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Kirsten Jackson Consultant BSc Hons PG Cert RD

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Sarah’s Story

by Kirsten Jackson Specialist Dietitian 1 Comment

Sarah is a recent client we have had at The Food Treatment Clinic and hopefully by sharing her story it will illustrate how seeing a dietitian could help you.

dietitian

Background

Sarah came to see us complaining of digestive health problems which had started many years ago. She reported a self-diagnosed lactose intolerance and said that despite avoiding lactose, she had random periods of severe diarrhoea with constant bloating.

Sarah’s symptoms were ruining her life as they were so unpredictable and she had often had to cancel meals out or take time off work.

Assessment

During her first dietitian appointment, Sarah reported that she had been accurately diagnosed with IBS 3 years ago (e.g. the correct bloods tests had been done whilst eating gluten).

Sarah’s diet showed that she ate regularly, avoided caffeine, had a good fibre intake, exercised regularly and drank plenty of fluid. All of the things you would need to address as a ‘first line’ in IBS.

Sarah did have some levels of stress in her life but these were fairly minor and did not seem to coincide with her symptoms.

Intervention

Sarah was trialled on a 100% milk free diet, ensuring that calcium requirements were still being met.

1 Week In

Sarah no longer had any diarrhoea, but still had some bloating. She was then started on a specific probiotic as it wasn’t surprising that her gut microbiota would be affected from years of diarrhoea.

4 Weeks In

Sarah had no symptoms at all. She was then started on a reintroduction phase to confirm a cow’s milk protein allergy.

5 Weeks In

Sarah managed to get 2 days into the reintroduction before severe diarrhoea confirmed a non-IgE mediated cow’s milk allergy,

Now 

Sarah is symptom free, no longer needs to take a probiotic and is enjoying dairy free alternatives. The dietitian also provided her with information to support label reading, eating out and ensuring that she does not become calcium deficient.

Q & A

Why did Sarah’s doctor not pick this up?

Food allergies are rare and there is actually no test for a non-IgE mediated allergy. You would need to work with a specialist such as a dietitian.

Why did Sarah still have symptoms on a lactose free diet?

If you have a lactose intolerance you only need to avoid foods which are high in lactose e.g. milk, ice-cream and yoghurt. However, Sarah was still eating foods such as butter, cheese and dark chocolate – these foods all contain milk proteins which will trigger a milk allergy.

 

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Filed Under: Medical advice for IBS Tagged With: patient story

About Kirsten Jackson Specialist Dietitian

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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🤷‍♀️Do you have any allergy specific symptoms? Comment below ⬇️
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🙋‍♀️I often find that people with food intolerances are confused over what they can and can not eat. They are too restrictive. If you have a food intolerance you can have small amounts of that food (the amount varies depending on your tolerance level). Whereas if you have a food allergy then you must 100% avoid that food.
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🙃The difference between the 2 is that only an allergy involves the immune system. When you eat an allergen, your body starts an immune reaction, causing your symptoms. In an intolerance it is because you are unable to digest part of the food which can lead to excess gas, bloating and looser stools.
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🙋‍♀️Occasionally I am seeing adults in clinic who have been wrongly diagnosed of IBS. They have 'non-IgE' mediated food allergies for which there is no testing (diagnosis via elimination diet and assessment). Their symptoms are similar to IBS but much more severe.
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As a member, you will also get access to
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😢Anxiety is a known trigger of IBS via the gut-brain axis. Sometimes, we wonder why our diet isn't improving our IBS and it is because we have not addressed our mental health.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙃Although anxiety is a common problem, I find that sufferers sometimes do not recognise the signs and so asking someone else who is close to you, for their opinion is a good way to assess this.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙋‍♀️IBS is so much more than the symptoms you have to deal with every day. It is what these symptoms bring. How they impact your life.
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😢IBS impacts everything from your mental health and your energy levels to things that others take for granted..like what clothes you can wear that day.
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🎉BUT you do not need to suffer with this anymore because my IBS Take Control Program is open for 2021 registration (It will close at the end of this week (or earlier if all slots are taken up).
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The Take Control Membership Program gives you access to step by step tutorials from me on how to understand your IBS and how to control it.
⠀⠀⠀⠀⠀⠀⠀⠀⠀
As a member, you will also get access to
✅Group calls with me each week
✅Access to a private community for support
✅Weekly goals setting for progress
✅Weekly positivity reflection task
✅Membership discounts
⠀⠀⠀⠀⠀⠀⠀⠀⠀
🔗You can sign up via the link in my bio.
⠀⠀⠀⠀⠀⠀⠀⠀⠀
🙋‍♀️You have questions? Hey! That is NORMAL - just post below or message me.
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🤷‍♀️Can you tolerate coffee? Comment below ⬇️⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙋‍♀️ Coffee contains the active ingredient caffeine. Although we think of caffeine as an everyday thing, it is a drug and does have an impact on our body. In IBS, this impact may be negative in the form of over stimulating bowels. It can also worsen anxiety and prevent good quality sleep, both of these aspects then have a knock on impact on your IBS. 

🤔Instead of blindly avoiding all coffee (which may not be needed). Here are some top tips from the Take Control Membership:
1️⃣ Never exceed 400mg caffeine a day (this is the general guidelines for a healthy intake and is lower for those pregnant and breast feeding) 
2️⃣ Reduce intake gradually to avoid headaches. 
3️⃣ Avoid coffee after mid-day (it's long 1/2 life means it may still be in your system when trying to sleep otherwise). 
4️⃣ Track your bowel habits and mood against intake to see if it is causing an issue.
5️⃣ Coffee isn't all bad for IBS - if you have IBS-C,  you may find that it helps you go! 

‼️ Have you downloaded my free 'morning guide' yet? (the link is in my bio).⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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SAVE THIS POST - FOR REFERENCE. 🤷‍♀️Have SAVE THIS POST - FOR REFERENCE.

🤷‍♀️Have you heard of SIBO before? Comment below ⬇️

🙋‍♀️SIBO (small intestinal bacterial overgrowth) is a condition caused by..you guessed it...an overgrowth of bacteria in the small bowel. It is unclear what causes SIBO but it does seem to be linked with PPI medications, low immunity and poor gut motility.

🤓The management of SIBO is difficult. Because the best diagnostic tools we currently have are not very accurate and the current treatments for SIBO are mostly antibiotics. We often see in practise that SIBO tends to return after antibiotic treatment, likely due the underlying cause not being treated.
 
🤓SIBO management;
✅Antibiotics
✅Addressing motility (avoiding constipation)
✅Optimising good gut bacteria (so it can thrive and compete with bad bacteria)
✅Elemental diet - some limited research to support this use as a treatment.
❓Low FODMAP diet - no evidence but the theory is that these FODMAPs will feed the bad bacteria so avoidance of them whilst taking antibiotics may allow the antibiotics to work better. 
❌Herbs - no placebo controlled trials to support this or any logical theory.

🤓Ultimately we have very limited research in this area. I tend to work with gastroenterologists on this one to first have the condition diagnosed and then get the individuals gut in a place where the antibiotics are mostly likely to work.

‼️ If you haven't already, do not forget to sign up to my free Veganuary IBS Guide (the link is in my bio).⠀⠀⠀⠀⠀⠀ 

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THE IMPORTANCE OF GETTING OUTSIDE?⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
🤷‍♀️How often do you get outside each week? For how long? Comment below ⬇️⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙋‍♀️When I discuss movement with my clients, I often find that either they rely on the gym / computer or simply do not do any exercise. And before you say, it is because of the weather, even my clients in warmer climates have a similar pattern. Failure to go outside in the day can be disruptive to your circadian rhythm (sleep cycle) and we know this is connected to you gut. Outside exercise can also beneficial to your gut microbiota.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤓So keep it simple and schedule in a 30 minute walk each day (15 mins out and back...not difficult at all :).⠀⠀⠀⠀⠀⠀⠀⠀⠀
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⏩⏩Have you downloaded my free Veganuary for IBS guide yet? The link is in the bio!.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤷‍♀️Which emotion are you today? Comment below ⬇️⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙋‍♀️when you have IBS, it is a whirlwind of emotion. One minute, everything is going well and then suddenly you have a flare up of symptoms. Or perhaps you are anxious about what your bowels may do. This whirlwind is due to having a limited understanding of your triggers and so you simply can not avoid them. Instead of this, opt for the low FODMAP process which will guide you step by step to pinpointing your trigger foods.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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⏩⏩Have you downloaded my latest free guide? “Veganuary for IBS.”⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙋‍♀️Who would say their quality of life is negatively impacted by their gut health?.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤓Research shows that IBS is directly linked to poor gut health, so it is not surprising that this was the main outcome for this client.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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