irritable bowel syndrome (IBS) Archives - Granite Peaks Gastroenterology of Utah

How to take care of your internal plumbing as you age

Posted on April 28, 2022April 28, 2022 by fuelmarketing

As we age, changes in our body often require change in our diet – not only what we eat, but how we eat it. A registered dietitian discusses some tips to keep your digestive health at its best as you age.

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TIP: Eat your food hot

By Ginger Bailey, RDN CD

Originally posted on 11/24/2020
Updated on 4/28/2022

My kids get very upset when we use the “O” word. According to them, the word “old” is a dirty word and adults are not allowed to refer to themselves as such – especially not their grandparents!

No one likes to think about getting older or to even admit that they are aging. Unfortunately, “Time” cannot be denied and our bodies change as we age. The good news is that if we understand how our body changes and what we can do to support it, we can make age a state of mind more than a state of body. In essence, we can become wiser rather than simply older. (Shh, don’t tell my kids I said the “O” word!)

One of the best ways to keep our bodies fit and active as we age is to take care of our “internal plumbing.” I’m referring, of course, to our digestive system.

As we age, our gut becomes a little less efficient at extracting nutrients from the food we eat. Every vitamin and mineral we eat goes through a complex pathway to convert from food to a form the body can absorb. Some of these pathways are more complex than others. Generally speaking, the more complex the pathway, the sooner we tend to lose the ability to adequately absorb the nutrients we need. So, let’s talk about a few of these nutrients, as well as some things you can do to slow down the aging process and take good care of your internal plumbing.

Vitamin B12

Let’s start with Vitamin B12. This nutrient is an important powerhouse. It’s critical for your body to be able to convert the food you eat into energy. It also has one of the most complex absorption pathways. A low level of B12 is one of the most commonly-found deficiencies in seniors, and can lead to a condition called pernicious anemia. Pernicious anemia can cause significant fatigue, headaches, and paleness.

As people age, they often start feeling more fatigued and just chalk it up to “old age”. In some cases, it may be a nutrient deficiency that can be corrected. This is not the only deficiency that can cause fatigue, but it is one of the more common ones because B12 is difficult to absorb in any case. People that have had bariatric surgery or any surgery involving the stomach or small intestines are at high risk of being B12 deficient.

Fortunately, vitamin B12 levels can be checked. If you are experiencing any of the above symptoms, or are concerned, you can work with your doctor to have your blood levels analyzed and decide on the best support options for your body.

Trace Minerals

Trace minerals include calcium, magnesium, iron, zinc, selenium, copper, phosphorus, potassium, manganese, and a few others. These minerals are responsible for many things, including but not limited to: bone health, nerve conduction, and immune health. Most of these nutrients are absorbed in the first part of your small intestine, but many compete for the same absorption pathways. That can make it difficult for your body to digest all of them equally. For anyone who has had a surgery that altered the anatomy of their GI tract – and this is the case for many people – this can be an issue.

Also, as time goes on, it is common for our bodies to produce fewer digestive enzymes. Digestive enzymes help our bodies break down food and easily absorb nutrients, so this process can become less effective as we age.

There is a very simple solution to this problem. Eat slower! You see, chewing your food more can help with this. The more work your teeth do, the less your stomach has to do. There are also enzymes in your mouth that start breaking down food. So, if you chew your food more thoroughly, there is a higher likelihood that you are going to get more nutrients out of it. If your teeth are not in good condition, or chewing is difficult for some reason, then blending or pureeing food can also be helpful.

Fiber

Most Americans don’t get adequate fiber in their diets. This causes a myriad of problems. Consequences of inadequate fiber intake include:

Higher risk of cancers
More issues with constipation and diarrhea
Poor immune function
Higher cholesterol levels
More GI disturbances
Higher inflammation
Poor blood sugar control

The best sources of fiber are whole grains, vegetables, fruits, and legumes. If you aren’t getting enough fiber in your food, adding a fiber supplement can be helpful.

Age and Appetite

Many people find that their appetite decreases as they get older, often because of a reduced sense of taste. It can be harder to get those appropriate nutrients we just talked about when your appetite decreases and your sense of taste fades. So, what do you do then? Most people resort to dumping extra salt on their food so they can taste it. While that theoretically can work, it is not the best solution for your overall health. Instead, let’s talk about how to spice things up a bit!

(If you are thinking, “um…my digestive tract can’t party like I’m in my twenties anymore,” worry not. There are seasonings and spices that are both safe and healthy for your gut.)

Garlic is a very versatile flavor that is potent and has positive health benefits. Now, garlic can be an issue for some people with severe irritable bowel syndrome. For most people though, garlic is a great way to add a depth of flavor to food and make it more exciting to eat. Garlic pairs nicely with other flavors. It can also help decrease inflammation and support immune function.

Basil is another powerful herb that packs a lot of punch with flavor. It is very gentle on the digestive tract, but strong enough to add flavor to many types of foods. There are many varieties of basil. It is generally easy to grow even year-round inside your home. You can add a little or a lot depending on how much you like.

Rosemary is another one of my flavor rock stars. It tastes great with pork and many vegetables. It can really elevate a dish from “fine” to “delicious.” This one is also gentle on your insides, while allowing your taste buds to dance a bit.

There is one flavor source that requires a bit of caution. Anything containing capsaicin (the source of the heat you feel when you eat a spicy pepper) can be irritating to the digestive tract. While many people enjoy the heat, capsaicin has a higher tendency to cause digestive discomfort. Spices that contain capsaicin include, but are not limited to:

Red pepper flakes
Cajun seasoning
Some taco seasonings
Chipotle/jalapeno peppers

It doesn’t mean you can’t ever use these flavors, but you may want to use them in smaller quantities since they are potent and have the potential to irritate your gut.

Here’s another tip: Eat your food hot!

Warmer foods tend to be more aromatic. Much of our sense of tastes comes from our sense of smell. Foods that have a stronger smell are also usually easier to taste. If you find that tasting your foods is a problem, keeping your sinuses clear will help. Eating a hot sandwich might be easier to taste than if you ate it cold, for example. Or having cooked vegetables rather than raw.

Hopefully a few of these little tricks will help you enjoy your food longer and keep your body working at top notch for as long as possible. And maybe help you avoid feeling the “O” word for as long as possible. Happy eating!

Do you have concerns about your gastroenterological health? Granite Peaks Gastroenterology can help! Click here to request your appointment with one of our gastroenterologists today!

Diet Management for IBS

Posted on June 8, 2020October 20, 2020 by fuelmarketing

How watching what you eat can make your bowels a little less irritable

by Ginger Bailey, Registered Dietitian/Nutritionist

If you have been diagnosed with Irritable Bowel Syndrome (IBS) you know how troublesome, and sometimes debilitating, the symptoms can be. IBS can be difficult to diagnose since symptoms may present differently from person to person. Some may have diarrhea while others struggle more with constipation. For others, nausea and bloating are more severe.

The good news is that better dietary management can often reduce symptoms and improve quality of life. Finding what works for you can be tricky as dietary management varies based on each person and their symptoms. However, there are a few general recommendations that can be helpful.

Keep a food/symptom log. This is the best way to find out which foods trigger your symptoms and which help alleviate them. Because people often don’t eat one food at a time, it can be difficult to pinpoint if there is a particular food that seems to cause issues for you. Make notes about any symptoms that appear within an hour of eating. Over the course of time, it will become easier to find correlations.Also, if your symptoms ever flare up, make note about other things happening at the time. Are you feeling more stress than usual? Did you just have a difficult conversation with someone? Did your schedule change suddenly and unexpectedly? Did you go to a new place? Keeping a log will help you learn more about how your body operates, and by extension, how you can best take care of it.
Limit the amount of processed foods and artificial ingredients you eat. The human body does not deal well with artificial sugars, fats, colors, etc. These foods may also have a negative impact on the microflora of your gut. The balance of bacteria in your GI tract is very important! Eating a lot of processed foods can disrupt that balance and worsen GI issues, in addition to being generally detrimental to your system. Instead, look for foods with ingredients you recognize. You can never go wrong with fresh fruits and vegetables, and whole, unprocessed foods.
Learn what activities help you discharge your stress. While the demands of daily life mean it’s often not possible to eliminate, or even decrease, your stress, there are ways to better manage it. There are ways of discharging stress and other negative feelings.Why is this important? Your gut has tons of nerves in it! Research has found that stress can wreak havoc on the nerves. If we don’t let go of our “emotional baggage that built-up tension can affect the nerves in your GI tract.
Enjoyable activities like exercise, meditation, reading, gardening, hobbies, art, and listening to music are all great ways to help dissipate pent-up energy and frustration.

To manage specific symptoms, try these suggestions:

Constipation

Constipation means stool moves too slowly through the large intestine, resulting in hard, painful bowel movements. To avoid this:

Get adequate amounts of fluid and fiber
Avoid excessive starches (bread, pasta, baked goods)
Talk to with your gastroenterology specialist about probiotics
Eat plenty of fruits and vegetables
Keep a food/symptom diary to log your body’s reaction to different foods.

You can also talk with your gastroenterology specialist about taking probiotics. These can be helpful for maintaining a good balance of healthy bacteria in your intestines. Eating plenty of fiber also helps provide more bulk to help your colon move food along more consistently, but always increase fiber intake gradually. Increased fluid intake is necessary when increasing fiber intake to prevent worsening constipation.

Diarrhea

People with diarrhea have the opposite problem of those with constipation – their stool is moving too quickly. In this case, starchy foods and foods high in soluble fiber tend to help bind extra fluid. For example, oatmeal has quite a bit of soluble fiber. Adding a soluble fiber supplement, like Benefiber®, may also be useful, but as with any fiber, add it to your diet gradually!

Gas

Some foods naturally produce more gas, but the situation is worsened for those with IBS. These foods may include beans, lentils, potatoes, eggs, asparagus, broccoli, Brussels sprouts, cabbage, onions, garlic, lactose (found in milk), soft drinks, artificial sweeteners, and some whole grains. Many of these foods are good for you in other ways, though, so you shouldn’t eliminate them from your diet entirely. Instead, practice moderation and note in your food log if a specific food is giving you trouble.

Wheat can be a common trigger for symptoms. It may be worth eliminating wheat for a period to see if it improves symptoms. Also, suddenly increasing your fiber intake will tend to cause more gas and GI distress. Consuming excess amounts of insoluble fiber in particular can also do this.

Again, gas isn’t an excuse to not eat your vegetables! Just try to avoid eating a lot of gas-producing foods together in one day if you are already struggling excess gas.

Nausea

Personally, this is usually my first indicator that something I ate didn’t agree with me. It typically starts before any of the other symptoms. So, I will immediately make note of anything I ate at that particular meal or snack. (Once again, keep a food/symptom log. It really is a powerful tool!)

If you experience nausea, ginger and mint are both excellent natural remedies. Ginger or mint tea – hot or cold – can also work. There are also ginger mints you can buy from many grocery stores that are helpful for nausea. Fresh ginger also adds a great flavor to meals.

Summary

As a dietitian, I have personally struggled with IBS and I know how challenging it can be. That said, because I listened to my body, I have found ways to keep my symptoms manageable and I feel good most of the time. I have found through my own personal experience, as well as that of my clients, that the most important thing is to listen to the cues your body gives you. Our body knows what it needs – we just don’t always pay attention. Do your best to create a positive environment surrounding eating. When people struggle with GI issues, food often becomes something they don’t even want to think about anymore. If your brain creates negative associations with food, it can make the situation worse. Try to make the experience of eating as positive as possible. Eat with family, listen to uplifting music while you eat, or even eat at a favorite location. Anything you can do to make eating a positive experience can be helpful. After all, good food is truly one of life’s greatest pleasures!

Think of it this way. Imagine it’s a Monday, and all day long you find yourself having to deal with things you’d rather not deal with. You get stuck in traffic, your desk piles up at work, the weather’s awful, and when you get home, you see that no one bothered to clean up the kitchen. You’d probably feel pretty irritable, wouldn’t you?

Your body works the same way. When we subject our GI tract to unhealthy food – or food our body simply doesn’t tolerate well – it reacts exactly the same way we do: It gets irritable. By following the steps above, you can make your gut a lot happier, making you a lot happier in the process.

Adjust Expectations During Shelter in Place

Posted on April 9, 2020October 19, 2020 by Granite Peaks

Granite Peaks GI Staff

4/09/2020

Part of the frustration that can come with this sort of change to our normal daily life is sustaining our normal expectations while living and working in an abnormal way. This goes for how we work, how we eat, how we exercise, how we create, sleep and plan. The secret to avoiding some of the frustration is to adjust our expectations – for now.

If you’re working reduced hours whether at home or at your place of work, you are likely able to adjust your schedule and some expectations. This is a great opportunity to build some new, positive habits by planning ahead to use your time wisely and productively.

Awaken at the same time. Try to keep it around your usual time so there won’t be a big adjustment when you go back to work full-time.
Use your commute time. If you aren’t commuting, use the extra time to ease into your morning with 10-30 minutes of exercise, meditation, reading, and a healthy breakfast. No, you can’t go to the gym right now, but you can figure out some ways to keep up some of your routine from home. Meditation (look online for free options for guided meditation) can help create mindfulness and ease anxiety during this unusual time.
Take a break from at-home work. If you’re used to grinding through the workday without breaks, rethink that. A break gives your mind and body the reprieve it needs. Those with children or family at home can use the time to reconnect with them and enjoy each other’s company. Have lunch outdoors on good-weather days to recharge and ready yourself for the afternoon’s work. That’s better than the work lunchroom any day!
Adjust expectations of your kids. If you have kids, you know this time has been tough on them and on you. They’re not in their normal routine, they can’t see their friends, they can’t even go to the playground at the park. That’s a recipe for tension and mayhem. So, you’re it! You’re in charge of their schooling, daycare, mind-filling and energy-burning activities – while you’re trying to work from home. Create a schedule of activities including learning, chores, creative play, outdoor and nap/quiet times. If you need to discuss adjusted work hours/expectations with your supervisor to accommodate this unusual situation, do it. Check the Workforce Services website if you have questions about your rights or eligibility for benefits surrounding daycare and your work hours.
If your work hours are over earlier than usual, plan to get outdoors for some exercise and fresh air, start a project you’ve been waiting to do, catch up on correspondence and reading, and remember to play. Make a list and schedule certain days or times for certain activities. Planning is key to making the most of your time at home the same way it is at work.
Eat healthy. Now is the time to learn how to properly meal-plan and shop for only those things you need to make your week’s meals. It’s not the time to indulge (too much) with unnecessary, unhealthy items. There are online planning tools to help you build a healthy, delicious week of meals. Remember to wear your facemask at the store and wash your hands thoroughly before and after you shop.
Adjust your TV consumption. Don’t overdose on news about the pandemic. Get one daily news report and move on to entertaining or educational programming. Choose the time you will stop watching television and begin winding down for a reasonable bedtime to allow for 8 hours of rest. Rest is an important part of staying healthy. This is an easy one – you can do it.
Shut off the TV. Even better! Now is a great to play games, work puzzles or work on projects alone or with your family. This is an adjustment that you can enjoy living with.

For those with digestive health issues, be sure to stock up on the items that keep you feeling healthy and keep your digestive system running smoothly. Whether you have celiac disease, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or other digestive health issues, be sure you are taking the precautions necessary to stay well. If you are immunocompromised, do what you can to minimize your risk of contracting the virus. Plan daily exercise and dietary goals for staying well.

Know that your providers at Granite Peaks Gastroenterology are available to you, even during the COVID-19 situation. We have telehealth appointments available that let you connect with your GI provider from the safety and privacy of your home. It’s easy to set up, convenient and safe!

For those who have symptoms that may necessitate an in-person appointment, our clinic is making it safe for you to come in to see us. We are scheduling patients to allow for social distancing, pre-screening patients, performing extra cleaning steps between patients and wearing personal protective equipment.

For now, we are all adjusting expectations and actions to stay well and avoid either contracting COVID-19 or spreading it to others, and it’s working. Keep up the good work, Utah! We wish everyone safe and healthy days ahead.

Treating IBS with Cognitive Behavioral Therapy

Posted on January 8, 2019August 13, 2019 by Christopher Cutler

By Christopher Cutler, M.D.

Irritable bowel syndrome (IBS) affects 10-15% of adults in the United States. It is a functional disorder of the gastrointestinal tract characterized by abdominal pain and altered bowel habits. IBS is usually treated with dietary modifications and medications directed at underlying symptoms (diarrhea, constipation, abdominal pain, bloating). Patients may also receive benefit from antidepressants, probiotics, and antibiotics. But what about patients with refractory symptoms that do not respond to traditional therapies? What are their options? One promising alternative to consider is cognitive behavioral therapy (CBT). CBT is a short-term therapy (4-10 one hour sessions with a therapist) that focuses on modifying behaviors and altering dysfunctional thinking in hopes of improving mood and GI symptoms.

The Brain-Gut Connection

In patients with IBS, there is dysregulation of the gut brain axis, a complex neurologic communication between the brain and GI tract. Stress and psychological factors can directly influence gut function via this pathway, contributing to IBS symptoms. Patients with IBS have an increased tendency to experience pain in response to normal bowel function. This may be attributed in part to abnormal pain processing in the brain. People affected by IBS also have a fear of bowel symptoms and associated avoidance of situations where symptoms may occur. It is a vicious cycle since symptoms themselves become a stressor, and this anxiety contributes to increased gut pain sensitivity and altered motility causing worse GI symptoms and worse anxiety.

Given the importance of brain-gut interactions in IBS, psychological interventions are an effective option for this condition. These modalities may include cognitive behavioral therapy, hypnotherapy, and mindfulness. CBT has been the most extensively studied with more than 20 published randomized clinical trials showing relief of IBS symptoms in 50-70% of patients. These benefits are frequently maintained for up to one year after therapy.

Treating IBS with CBT

CBT involves relaxation strategies such as specialized deep breathing. This increases the patient’s awareness of the connection between distorted thinking patterns, stress, and digestive symptoms. CBT also helps patients develop coping strategies by encouraging them to shift from a solution-focused approach to a self-management approach to deal with this chronic condition. CBT also uses exposure techniques which involve facing situations the patient avoids because of fear of symptoms. With time, avoidance behaviors decrease and the thought of symptoms being harmful is reduced.

The American Gastroenterology Association recommends psychological interventions for patients with moderate-to-severe IBS who do not respond to standard medical therapies, and for patients for whom psychological factors exacerbate their symptoms. CBT is an effective treatment option for patient with IBS, and its use to treat this disorder is becoming more widely accepted. The physicians at Granite Peaks are experts in the diagnosis and therapy of IBS and are eager to help you. Please call us to discuss traditional and alternative strategies to help you manage your IBS symptoms.