . 

The current British Society of Gastroenterology guidelines 2021 recommend that probiotics can be trialled as a first line management for IBS [1]. 

But you need to be cautious when choosing a probiotic as not every probiotic will be specific to what you need for your symptoms. 

Probiotics have been shown to reduce the following symptoms of IBS: 

  • Constipation 
  • Diarrhoea 
  • Bloating
  • Flatulence
  • Pain and discomfort  

Another interesting use of probiotics for IBS is on the low FODMAP diet. This diet has been shown to  reduce levels of bifidobacteria but the use of probiotics prevents this [2]. 

Probiotics can also be used when taking a course of antibiotics to prevent antibiotic-related diarrhoea [3]. This decreases the risk of post-infectious IBS.

How do probiotics benefit IBS?

It makes sense that probiotics may help relieve your symptoms. This is likely due to IBS sufferers having an altered balance of gut microbiota) [4]. 

Probiotics may reduce your symptoms by [5, 6]:

  • Providing your gut with the beneficial bacteria it is lacking 
  • Altering your gut motility 
  • Improving gut barrier function
  • Increase your production or secretion of substances such as short chain fatty acids
  • Altering your gut-brain axis

How do probiotics help with bloating?

Gut bacteria play a key role in the digestion (fermentation) of fibre, releasing gases as they do so. This can leave you feeling bloated and in pain and discomfort. 

Probiotics therefore may help relieve your bloating due to restoring the good bacteria in your gut microbiome. This can result in changes such as changes in the fermentation and those listed above (6).

Which probiotics help with bloating?

Studies have shown mixed results, depending on the microorganisms used in the probiotic product. The microorganisms are classified using the following:

  • Genus e.g. Lactobacillus 
  • Species e.g. acidophilus
  • Strain e.g. NCFM

Well researched bacteria genera into the reduction of bloating include (7, 8): 

  • Lactobacillus 
  • Bacillus
  • Bifidobacterium 

However, it is important that the specific species and strains within the genera are also considered when looking into the research. This is because different species and strains have been shown to only have an effect on specific symptoms. 

This will help in choosing a probiotic that is right for you and your specific IBS symptoms. This will also prevent you from wasting your money – probiotics are not cheap!

Here is a list of specific probiotics shown to help IBS;

VSL#3: 

This is a multi-strain probiotic beneficial for bloating in IBS. One research trial showed promising results in those with IBS-D (8).

This probiotic has also shown to be beneficial in maintaining Bifidobacterium levels during the low FODMAP diet (9).

It has 112.5 billion CFU and must be kept refrigerated. 

PrecisonBiotics Alflorex:

This probiotic contains Bifidobacterium longum (or infantis) 35624® culture (10). This culture is not available in any other probiotic products in the United Kingdom. One large clinical trial showed a significant reduction in bloating in women with IBS and contributed to a 20% reduction in general IBS symptoms (11).

It is suitable for those on the low FODMAP diet. It is also free from milk, lactose, gluten and soya and bonus points that it does not need to be refrigerated.

Optibac Probiotics Every Day EXTRA (Named Daily Wellbeing EXTRA Strength outside of the EU):

This product contains four strains including Lactobacillus acidophilus NCFM and bifidobacterium lactis Bi-07. One trial showed a significant reduction in bloating after just four weeks (12). 

This Every Day EXTRA version is free from fructo-oligosaccharides (FOS) making it suitable for the low FODMAP diet. It is also suitable for vegans, vegetarians, and gluten-free, dairy-free or soy-free diets.

This probiotic contains 20 billion CFU. Refrigeration is not required.

Bio-Kult: 

This is a multi-strain probiotic containing 14 strains of live bacteria. 

One study showed that symptoms (including bloating) were significantly reduced in those with IBS-D taking this probiotic (but not those with IBS-C). It also showed that quality of life significantly improved, where the gut-brain axis plays a key role (13).

This product contains soya and milk.

It contains 2 billion CFU and does not need to be stored in the refrigerator.

Can probiotics cause bloating?

Side effects of probiotics are not common or expected. However, probiotics may cause you to have initial side effects, such as bloating. This will be short lived as your digestion system adjusts.

Symptoms such as bloating will be individual to you. This may depend on your original gut bacteria and if the strain selected is right for you or not. Symptoms such as bloating are more likely to occur if the probiotic contains a prebiotic, such as fructo-oligosaccharides (FOS). 

Prebiotics are beneficial as they feed good bacteria, enhancing their growth. FOS is classified as a fructan (a type of FODMAP) and may be poorly tolerated in those with IBS. They may result in bloating, flatulence and diarrhoea. If you are on the low FODMAP diet, you should look to take a probiotic that is free from FOS.

Are probiotics good for gas?

Excess gas production can result in bloating, discomfort and flatulence. It can be a result of the fermentation process by bacteria in your gut whereby gases are released. 

Probiotics may therefore help to reduce gas and flatulence in the same way that they reduce bloating. 

Gas may also be an initial side effect of taking a probiotic, but this should settle.

Are fermented foods probiotics?

Fermented foods are those that have been ‘pre-digested’ by microbes – known as fermentation. This results in the conversion of carbohydrates to organic acids (14). 

Examples include:

  • Kimchi
  • Kombucha
  • Miso
  • Tempeh
  • Fermented dairy products

Fermented foods can be a probiotic product if the microbes are still alive in the product. They must survive the digestion process and make their way to your large intestine. They must also be present in sufficient numbers to have a positive impact on you.

Unlike probiotic supplements, it can be difficult to label the exact strains and amount of cultures in the food product. This can also make the research into the positive health benefits of fermented foods difficult. 

Fermented dairy has the strongest clinical evidence behind it in terms of health benefits. 

These include fermented yoghurts, milk and cheeses, where Lactobacilli are used in the fermentation process. Benefits include improvements in heart health, weight management and digestion (15).

How long should you take a probiotic for?

The British Society of Gastroenterology guideline on IBS management states that probiotics can be taken for up to 12 weeks. If there is no improvement after this point, they should be discontinued (16).

Summary

Taking a probiotic for IBS may help your symptoms but you need to ensure that it has been scientifically proven to work. Taking probiotics is not a one size fits all approach.

Article written by Beth Wilson (Registered Dietitian with specialist interest in gastroenterology) and reviewed by Kirsten Jackson Consultant IBS Dietitian

Filed Under: Supplements Tagged With: probiotics, Probiotics for IBS

About Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

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Reader Interactions

Comments

  1. Sarah Moshe says

    at

    Very informative.
    I have a long history of IBS – D. The worst of my symptoms is the debilitating weakness after bowel movements with feeling of gut emptiness (after having eaten, especially in the morning), forcing me to lie down in fetal position for hours. I need to drink warm herbal tea, sometimes even a sip of pure prune brandy to warm up my stomach.
    What causes this symptom?
    I follow the FODMAP diet, not strictly. I take probiotics.
    I would like to take your free course on IBS.

    Reply
    • Kirsten Jackson Specialist Dietitian says

      at

      Hi Sarah, sadly we can not give personalised dietary advice out without further assessment.

      Reply

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👉So you tried the low fodmap diet with the hopes and promises that it would fix your IBS. You stuck with the relentless restrictive diet for what felt like weeks…but yet achieved no results 😞 Leaving you feeling hopeless and defeated. 
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👉 but I’m here to tell you that the low FODMAP diet doesn’t work for everyone and thats OKAY! There are other options that we use for individuals who follow the Take Control Programme. There is hope so please hold on in there 🙏🏻.
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😭 I think this post emphasises the point that NOT EVERY DISABILITY IS VISIBLE. As IBS sufferers we often hide our pain in silence day in day out, hoping nobody notices or asks questions. When people ask how we’re doing, we do the polite thing and reply with “I’m fine”. Leaving the burden of IBS to be dealt with alone…​​​​​​​​​​​​​​​​
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😍Instead of wasting your time and money on supplements, fad diets and intolerance tests (the list goes on) why not focus on the core foundations of IBS management - diet, movement, sleep and mental health. In the Take Control Method we make small changes in each of these areas which leads to life-changing differences.​​​​​​​​​​​​​​​​
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🥰If you find your dog can help you when you’re in a rut with your IBS symptoms then the Take Control Programme supports you! Emotional support, whether that is in the form of a human being or a fluffy animal is key to mastering your IBS symptoms.​​​​​​​​​​​​​​​​
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👩‍❤️‍💋‍👨This is why explaining to your partner what is going on can be crucial to having a harmonious relationship. You may even find that opening up to them helps you to manage your IBS as you’re less stressed about letting them down. In the Take Control Programme we emphasise that it is crucial that you have this support in place to manage your IBS 🙏🏻. 
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE top 10 IBS mistakes! Link in bio.⠀
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🙁A lot of people assume that they have IBS when their digestive system isn’t working the way that it usually should be. You may think this is a fair assumption, but your symptoms may actually be red flags for other conditions such as Inflammatory Bowel Disease (IBD). This is not good as a misdiagnosis leads to inappropriate treatment.​​​​​​​​
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❤️ In the Take Control Programme we always ensure that IBS has been officially diagnosed prior to starting your management journey. Look up ‘How to Get an Official IBS Diagnosis’ on my website if you’re unsure where to start.​​​​​​​​
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⏩ Overview of what we discussed.
👉 Salmonella is a bacteria which can live in the intestines of animals (including us humans).
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👉 Good hand hygiene and safe food storage and prep is vital to prevent this.
👉 Do NOT wash raw chicken as this can lead to contamination of your kitchen with salmonella
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#salmonella #publichealth @bda_dietitians
HAVE YOU HEARD SOMETHING LIKE THIS BEFORE? 🥺​ HAVE YOU HEARD SOMETHING LIKE THIS BEFORE? 🥺​​​​​​​​
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☹️ IBS is often belittled as a condition that 'isn't that bad'. by friends, by family and even by healthcare professionals. It leaves you feeling frustrated but also second guessing your own pain and struggles... ​​​​​​​​
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💪I am here to tell you that you have every right to advocate for your own health - if you won't, no one else will. Surrounding yourself with people who understand what you're going through, and defying those who belittle it is key. Social support is a key element of my Take Control Programme.​​​​​​​​
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🎉 🎉 Have you downloaded my FREE IBS guide yet? The link is in the bio. 🤩 ​​​​​​​​
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Have you been impacted by this? 😔 ❤️​​​​​​​​
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😞As I’m sure lots of you can relate, IBS has a close link with our mental health, including the link between IBS and depression. Poor mental health can lead to worsening of our symptoms, and our IBS symptoms can lead to worse mental health…it’s a vicious circle 😥. ​​​​​​​​
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🙏🏻 the good news is there are multiple ways to help manage your mental health. Adopt the Take Control Approach and prioritise your mental health. Not tomorrow, not next week but now as it is a core element to IBS management ❤️. ​​​​​​​​
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🥵We all know exercise is good for us, but the thought of intensive HIIT workouts doesn't exactly appeal to all of us...in fact intense exercise can actually contribute to IBS symptoms for some.​​​​​​​​​​​​​​​​
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🤔But what if it didn't have to be so complicated? Instead of seeing movement as a scary and intense activity, why not try walking? - this counts as movement and has so many fabulous benefits for IBS as listed above  Movement is one of the KEY pillars of IBS management that we tackle in my Take Control Programme.​​​​​​​​​​​​​​​​
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🎉 🎉 Are you ready to FINALLY master your IBS with guidance? Book a 15 minute enquiry call with me or my colleague (link in bio). 🤩 
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#ibs #walking #movement #irritablebowelsyndrome #ibsexpert
🤔 Have you ever tried to eat intuitively? ​​​​​​​​
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🤝 Myself and @wholistic_health_and_wellness have teamed up to look at how intuitive eating could help you with your IBS. Because there is such a strong relationship between IBS and disordered eating behaviors, it’s important to look at our relationship with food when working to reduce IBS symptoms.​​​​​​​​
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🥰Learning to eat intuitively is a great way to improve your relationship with food, remove guilt and stress from the eating experience, reconnect with hunger and fullness cues, and find the foods that work best with your body!​​​​​​​​
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#intuitiveeating #healthyeating #mindfulness #disorderedeating #eatingdisorder #ibs #ibsdiet #lowfodmap
DO YOU DO ANY OF THESE? 😔 ​​​​​​​ DO YOU DO ANY OF THESE? 😔 ​​​​​​​​
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👉 In IBS, there are a lot of subtle behaviour changes that we make in order to hide our struggle 😕. We are scared if the judgement and we are scared of being singled out 😭. ​​​​​​​​
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👉 Instead of making behaviour changes to mask your symptoms, why not try making small changes to reduce your symptoms? In the Take Control Method we encourage individuals to be open about their problems, instead of hiding them from others so that they can receive the the support they need to put these changes in place ❤️. ​​​​​​​​
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🎉 🎉 Are you ready to FINALLY master your IBS with guidance? Book a 15 minute enquiry call with me or my colleague (link in bio). 🤩 ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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#ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #ibsd #ibd #tea #5steps #chronichealth #multifactorial. #chronicallyunwell #endo #ibstype #ibstyping #ibsc
WHICH ONE ARE YOU? Comment below!​​​​​​​​​​​​​​​​
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👉I will say it time and time again... IBS is SO individualised and personal. No 2 clients ever look the same. This is why generic IBS advice often does not lead to the results that you are hoping for. Taking a random probiotic, eating more fibre or even trying the low FODMAP diet (without professional help) can leave many IBS sufferers no nearer to symptom relief than they were...​​​​​​​​​​​​​​​​
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🤩This is why working with an expert in the field of IBS is so crucial in order to get that specific advice that you need to achieve your symptom relief - we value that everyone is different and it is not a one size fits all world❤️.​​​​​​​​​​​​​​​​
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🎉 🎉 Are you ready to FINALLY master your IBS? Book a FREE 15 minute discovery call with me or my colleagues. 🤩​​​​​​​​
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#ibs #irritiablebowelsyndrome #ibsdiet #lowfodmap #lowfodmaprecipes #ibsc #ibsd
Do you suffer with any of these other symptoms? CO Do you suffer with any of these other symptoms? COMMENT BELOW.
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🤦‍♀️Your 'IBS' may actually be a histamine intolerance as some symptoms are similar. Additional symptoms include headaches, itchy skin and sinus problems - symptoms vary though.
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🤦‍♀️A histamine intolerance is caused by a lack of the enzymes which would normally break histamine down. Leading to an overload of histamine in the body.
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🤦‍♀️Histamines are found naturally occurring in certain foods and how a food is processed can impact the histamine quantity.
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🤦‍♀️This intolerance is diagnosed by symptoms improving whilst avoiding histamines and these symptoms then come back with the reintroduction of histamines (to confirm). Please note though that you should always visit your doctor first to rule out other conditions that can also cause these symptoms.
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🤔Having a histamine intolerance is not like having an allergy. You will have a certain tolerance level and it is important to work this out in order to avoid an overly restrictive diet. 
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🤩We cover histamine intolerances in my NEW histamine intolerance E-Book! 
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#ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #mumlife #dubaimom #constipation #chronicpain #chronicallyunwell #women'shealth #histamine #foodchemicalintolerances
👇Do you get any symptoms of histamine intoleran 👇Do you get any symptoms of histamine intolerance? Comment below?​​​​​​​​
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🤓Histamine intolerance impacts 1-3% of the population (more than coeliac disease which you would have been tested for as part of your IBS diagnosis).​​​​​​​​
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🙃The symptoms of histamine intolerance do have some overlap. If you have IBS but have seen no relief with typical IBS treatments you may well have histamine intolerance.​​​​​​​​
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🎉Check out our new E-Book all about this condition, how to diagnose it and how to manage it (link in bio).​​​​​​​​
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#histamineintolerance #ibssymptoms #guthealthdiagnosis #histamineguide
🎉 Histamine Intolerance E Book - on sale now 🔗 link in bio.​​​​​​​​
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→58 pages​​​​​​​​
→Histamine intolerance diagnosis protocol​​​​​​​​
→Meal plan​​​​​​​​
→Recipes​​​​​​​​
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‼️ A step by step guide based on scientific facts to help people get accurately diagnosed with histamine intolerance.​​​​​​​​
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#histamineintolerance #ibs #guthealth #dietitians #refractoryibs #itchyskin #foodintoleranceguide
Anyone investing in this?🤷‍♀️ comment bel Anyone investing in this?🤷‍♀️ comment below 👇 ​​​​​​​​​​​​​​​​
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​​​​🤩🤩Fed up of being fed up with your IBS? Download my free top 10 IBS mistakes! - link in bio!​​​​​​​​​​​​​​​​
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#onions #elonmusk #ibs #ibsmemes
WHAT IS YOUR BINGO LOOKING LIKE? 😔 comment belo WHAT IS YOUR BINGO LOOKING LIKE? 😔 comment below 👇 ​​​​​​​​
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😥 IBS can be unpredictable in nature and it can feel like you never know if you’re going to have a good or bad day…You try to pinpoint a trigger but gosh is it hard 😫.​​​​​​​​
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😊 But what if you could predict the future? Identifying YOUR personal triggers and how to manage these is key to Taking Control of your IBS and is an integral part of the Take Control Programme. Why not try filling out a food and mood diary this week to see if you can pinpoint if what you eat and/or your feelings play a role? ​​​​​​​​
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🤩🤩Fed up of being fed up with your IBS? Download my free top 10 IBS mistakes! - link in bio!​​​​​​​​
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#ibs #ibsdiet #irritablebowelsyndrome #guthealth #guthealing #lowfodmap #lowfodmaprecipes #gutissues #healthygut
❤️As April is IBS awareness month, myself and ❤️As April is IBS awareness month, myself and @dieteticallyspeaking have teamed up to spread the word about the relationship between disordered eating and IBS.
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➡️Swipe for information about the overlap between these conditions and also how this relationship can go in either direction i.e. there’s s higher risk of gut issues with disordered eating or an eating disorder and a higher risk of disordered eating with IBS.
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🥰For more information go to @dieteticallyspeaking bio for a full article about this important topic! 
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#ibs #ibsawarenessmonth #guthealth #guthealing #disorderedeating #eating disorder
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