StayCurious Metabolism

The Hidden Link Between Insulin Resistance and IBS

In a new study published in Cell Host & Microbe, researchers went looking in the guts of people with irritable bowel syndrome (IBS) and people with insulin resistance…

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11 days ago · 39 likes · 14 comments · Nick Norwitz MD PhD

This one stopped me in my tracks. 👇

New research just found something fascinating: people with IBS and people with insulin resistance are both missing the same gut-derived molecule, a fatty acid ethanolamide made from dietary fat (think olive oil). Same microbiome connection, two conditions we usually treat as completely separate.

If you’ve ever felt like your gut symptoms and your metabolic health seem tangled together somehow, this is exactly why. The body doesn’t split us into “gut stuff” and “metabolism stuff” the way our appointment calendars do.

This is such a good reminder of why we go beyond just cutting out trigger foods and look at the whole picture: your microbiome, your metabolism, all of it working together. If you’re working through your own food triggers, my IBS Food Detective Guide walks you through finding your individual pattern, and inside the recipe club we’re always digging into the “why” behind what helps our guts heal. 💛

Now what?

This is where most people make a critical mistake: they assume they need to avoid that entire category forever. If fat was the problem, they go low-fat permanently. If fiber-triggered symptoms, they avoid all high-fiber foods indefinitely.

This is unnecessary and will keep your diet more restricted than it needs to be.

Today, I’m teaching you how to fine-tune your results through subdivision testing and threshold testing. This is how you go from “I can’t eat fat” to “I can eat plant-based fats in small amounts, but I need to avoid fried foods and heavy cream.”

That level of precision is what gives you food freedom.

Step 4: Subdivision Testing (Weeks 4-8)

(See weeks 1 - 3 in part 2A here.)

If you saw improvement during your elimination, don’t just avoid that entire category forever. Most trigger categories have subcategories, and you likely only react to some of them.

Example: If eliminating high-fat foods improved your symptoms, here’s how I recommend testing subgroups:

• Week 4: Test plant-based fats (avocado, olive oil, nuts)

• Week 5: Test dairy fats (cheese, butter, cream)

• Week 6: Test fried foods

• Week 7: Test fatty meats

How to test: Add back one subgroup for 3-4 days while keeping everything else low-fat. If symptoms return, that subgroup is a problem. If you stay stable, that subgroup is fine.

Example: If eliminating high-FODMAP foods improved your symptoms, I recommend testing these subgroups following the official FODMAP reintroduction protocol:

• Week 4: Test fructans (wheat, garlic, onion—one at a time)

• Week 5: Test lactose (milk, ice cream)

• Week 6: Test polyols (stone fruits, sugar alcohols)

• Week 7: Test GOS (legumes, beans)

Example: If eliminating high insoluble fiber improved your symptoms, test:

• Week 4: Test cooked cruciferous vegetables (broccoli, cauliflower - well-cooked)

• Week 5: Test raw vegetables in very small amounts

• Week 6: Test whole grain products (one type at a time)

• Week 7: Test nuts and seeds in small amounts

The goal: Build a precise list of “foods I actually need to avoid” rather than avoiding broad categories indefinitely.

How to Run a Subdivision Test

Let’s walk through a specific example. Say you eliminated high-fat foods and felt significantly better. Now you’re testing the plant-based fats subgroup.

Days 1-2: Test olive oil

• Add 1 tablespoon of olive oil to your meals (on vegetables, in cooking)

• Keep everything else low-fat

• Track symptoms

Days 3-4: Test avocado

• Eat 1/4 to 1/2 of an avocado

• Keep everything else low-fat (no olive oil these days)

• Track symptoms

Days 5-6: Test nuts

• Eat 10-15 almonds or walnuts

• Keep everything else low-fat (no olive oil or avocado these days)

• Track symptoms

Days 7-8: Rest days

• Return to low-fat eating

• Let your gut reset before testing the next subgroup

Evaluate results:

• Olive oil: No symptoms → SAFE

• Avocado: Mild bloating → MAYBE (needs threshold testing)

• Nuts: Cramping and diarrhea → AVOID

Now you know you can use olive oil freely, need to be careful with avocado portions, and should avoid nuts for now. That’s way more freedom than “avoid all fats.”

Why Subdivision Testing Matters

Without subdivision testing, you end up with overly broad restrictions:

• “I can’t eat vegetables” (when really you just can’t eat raw cruciferous vegetables)

• “I can’t eat fruit” (when really you just can’t eat high-FODMAP fruits like apples and pears)

• “I can’t eat fat” (when really you just can’t eat fried foods and heavy cream)

These broad restrictions are unnecessarily limiting. Most people can tolerate some foods within their trigger category—you just need to find out which ones.

Step 5: Determine Your Tolerance Threshold (Weeks 8-10)

For the foods you’ve identified as triggers, you need to find your threshold. Most people can tolerate small amounts but react to larger amounts.

How to test thresholds:

Start with a very small amount and gradually increase over several days:

• Day 1: 1/4 normal serving

• Day 2: 1/2 normal serving

• Day 3: 3/4 normal serving

• Day 4: Full normal serving

Stop increasing when symptoms appear. The last amount that didn’t trigger symptoms is your threshold.

Example with garlic:

• Day 1: 1/4 clove cooked in food (fine)

• Day 2: 1/2 clove (fine)

• Day 3: 1 whole clove (bloating and gas) → Your threshold is 1/2 clove. You can have small amounts in cooked dishes, but not in dishes where garlic is a main ingredient.

• Then try the same test with raw garlic

Example with avocado:

• Day 1: 2 tablespoons (fine)

• Day 2: 1/4 avocado (fine)

• Day 3: 1/2 avocado (mild symptoms)

• Day 4: Whole avocado (significant symptoms) → Your threshold is 1/4 avocado. You can have small amounts, but not the whole Instagram-worthy avocado toast.

Example with coffee:

• Day 1: 4 oz (1/2 cup) coffee (fine)

• Day 2: 8 oz (1 cup) coffee (fine)

• Day 3: 12 oz (fine on some days, symptoms on others)

• Day 4: 16 oz (symptoms) → Your threshold is 8 oz. One cup of coffee is fine, but not a giant mug.

This threshold testing is crucial. It’s the difference between “I can never have garlic” and “I can have garlic-flavored dishes but not dishes where garlic is a main ingredient.”

Thresholds Can Vary by Context

Your threshold for a trigger food might be different depending on:

• Your stress level (lower tolerance when stressed)

• Other foods in the meal (lower tolerance when combined with other triggers)

• Time of day (some people tolerate triggers better at certain times)

• Where you are in your menstrual cycle (if applicable)

• How well you slept (poor sleep lowers tolerance)

This is why you might tolerate 1/2 cup of coffee on a calm Tuesday morning but react to the same amount on a stressful Monday after poor sleep.

Track these contextual factors in your food diary. Over time, you’ll learn not just your thresholds but the conditions under which those thresholds shift.

Common Elimination Mistakes I See (and how to avoid them)

Mistake 1: Eliminating Too Many Categories at Once

The fix: Test one category at a time, even if it takes longer. I promise you, patience now saves months of confusion later.

Mistake 2: Not Being Strict Enough

“I mostly avoided dairy except for a little cheese” won’t give you useful data. If you’re testing it, eliminate it completely.

The fix: Read every label. Ask about ingredients at restaurants. Take the test seriously.

Mistake 3: Testing During a Flare-Up

You can’t tell if an elimination is working when your gut is already in chaos from stress, illness, or hormones.

The fix: Wait for relative stability before starting. Or use the reset diet first.

Mistake 4: Not Giving It Enough Time

3-4 days isn’t enough to clear most triggers and see consistent results.

The fix: Commit to 2-3 weeks. Mark it on your calendar. Don’t quit early.

Mistake 5: Avoiding Foods Forever Without Retesting

Your gut changes over time. What triggered you 6 months ago might be fine now, especially if you’ve been working on the gut-brain connection and sleep.

The fix: Retest previously identified triggers every 6-12 months. You might be pleasantly surprised.

Mistake 6: Not Doing Subdivision or Threshold Testing

This is the biggest mistake. People identify a trigger category and avoid it forever without narrowing it down.

The fix: Always do subdivision and threshold testing. Don’t stop at “fat is bad” or “fiber is bad.” Get specific.

Mistake 7: Blaming Everything on Food

If you’ve eliminated multiple categories and still have constant symptoms, food probably isn’t your main issue.

The fix: Shift focus back to stress, sleep, gut-brain axis, hormones, or go back to your gastroenterologist to rule out other conditions.

The Reintroduction Mindset Shift

This is the most important mental reframe: The goal of elimination is reintroduction.

You’re not trying to find out what you can’t eat. You’re trying to find out what you CAN eat. Every food you successfully reintroduce is a win.

Most people approach this with dread: “Oh no, I have to test this food I’m scared of.”

Flip it: “I’m excited to find out if I can actually tolerate this!”

When a food passes the test, celebrate it. Add it to your “safe foods” list with confidence. Your diet should be expanding over time, not shrinking.

Shifting from Fear to Curiosity

Instead of:

• “What if this triggers my symptoms?” → Try: “I’m curious to see how my body responds to this.”

Instead of:

• “I’ll never be able to eat normally again.” → Try: “I’m building a personalized diet that works for my body.”

Instead of:

• “I failed because I reacted to this food.” → Try: “I gained valuable information. Now I know to avoid this.”

This mindset shift makes the whole process feel less like deprivation and more like discovery.

Your Testing Schedule Template

Here’s a sample 12-week testing schedule:

Weeks 1-3: Eliminate high-fat foods (your suspected primary trigger)

Weeks 4-7: Subdivision testing of fats (plant vs. dairy vs. fried vs. meats)

Weeks 8-10: Threshold testing for identified fat triggers

Week 11: Rest week (eat your safe foods, let your gut stabilize)

Weeks 12-14: Eliminate next suspect category (FODMAPs by category for example)

Notice the rest week between testing phases. Your gut needs breaks from experimentation.

Important: This timeline is flexible. If you need more time in any phase, take it. If you’re moving faster, that’s fine too. The point is to be systematic, not to rush.

When to Get Professional Help

Consider working with a registered dietitian or coach who specializes in IBS if:

• You’ve eliminated multiple categories and still have severe symptoms

• You’re down to fewer than 15 safe foods

• You’re losing weight unintentionally

• You’re so anxious about food that it’s interfering with your life

• You need help navigating the low-FODMAP protocol specifically

• You have other dietary restrictions (vegetarian, vegan, allergies) that make this complicated

A good dietitian or coach can help you test systematically, ensure nutritional adequacy, and provide accountability.

Tracking Tools That Actually Help

The simple version: Use a notebook or note app with three columns:

• Date | Foods eaten | Symptoms (0-10 scale)

The detailed version: Use a spreadsheet with columns for:

• Date | Time | Food | Amount | Category tested | Preparation method | Stress level | Symptoms | Time to symptoms | Notes

Apps that can help:

• Cara Care (designed specifically for IBS food tracking)

• MySymptoms Food Diary (tracks foods and symptoms with charts)

• Simple spreadsheets in Google Sheets or Excel

The best tool is the one you’ll actually use consistently.

What I’m Covering in Part 3

In Part 3, I’m covering reintroduction done right—the exact step-by-step process for adding foods back safely, how to interpret mixed results, what to do when you react to something you really want to eat, and how to build a sustainable, varied diet that doesn’t feel restrictive.

I’ll also tackle the psychological side of reintroduction: the fear, the anxiety, and the tendency to stay restricted even when you don’t need to be.

What’s been your biggest challenge with food elimination? Have you done subdivision or threshold testing?

Disclaimer: This content is for informational purposes only and should not replace professional medical advice. Work with a registered dietitian or healthcare provider when making significant dietary changes, especially if you have other health conditions or dietary restrictions.

Get the Whole IBS Food Detective Series as an eBook

I see most people approach food elimination completely wrong. They either eliminate too much at once (and can’t tell what helped), eliminate too little (and see no change), or eliminate things indefinitely without ever testing them again.

The result? People end up with impossibly restricted diets, still have symptoms, and have no idea what they can actually eat.

Today, I’m going to fix that.

This is the elimination protocol I’ve developed after years of working with my own IBS and helping hundreds of others. It’s strategic, it’s scientific, and most importantly, it’s designed to expand your diet over time, not shrink it forever.

The Three Cardinal Rules of Smart Elimination

Before I dive into the protocol, you need to understand these fundamental principles:

Rule 1: Test One Category at a Time

If you eliminate five things at once and feel better, you have no idea which of the five was the problem. Maybe it was only one. Maybe it was the combination of two. You’ve just made your life harder than it needs to be.

The only exception: If you’re in crisis mode with severe daily symptoms, you might need to start with a very basic “reset diet” before testing. I’ll cover that scenario at the end of this post.

Why this matters:

Let’s say you eliminate dairy, gluten, high-fat foods, caffeine, and FODMAPs all at once. After two weeks, you feel better. Great! But now what?

You have no idea which of those five was actually the problem. Was it all of them? Just one? A combination of two? You’re stuck avoiding all five indefinitely because you’re scared to test them.

Instead, if you eliminate high-fat foods first and feel better, you know fat is a trigger. Then you can test the other categories while keeping fat low. This gives you clear, actionable data.

Rule 2: Give It Enough Time (But Not Too Much)

I see most elimination diets fail because of timing. Too short (3-4 days) and you haven’t cleared the suspected trigger from your system or seen consistent results. Too long (6+ months) and you’ve unnecessarily restricted your diet.

The sweet spot I’ve found: 2-3 weeks for most food categories. This is long enough to see clear patterns but short enough that you’re not living in restriction purgatory.

Why 2-3 weeks?

• Days 1-3: Your body is still processing the trigger foods you ate before starting

• Days 4-7: Your gut is adjusting to the change

• Days 8-14: You’re seeing the true effects of the elimination

• Days 15-21: You’re confirming the pattern is consistent

If you only eliminate for 3-4 days, you might still be dealing with residual effects from before you started. If you eliminate for 6 months, you’re just punishing yourself unnecessarily.

Rule 3: Test During Stable Times

Don’t start an elimination during a major life stressor, right before your period (if you’re female), during travel, or in the middle of a severe flare-up. You need a reasonably stable baseline to see if the elimination actually makes a difference.

If you’re never stable, that’s information too—it suggests your triggers might be more about stress, sleep, or hormones than food.

What “stable” means:

• You’re not in the middle of a major flare-up

• You’re not traveling or disrupting your routine significantly

• You’re not in an unusually stressful period (moving, job change, etc.)

• If you menstruate, you’re not testing during the week before your period

• You’re not sick with a cold, flu, or other illness

You don’t need to be symptom-free to start testing—just relatively consistent day-to-day.

The Smart Elimination Framework: Your Roadmap

Here’s the step-by-step process:

Step 1: Choose Your First Suspect (Week 0)

Based on your food diary from Parts 1A and 1B, identify the single most likely trigger category. How do you choose?

Pick the category where:

• You have the most consistent symptom patterns

• The timing matches (remember: fat/caffeine = 30-90 min; FODMAPs/fiber = 2-6 hours; histamine = variable)

• The symptoms are most severe or disruptive

Common first eliminands by symptom pattern:

• Urgent diarrhea within 30-60 minutes of eating? Start with high-fat foods or caffeine

• Bloating and gas 3-4 hours after meals? Start with high-FODMAP foods

• Inconsistent reactions to “healthy” foods? Start with additives/processed foods

• Issues with leftovers but not fresh food? Start with high-histamine foods

Don’t second-guess this. Pick one based on your data and commit to testing it properly.

My recommendation: If you’re torn between two categories, start with the one that’s easiest to eliminate. Fat is often easier to test than FODMAPs because it’s more straightforward to identify high-fat foods.

Step 2: Define What You’re Eliminating (Week 0)

Be specific. “No dairy” is vague. “No high-lactose dairy products (milk, ice cream, soft cheese) but keeping hard cheese and butter” is specific.

Write down:

• The foods you’re eliminating (complete list)

• The foods you’re keeping (yes, write this too—it prevents scope creep)

• Your start date (pick a Monday or the start of a stable week)

• Your end date (2-3 weeks from start)

Example elimination - High Fat:

• Eliminating: Fried foods, creamy sauces, fatty cuts of meat, full-fat dairy, pastries, foods cooked in lots of oil, avocados, nuts beyond 10-15 pieces

• Keeping: Lean proteins (chicken breast, white fish, turkey), low-fat dairy, olive oil in small amounts (1 tablespoon), baked/grilled foods

• Start date: Monday, April 7

• End date: Sunday, April 27 (3 weeks)

Example elimination - High Insoluble Fiber:

• Eliminating: Raw vegetables, large salads, whole wheat products, popcorn, nuts with skins, seeds, raw fruit skins

• Keeping: Cooked vegetables (peeled when possible), white rice, white bread/sourdough, peeled fruit, oatmeal, smooth nut butters

• Start date: Monday, April 7

• End date: Sunday, April 27 (3 weeks)

Example elimination - Caffeine:

• Eliminating: Coffee (regular and decaf has some caffeine), black tea, green tea, energy drinks, chocolate, caffeinated sodas

• Keeping: Herbal teas, water, caffeine-free beverages

• Start date: Monday, April 7

• End date: Sunday, April 27 (3 weeks)

Notice how specific these are. There’s no ambiguity about what’s in or out.

Step 3: Elimination Phase (Weeks 1-3)

For the next 2-3 weeks, completely avoid your target category. Not “mostly avoid” or “just a little.” Completely.

During this phase:

• Continue your food-symptom diary (now tracking compliance with elimination)

• Note your symptom levels daily (1-10 scale for bloating, pain, bowel disruption)

• Note any other changes (stress, sleep, hormones, illness)

• Stay consistent with other aspects of your life (don’t change five other things simultaneously)

What to track each day:

• Overall symptom severity (1-10)

• Specific symptoms (bloating, cramping, diarrhea, constipation, urgency)

• Number of “good” hours vs. “bad” hours

• Any instances where you accidentally ate the trigger (it happens—note it and move on)

• Stress level, sleep quality, other relevant factors

What counts as success:

After 2-3 weeks, you should see one of three outcomes:

Outcome A: Significant improvement (symptoms reduced by 50% or more, more good days than bad) → This was likely a major trigger. Proceed to subdivision testing (which I’ll cover in Part 2B).

Outcome B: Moderate improvement (symptoms reduced by 20-40%, some better days) → This might be a trigger but probably not your only one. Proceed to subdivision testing, but plan to test another category afterward.

Outcome C: No improvement (symptoms unchanged or worse) → This probably isn’t a trigger for you. Move on to testing the next category on your suspect list.

Important: Don’t panic if you have a few bad days during the elimination. Look at the overall trend, not individual days. Did week 3 feel better than week 1? That’s what matters.

The Crisis Mode Reset Diet (For Severe Cases Only)

If your symptoms are so severe and constant that you can’t establish a baseline, you might need to start with a basic reset diet before testing individual categories.

The 1-Week Reset:

Eat only these foods for 7 days:

• White rice

• Baked or grilled chicken breast (no skin)

• Baked or grilled white fish

• Peeled, cooked carrots

• Peeled, cooked zucchini

• Bananas (ripe but not overripe)

• White bread or sourdough (small amounts)

• Water, peppermint tea

• Salt, black pepper (only seasonings)

This is extremely restrictive and is NOT meant to be followed long-term. It’s a reset button to calm your system.

After 7 days on this reset:

• If symptoms significantly improve: Start adding foods back one at a time, one every 2-3 days

• If symptoms don’t improve: Your triggers are likely not primarily food-related. Focus on stress, sleep, and gut-brain work from our previous series

Start with the least likely triggers first when adding back:

• Week 2: Add cooked vegetables (potatoes, green beans, cooked spinach)

• Week 3: Add other lean proteins (turkey, eggs)

• Week 4: Add low-FODMAP fruits (strawberries, blueberries, oranges)

• Week 5: Add small amounts of fats (olive oil, small amounts of nuts)

Build slowly. The goal is to get back to a varied diet as quickly as possible while identifying your specific triggers.

When NOT to Do a Reset Diet

The reset diet is only for people who:

• Have severe symptoms every single day

• Can’t identify any pattern in their symptoms

• Have already tried eliminating individual categories without success

• Are willing to be extremely restrictive for a short period

Don’t do a reset if:

• You have a history of disordered eating

• You’re already very restricted (fewer than 20 safe foods)

• You have identifiable patterns in your symptoms (test those specific categories instead)

• You’re pregnant, breastfeeding, or have other medical conditions requiring varied nutrition

What I’m Covering in Part 2B

In the next post, I’ll walk you through what happens after you’ve completed your elimination:

• Subdivision testing (how to narrow down exactly which foods in a category are the problem)

• Threshold testing (finding the amount you can tolerate)

• Common elimination mistakes and how to avoid them

• The reintroduction mindset shift

• Your testing schedule template

You’ll learn how to go from “fat is a trigger” to “I can handle small amounts of plant-based fats but need to avoid fried foods and heavy cream” — that level of precision is what gives you food freedom.

Have you tried elimination diets before? What mistakes did you make? What worked? Share in the comments!

Get the Whole IBS Food Detective Series as an eBook

If you’ve ever thought, “Why does this protein bar destroy my gut when it’s supposed to be healthy?” or “Why do leftovers always make me feel worse than fresh food?” or “Why does my ‘gut-healthy’ kombucha make me bloated?”—this post is for you.

Let’s talk about the three hidden trigger categories that most doctors never mention.

Trigger Category 3: Food Additives and Preservatives

This is the trigger category most doctors don’t talk about, but it’s huge for many people with IBS.

Artificial sweeteners are particularly problematic:

• Sugar alcohols (sorbitol, mannitol, xylitol, erythritol): Found in “sugar-free” products, these are actually FODMAPs and can cause severe gas, bloating, and diarrhea

• Sucralose and aspartame: May alter gut bacteria and trigger symptoms in some people

Other common additive triggers:

• Carrageenan: A thickener in dairy products, non-dairy milks, and processed foods. Can cause inflammation in sensitive individuals

• Inulin/chicory root: Added to protein bars, fiber supplements, and “healthy” processed foods as a fiber booster. It’s a FODMAP that causes severe bloating for many

• MSG and related flavor enhancers: Can trigger symptoms in some people

• Guar gum and xanthan gum: Thickeners that can cause gas and bloating

• Artificial colors: Particularly in candy, drinks, and processed foods

Detective clue: If you have symptoms from processed or packaged foods but not from simple, whole foods, start reading ingredient labels carefully. If you react to protein bars, “healthy” snacks, or diet products, additives might be the issue.

The “Health Food” Additive Trap

Here’s what I see all the time: Someone switches to “healthier” versions of foods—sugar-free yogurt, low-carb protein bars, diet sodas, almond milk yogurt—and their symptoms get worse, not better.

Why? Because these products are loaded with additives:

• Sugar-free yogurt → artificial sweeteners or sugar alcohols

• Protein bars → inulin, chicory root fiber, sugar alcohols

• Almond milk yogurt → carrageenan, guar gum

• Diet soda → artificial sweeteners, artificial colors

The “regular” version might have actually been easier on your gut than the “healthy” version.

How to Spot Additive Triggers

Start reading ingredient labels. If there are more than 5-7 ingredients, or if you can’t pronounce half of them, that’s a red flag.

Compare your symptoms when eating:

• Whole foods (single ingredient: chicken, rice, banana) vs. processed foods

• Foods with short ingredient lists vs. foods with long ingredient lists

• “Regular” versions vs. “diet” or “sugar-free” versions

If the processed/diet versions consistently make you worse, additives are likely your issue.

Trigger Category 4: Caffeine and Other Stimulants

Caffeine stimulates gut motility. For people with IBS-D, this can mean coffee = bathroom emergency within 30 minutes.

But it’s not just coffee:

• Tea (black, green, white—all contain caffeine)

• Chocolate (contains both caffeine and theobromine, another stimulant)

• Energy drinks and pre-workout supplements

• Certain medications (some pain relievers, diet pills)

The dose matters. Some people can handle one cup of coffee but not two. Some can tolerate tea but not coffee. Some are fine with caffeine in the morning but not in the afternoon.

Detective clue: If symptoms consistently appear within 30 minutes of your morning coffee or after eating chocolate, and especially if they involve urgent bowel movements, caffeine might be your trigger.

The Coffee Conundrum

Coffee is tricky because it’s often consumed with other potential triggers:

• Coffee + pastry (caffeine + fat + wheat)

• Coffee + cream (caffeine + dairy fat)

• Coffee + sugar-free sweetener (caffeine + artificial sweetener)

You might think coffee is your trigger when it’s actually the combination. Or you might think the food is the problem when it’s actually the coffee.

This is why testing in isolation is so important (which we’ll cover in Part 2).

Beyond Coffee: Other Stimulants

Chocolate deserves special attention. It contains:

• Caffeine (though less than coffee)

• Theobromine (a similar stimulant)

• Fat (often a lot of it, especially in milk chocolate)

• Sugar or sugar substitutes

Dark chocolate has more caffeine and theobromine but less fat. Milk chocolate has more fat but less caffeine. Some people tolerate one better than the other.

Energy drinks and pre-workout supplements often combine caffeine with other stimulants, artificial sweeteners, and additives. They’re a multi-trigger bomb for many people with IBS.

Trigger Category 5: Histamine and Food Chemicals

This is the most overlooked category, and it explains why some people react to seemingly random foods that don’t fit any other pattern.

Some people with IBS have issues processing histamine or other natural food chemicals. This isn’t a true allergy—it’s more like a sensitivity or intolerance.

High histamine foods:

• Aged cheeses

• Fermented foods (sauerkraut, kimchi, kombucha)

• Aged or cured meats (salami, pepperoni, bacon)

• Alcohol (especially red wine and beer)

• Leftover meat (histamine increases as food sits)

• Certain fish (tuna, mackerel, sardines)

• Tomatoes and tomato products

• Eggplant

• Spinach

Other food chemicals that can trigger symptoms:

• Salicylates: Found in many fruits, vegetables, herbs, and spices

• Amines: Found in chocolate, cheese, bananas, and avocados

• Glutamates: Naturally occurring in tomatoes, mushrooms, and aged cheese

Detective clue: If you react to fermented foods that are supposed to be “good for your gut,” if leftovers trigger symptoms but fresh food doesn’t, or if your symptoms include flushing, headaches, or nasal congestion along with gut issues, histamine might be involved.

The Leftover Mystery Solved

One of the most common patterns I see: “I’m fine when I eat fresh chicken, but if I eat the leftovers the next day, I get symptoms.”

This isn’t in your head. Histamine levels increase in food as it sits, even when properly refrigerated. For people with histamine sensitivity, fresh food is fine, but day-old food triggers symptoms.

The same thing happens with:

• Fish (fresh is better than frozen, and both are better than canned)

• Meat (fresh is better than leftovers)

• Tomato sauce (freshly made is better than jarred and sitting in the fridge)

The “Healthy Fermented Food” Paradox

You’ve probably heard that fermented foods are great for gut health. Probiotics, beneficial bacteria, all that good stuff.

But for people with histamine sensitivity, fermented foods can be gut nightmares:

• Kombucha → high histamine + carbonation

• Sauerkraut → high histamine + high fiber

• Kimchi → high histamine + spicy + garlic

• Kefir → high histamine + potential lactose

If your gut hates these foods despite everyone saying they’re “healing,” you might have histamine issues. It doesn’t mean your gut is broken—it means your gut processes histamine differently.

Putting It All Together: Your Five Trigger Categories

Now you have the complete picture of dietary triggers beyond FODMAPs:

1. Fat content and type (symptoms 30-90 min after eating)

2. Fiber type and quantity (symptoms 2-6 hours after eating)

3. Food additives and preservatives (especially in processed “health” foods)

4. Caffeine and stimulants (symptoms within 30 minutes)

5. Histamine and food chemicals (variable timing, often with leftovers or fermented foods)

Most people have triggers in 2-3 of these categories. Very few people have triggers in all five.

Your Homework: Identifying Your Categories

After tracking your food diary for two weeks (using the tracking queues from Part 1A), try to identify which of the five trigger categories seems most relevant to you:

Look for patterns like:

• Do symptoms happen quickly (30-90 min) after high-fat meals or coffee? → Fat or caffeine

• Do symptoms happen several hours (2-6 hours) after fiber-heavy meals? → Fiber or FODMAPs

• Do processed foods trigger symptoms, but whole foods don’t? → Additives

• Do leftovers trigger symptoms but fresh food doesn’t? → Histamine

• Do “healthy” fermented foods make you worse? → Histamine

Write down your top 1-3 suspect categories. This is what you’ll test systematically in Part 2.

A Word About Overwhelm

I know this seems like a lot. Five trigger categories plus FODMAPs? How are you supposed to eat anything?

Here’s the important thing to remember: You’re not going to react to all of these. Most people have 1-3 main trigger categories, and even within those categories, they don’t react to everything.

The goal of this detective work isn’t to eliminate everything. It’s to identify YOUR specific triggers so you can avoid those while eating everything else freely.

Right now, you might be avoiding foods unnecessarily because you don’t know what’s actually causing your symptoms. Once you identify your specific triggers, you’ll actually be able to expand your diet, not restrict it further.

What I’m Covering in Part 2

In Part 2, I’ll walk you through the smart elimination protocol—the exact step-by-step process for testing your suspected trigger categories one at a time.

You’ll learn:

• How to choose which category to test first

• Exactly what to eliminate and for how long

• How to know if the elimination worked

• The critical mistakes that lead to false results

• How to avoid getting stuck on an overly restricted diet

This is where the detective work gets systematic and scientific. No more guessing. No more eliminating everything. Just strategic testing that gives you clear answers.

The whole IBS Food Detective Series is available as an eBook!

Click the button below to get the complete guide.

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Here’s what I’ve learned after years of working with my own IBS and helping others through theirs: FODMAPs are just one piece of the puzzle. They’re important, yes, but they’re not the only thing that can trigger IBS symptoms. In fact, for some people, FODMAPs aren’t even the main culprit.

If you’ve been living on plain chicken and white rice, convinced that everything else is a trigger, this series is going to open up your world. I’m going beyond the FODMAP headlines to explore the other dietary triggers that might be causing your symptoms, and more importantly, how to identify YOUR specific triggers.

Because here’s the truth you need to understand: IBS is highly individual. What triggers your symptoms might be completely fine for someone else. The goal isn’t to follow someone else’s safe food list—it’s to become a detective of your own body.

The FODMAP Myth

First, let me clear something up: The low-FODMAP diet is a diagnostic tool, not a permanent lifestyle. It was designed to be followed for 2-6 weeks to identify triggers, then systematically reintroduce foods to find your personal tolerance levels.

But somewhere along the way, it became a “safe diet” that people follow indefinitely. This is a problem because:

• Long-term restriction can actually harm your gut microbiome

• You might be avoiding foods you can actually tolerate

• You’re missing out on the diversity your gut needs to heal

• The stress of extreme restriction can itself trigger symptoms

So if you’re stuck in FODMAP restriction purgatory, this series is going to help you find a way out.

The Five Hidden Trigger Categories I’ve Identified

Beyond FODMAPs, there are five major categories of dietary triggers that can cause IBS symptoms. In my experience, most people have triggers in 2-3 of these categories, not all of them.

In this post, I’m covering the first two: fat and fiber. In Part 1B, I’ll cover the other three categories that often fly under the radar.

Trigger Category 1: Fat Content and Fat Type

High-fat meals slow gastric emptying and can trigger something called the gastrocolic reflex: the signal that tells your colon to start moving. For people with IBS-D, this can mean urgent diarrhea 20-90 minutes after eating.

But here’s where it gets interesting: not all fats affect everyone the same way.

Some people tolerate olive oil but not butter. Others can handle avocado but not fried foods. The difference often comes down to:

• How much fat (a little might be fine, a lot triggers symptoms)

• What type of fat (saturated vs. unsaturated, animal vs. plant)

• How it’s prepared (raw vs. cooked, fried vs. baked)

Common high-fat triggers:

• Fried foods (the combination of fat + processing is often the worst)

• Creamy sauces and dressings

• Fatty cuts of meat (bacon, ribeye, dark meat chicken with skin)

• Full-fat dairy (cheese, cream, whole milk)

• Certain nuts (macadamia, pecans, walnuts in large amounts)

• Pastries and baked goods (butter + flour can be a double whammy)

Detective clue: If your symptoms typically start 30-90 minutes after eating and involve cramping followed by urgent bowel movements, fat might be your culprit.

What This Looks Like in Real Life

Let me give you an example: You might be fine with a grilled chicken breast (low fat), but get symptoms from the same chicken if it’s fried or covered in a creamy sauce. Or you might tolerate a small drizzle of olive oil on your vegetables but react to a large salad with 3 tablespoons of dressing.

This is why portion size and preparation method matter so much when it comes to fat.

Trigger Category 2: Fiber Type and Quantity

Everyone tells you to “eat more fiber” for digestive health. But for IBS, it’s not that simple. In fact, the wrong type or amount of fiber can make things significantly worse.

There are two types of fiber:

• Soluble fiber: Dissolves in water, forms a gel, and is generally gentler on the gut

• Insoluble fiber: Doesn’t dissolve, adds bulk, can be irritating for sensitive guts

People with IBS-D often do better with soluble fiber and worse with insoluble fiber. People with IBS-C might need more fiber overall, but need to increase it very gradually.

High insoluble fiber foods that commonly trigger symptoms:

• Raw vegetables (especially cruciferous: broccoli, cauliflower, cabbage)

• Salads with lots of raw greens

• Whole wheat products (especially if you’re also sensitive to gluten/fructans)

• Seeds and seed-containing foods (raspberries, strawberries, tomatoes)

• Popcorn

• Nuts with skins on

Better-tolerated soluble fiber sources:

• Oatmeal

• Peeled, cooked carrots

• Bananas

• White rice

• Potatoes (without skin)

• Psyllium husk (start small!)

Detective clue: If you get worse after “being healthy” and eating big salads or loading up on vegetables, or if you feel bloated and uncomfortable for hours after high-fiber meals, this might be your issue.

The “Healthy Salad” Trap

I can’t tell you how many people come to me saying, “I tried to eat healthier by having a big salad for lunch, and I felt terrible for the rest of the day.”

Here’s why: A big raw salad with lots of different vegetables, seeds, and a creamy dressing is basically a triple threat—high insoluble fiber, raw form (harder to digest), and often high fat from the dressing. For someone with a sensitive gut, it’s a recipe for bloating, gas, and discomfort.

The same vegetables, cooked until soft and served with a small amount of olive oil? Often completely fine.

The Combination Effect: When Triggers Stack

Here’s something crucial that I see people miss all the time: Triggers often stack.

You might tolerate a small amount of fat OR a small amount of FODMAPs OR caffeine individually, but combine them in one meal, and you’re in trouble.

Example stacking scenarios I’ve seen:

• Coffee (caffeine) + pastry (fat + wheat/fructans) = disaster

• Restaurant meal with fried food (fat) + garlic sauce (FODMAPs) + diet soda (artificial sweetener) = severe symptoms

• Large salad (insoluble fiber) + creamy dressing (fat) + artificial sweetener in your drink = bloating and pain

This is why you might react to a food sometimes but not others. The food itself might be fine in isolation, but it can be problematic when combined with other triggers.

Your detective work needs to account for the whole meal, not just individual foods.

The Timing Factor: When You Eat Matters Too

Two other factors that affect whether a food triggers symptoms:

Your Stress State

Remember from the Gut-Brain Reset series: eating while stressed changes how your gut processes food. A meal that’s fine when you’re relaxed might trigger symptoms when you’re anxious.

Your Gut’s Current State

If your gut is already irritated or inflamed, your tolerance is lower. You might handle a trigger food fine on a good day, but react strongly on a bad day.

This variability is frustrating, but it’s normal. Your gut isn’t broken—it’s just sensitive and context-dependent.

Starting Your Detective Work: The Next-Level Food Diary

Remember the food-symptom diary from our first tips series? Now I’m upgrading it to track these additional triggers.

For the next two weeks, track:

1. Everything you eat and drink (be specific about brands, preparation methods, and portion sizes)

2. Timing (when you ate and when symptoms appeared)

3. Fat content (low, medium, high—estimate is fine)

4. Fiber content and type (raw veggies, cooked veggies, whole grains, etc.)

5. Your stress level when eating (1-10 scale)

6. Symptoms (what, when, severity 1-10)

This might seem like a lot, but you’re building a database. After two weeks, patterns will emerge that you’d never spot otherwise.

What You’re Looking For

As you review your food diary, watch for:

• Foods that trigger symptoms every single time (clear triggers)

• Foods that trigger symptoms when combined with other things (stacking triggers)

• Foods that are fine sometimes but problematic at other times (context-dependent triggers)

• Timing patterns (symptoms 30 min after = probably fat; 2-6 hours after = probably FODMAPs or fiber)

Don’t jump to conclusions after one or two meals. You need consistent patterns across multiple days.

What I’m Covering in Part 1B

In the next post, I’ll cover the three trigger categories that most doctors never mention: food additives and preservatives, caffeine and stimulants, and histamine/food chemicals.

These are the hidden triggers that explain why you might react to seemingly random foods that don’t fit the FODMAP or fat/fiber pattern.

After Part 1B, you’ll have a complete picture of all five trigger categories, and you’ll be ready to move into the systematic testing protocol in Part 2.

Have you noticed fat or fiber triggering your symptoms? What patterns have you spotted? Share in the comments—your experience might help someone else recognize their own patterns.

The whole IBS Food Detective Series is available as an eBook! Click the button below to get the complete guide.

Get the eBook

But first, let’s address the elephant in the room: Why is it so hard to break the IBS cycle even when you know what to do?

The answer is surprisingly simple: The symptom-anxiety cycle is a learned pattern, and your nervous system protects learned patterns—especially ones it believes are keeping you safe. Even when the pattern is making you miserable, your brain resists changing it because it’s familiar.

Breaking this cycle isn’t about willpower. It’s about patient, consistent rewiring of your nervous system. And that’s exactly what this protocol is designed to do.

The Reality Check: What to Expect

Before we dive in, let’s set realistic expectations. This isn’t a 7-day cure. This is a 8-12 week process of nervous system retraining.

Week 1-2: You might not notice much change. You’re establishing habits and collecting data. This can feel frustrating. Trust the process.

Week 3-4: Small signs of progress. Maybe one day without symptoms, or symptoms that are less intense. Don’t get discouraged if you still have bad days—this is normal.

Week 5-8: Noticeable shifts. More good days than bad. Symptoms become more predictable and manageable. Your anxiety about symptoms starts to decrease.

Week 9-12: The new normal. Symptoms are present but no longer dominating your life. You have tools that work. Your nervous system has learned a new baseline.

Beyond 12 weeks: Continued improvement. Occasional flare-ups happen but don’t derail you. You understand your patterns and can navigate them.

This timeline assumes consistent effort. If you’re on-and-off with the protocol, progress will be slower. That’s okay—there’s no failure here, just different speeds of progress.

Read on for your daily protocol, the Mental Game: Rewiring Your Thoughts, and more.

Want the full picture? Paid subscribers get unlimited access to every article, deep dive, and IBS strategy I publish, for just $2 a week. That’s less than a coffee a week, and a whole lot better for your gut.

Your Daily Protocol: The Non-Negotiables

These are the foundational practices you do every single day, no matter what. They’re the bedrock of your gut-brain reset.

Morning Routine (10 minutes)

Immediately upon waking:

1. Vagus nerve activation (5 minutes): Cold water face splash, humming, gargling, deep breathing

2. Check-in journal (3 minutes): Rate your gut symptoms (1-10), anxiety level (1-10), sleep quality (1-10)

3. Set your intention (2 minutes): Choose one small goal for the day (e.g., “I will eat lunch sitting down without my phone”)

Before breakfast:

• Drink a full glass of water at room temperature

• Take a 5-10 minute gentle walk if possible

Evening Routine (30 minutes)

3 hours before bed:

• Last meal finished

• Note what you ate in your food-symptom journal

1 hour before bed:

• Vagus reset (5-10 minutes): Choose 2-3 exercises from Part 2

• Worry download (5 minutes): Write out anxious thoughts

• Wind-down activity (15 minutes): Reading, gentle stretching, or quiet conversation

• Pre-sleep bathroom visit

At bedtime:

• Lights out at the same time every night

• 4-7-8 breathing pattern (4 rounds) in bed

Consistent Wake Time

Set your alarm for the same time every day (including weekends). This is non-negotiable. Your gut’s circadian rhythm depends on it.

The Three-Pillar System: Managing Different Types of Days

You’ll have three types of days. Each requires a slightly different approach.

Pillar 1: Good Days (Low symptoms, manageable anxiety)

Your focus: Building resilience and expanding your comfort zone

What to do:

• Stick to the daily protocol

• Gently challenge yourself (maybe try a food that’s borderline, or eat somewhere new)

• Practice the SOS breathing even when you don’t need it (building muscle memory)

• Celebrate the win (acknowledge the good day without waiting for the other shoe to drop)

What NOT to do:

• Abandon your routines because you “don’t need them”

• Overdo it and trigger a flare-up tomorrow

• Minimize the progress (”it’s just one day”)

Pillar 2: Medium Days (Some symptoms, moderate anxiety)

Your focus: Steady management and preventing escalation

What to do:

• Double down on the daily protocol

• Use the SOS breathing at first sign of symptoms

• Stick to your safe foods

• Increase vagus nerve exercises (do them 3-4 times during the day)

• Give yourself permission to say no to stressful activities

• Use the heating pad proactively

What NOT to do:

• Panic that you’re “back to square one”

• Abandon all your practices because they “aren’t working”

• Engage in catastrophic thinking (”it’s never getting better”)

Pillar 3: Bad Days (Severe symptoms, high anxiety)

Your focus: Compassion and damage control

What to do:

• Minimum viable protocol: Do just the morning vagus reset and evening routine, even if poorly

• Go into comfort mode: safe foods only, quiet environment, heating pad, rest

• Use the SOS breathing every hour

• Remember: bad days are part of the healing process, not evidence of failure

• If you need to cancel plans, do it without guilt

• Journal about what might have triggered this (but don’t obsess)

What NOT to do:

• Blame yourself

• Make major decisions about your protocol on a bad day

• Let one bad day convince you nothing works

The Weekly Review: Course Correction

Every Sunday evening (or whatever day works for you), spend 20 minutes reviewing your week.

What to assess:

1. Symptom patterns: Did symptoms correlate with specific foods? Stress events? Poor sleep? Time in your cycle (for women)?

2. Protocol compliance: Which parts of the daily routine did you do consistently? Which ones fell off? Why?

3. Wins: What went well this week? Even small things count. Did you use the SOS breathing successfully? Have one symptom-free day? Sleep better for a few nights?

4. Challenges: What made things harder? Be specific. “Everything was terrible” isn’t useful. “Tuesday’s work deadline caused poor sleep which triggered symptoms Wednesday” IS useful.

5. Adjustments: What’s one small thing you can tweak for next week?

Write this down. Over time, this weekly review becomes your roadmap. You’ll see patterns that aren’t visible day-to-day.

The Mental Game: Rewiring Your Thoughts

The physical protocols are crucial, but the mental patterns need work too. Here are the thought shifts that make the biggest difference:

From: “What if I have symptoms?”

To: “If symptoms come, I have tools to handle them.”

This shift from fear to preparedness changes everything. You’re not trying to prevent all symptoms (impossible), you’re building confidence that you can manage them.

From: “My gut ruins everything.”

To: “My gut is sending me information.”

Your gut isn’t attacking you. It’s responding to signals—from your nervous system, your diet, your environment. When you reframe symptoms as information rather than attacks, they become less threatening.

From: “I should be better by now.”

To: “Healing isn’t linear, and I’m making progress.”

This is the hardest shift for most people. You’ll have setbacks. They’re not failures. They’re part of the process of rewiring a nervous system that’s been in overdrive for possibly years.

From: “I can’t do anything because of my gut.”

To: “I’m learning what I can do and adapting.”

This is about reclaiming agency. Yes, IBS is limiting. But within those limits, you have choices. Small choices, made consistently, add up to big changes.

When to Add Professional Support

This protocol is powerful, but it’s not a replacement for professional help when you need it. Consider working with professionals if:

You need a gastroenterologist if:

• You haven’t had a proper IBS diagnosis and are self-diagnosing

• You have red flag symptoms (blood in stool, unexplained weight loss, symptoms that wake you from sleep)

• Your symptoms are changing significantly

• You want to explore medication options

You need a mental health professional if:

• Anxiety or depression are severe and interfering with daily life

• You have a trauma history that’s linked to your gut symptoms

• You’re experiencing panic attacks

• The thought patterns are overwhelming the practical strategies

You need a nutrition coach (ideally one specializing in IBS) if:

• You’re confused about what to eat

• You want guidance on the low-FODMAP diet

• You’ve cut out so many foods you’re at risk of nutritional deficiencies

• You need structured meal planning support

You need a pelvic floor physical therapist if:

• You have pain with bowel movements

• You feel like you can’t fully empty

• You have IBS-C that’s not responding to other interventions

Getting help isn’t a sign of failure. It’s strategic support for your healing.

The Integration Timeline: Putting It All Together

Here’s how to layer in everything you’ve learned across this series:

Weeks 1-2: Foundation

• Daily morning and evening routines

• Food-symptom journal

• Consistent sleep schedule

• Choose 2 vagus nerve exercises and do them daily

Weeks 3-4: Adding Layers

• Continue everything from weeks 1-2

• Add the SOS breathing when symptoms arise

• Implement the 3-hour pre-sleep eating window

• Start the weekly review process

Weeks 5-6: Fine-Tuning

• Continue everything from weeks 3-4

• Add more vagus nerve exercises to your toolkit

• Start identifying your specific triggers

• Begin gentle exposure to situations you’ve been avoiding

Weeks 7-8: Building Resilience

• Continue everything from weeks 5-6

• Work on the thought pattern shifts

• Expand your safe foods slightly

• Practice responding to symptoms with curiosity instead of panic

Weeks 9-12: Consolidation

• All practices become more automatic

• You’re making adjustments based on your data

• Bad days don’t derail you

• You’re building a sustainable lifestyle, not following a temporary protocol

Your Emergency Toolkit: For the Really Bad Days

Keep this list somewhere you can access it quickly:

1. 4-7-8 breathing (4 rounds)

2. Heating pad on abdomen (15 minutes)

3. Ear massage (2 minutes each side)

4. Sip warm ginger or peppermint tea slowly

5. Lie on your left side with knees pulled up slightly

6. If diarrhea: electrolyte drink, bland foods (rice, banana, toast)

7. If constipation: gentle walk, belly massage, magnesium if approved by doctor

8. Text a trusted friend “I’m having a rough gut day” (connection helps)

9. Give yourself permission to do nothing but rest

10. Remind yourself: “This will pass. It always does.”

The Maintenance Phase: After 12 Weeks

Once you’ve completed the initial 12-week protocol, you don’t abandon everything. You maintain the core practices and ease up on the intensive tracking.

Keep forever:

• Morning vagus reset

• Consistent sleep schedule

• Evening wind-down

• Core safe eating patterns

Keep weekly:

• Weekly review

• At least a few vagus nerve exercises

Keep as needed:

• SOS breathing when symptoms arise

• Food-symptom tracking when investigating new triggers

• Detailed journaling when stress is high

Release:

• Perfectionism about the protocol

• Anxiety about following every rule exactly

• The belief that you’re fragile and can’t handle normal life

The Truth About Healing

Here’s what I want you to understand: You’re not trying to eliminate IBS entirely. You’re changing your relationship with it.

You’re teaching your nervous system that gut sensations don’t always mean danger. You’re building resilience so that symptoms, when they come, don’t derail your entire life. You’re creating a foundation of practices that support both your gut and your mental health.

This isn’t about perfection. It’s about progress. It’s about having more good days than bad ones. It’s about reclaiming your life from the constant vigilance and fear that IBS creates.

You’re rewriting the story. Instead of “I’m the person who’s broken and can’t do things because of my gut,” you’re becoming “I’m the person who understands my body, has tools to manage it, and is building a life I want to live.”

That’s the real gut-brain reset.

Final Thoughts

If you’ve made it through all four parts of this series, you now have a comprehensive protocol for managing IBS through the gut-brain connection. You understand the why, the how, and the when.

But understanding isn’t enough. Knowledge without action is just information. You have to actually do this.

Start small. Pick one thing from Part 1, one from Part 2, one from Part 3, and one from this post. Do those four things consistently for two weeks. Then add more.

You’ve got this. Your nervous system is capable of change. Your gut can heal. And you deserve to live a life that isn’t dominated by bathroom anxiety and unpredictable symptoms.

What’s the one practice from this series you’re committing to starting today?

If this sounds familiar, you’re not alone. Poor sleep and IBS feed into each other in a vicious cycle that’s hard to break—but understanding how they’re connected is the first step to fixing both.

Here’s the truth most doctors don’t emphasize enough: Sleep isn’t just important for IBS management. It’s foundational. You can have a perfect diet, do all the right stress management, and still struggle with symptoms if your sleep is broken.

Today, we’re fixing that.

The Sleep-Gut Connection You Need to Understand

Your gut has its own circadian rhythm—a 24-hour cycle that controls when it’s active, when it rests, when it repairs, and when it produces hormones and neurotransmitters.

When you don’t sleep well:

• Your gut’s circadian rhythm gets disrupted

• Your gut bacteria composition changes (poor sleep literally alters your microbiome)

• Your intestinal barrier becomes more permeable (increasing inflammation)

• Your pain sensitivity increases (making normal gut sensations feel worse)

• Your stress hormone cortisol stays elevated (keeping you in fight-or-flight mode)

But here’s where it gets complicated: IBS symptoms also disrupt your sleep, creating a feedback loop that’s hard to escape. Nighttime symptoms, anxiety about symptoms, and disrupted gut-brain signaling can all interfere with quality sleep.

The good news? When you improve sleep, you often see gut symptoms improve—and vice versa. They’re two sides of the same coin.

Why Standard Sleep Advice Doesn’t Work for IBS

You’ve probably heard the basics: keep your room cool and dark, avoid screens before bed, go to bed at the same time every night. This is all good advice, but it ignores the specific challenges of IBS.

Here’s what’s different for people with IBS:

1. You might need to use the bathroom during the night (making it hard to sleep through)

2. Anxiety about symptoms keeps your mind racing (even when you’re physically tired)

3. Your gut might be more active at night (when it should be resting)

4. Certain foods eaten too close to bedtime trigger nighttime symptoms

5. Stress from the day manifests as gut symptoms when you finally lie down

Standard sleep hygiene doesn’t address these issues.

Read on for the IBS-specific approach we need!

Want the full picture? Paid subscribers get unlimited access to every article, deep dive, and IBS strategy I publish, for just $2 a week. That’s less than a coffee a week, and a whole lot better for your gut.

The 3-Hour Pre-Sleep Window: Your Most Important Strategy

This is the foundation everything else builds on: what you do in the three hours before bed determines how well you’ll sleep and how your gut will behave the next day.

Here’s your new evening protocol:

Hour 3 Before Bed: The Last Meal Window

The rule: Finish eating at least 3 hours before bed. For many people with IBS, 4 hours is even better.

Why it matters: Your gut needs time to process food before you lie down. When you eat too close to bedtime, you’re asking your digestive system to work while it’s trying to shift into rest mode. This creates conflict in your gut-brain signaling.

What to eat: Your last meal should be relatively simple and easy to digest. This isn’t the time for a heavy, fatty meal or a big salad. Think: baked chicken with rice, scrambled eggs with toast, or a simple pasta with olive oil.

What to avoid: Anything you know triggers your IBS, plus common sleep disruptors like caffeine, alcohol, large amounts of fat, and raw vegetables.

Hour 2 Before Bed: The Wind-Down Begins

This is when you start signaling to your nervous system that it’s time to transition from day mode to night mode.

Light management: Dim your lights. Your brain produces melatonin in response to darkness, and bright lights suppress this. If you need to be on screens, use blue light filters.

The evening vagus reset: Do the vagal exercises from Part 2. Spend 5-10 minutes on humming, gentle breathing, and the ear massage. This helps shift your nervous system into rest mode.

Gentle movement: A slow 10-15 minute walk can help digestion and reduce anxiety. Don’t do vigorous exercise—you want to calm your system, not activate it.

Hour 1 Before Bed: The Sacred Wind-Down

This is your non-negotiable transition time. No work, no stressful conversations, no scrolling through anxiety-inducing content.

The warm drink ritual: Herbal tea (peppermint, chamomile, or ginger) can be soothing for both your gut and your nervous system. Sip it slowly. Make it a ritual, not a task.

The worry download: Keep a notebook by your bed. Spend 5 minutes writing down any worries, to-do items, or anxious thoughts. Get them out of your head and onto paper. This tells your brain it doesn’t need to keep reminding you about these things.

The bathroom trip: Even if you don’t feel like you need to, try to have a bowel movement or at least sit on the toilet for a few minutes. You’re training your body to empty before sleep rather than waking you up during the night.

Your Sleep Environment: The IBS Edition

Beyond the standard advice about temperature and darkness, here are IBS-specific considerations:

Bathroom access: If nighttime urgency is an issue, make sure you have clear, easy access to the bathroom. Remove obstacles, use a nightlight, and consider keeping a robe right by your bed. The anxiety about getting to the bathroom in time can itself worsen symptoms.

Elevation strategy: If you struggle with reflux or bloating at night, try elevating the head of your bed by 6-8 inches (put blocks under the legs of the bed frame, don’t just pile up pillows). This uses gravity to help your digestive system.

The heating pad backup: Keep a heating pad by your bed for nighttime cramping. Sometimes just knowing you have relief available reduces anxiety enough to prevent symptoms.

Comfortable positioning: Side sleeping (particularly on your left side) can reduce reflux and help with gas movement. Experiment with a pillow between your knees for comfort.

The 3 AM Wake-Up Solution

If you’re waking up with gut symptoms in the middle of the night, here’s your action plan:

Don’t fight it: Trying to force yourself back to sleep while experiencing symptoms only increases anxiety. Get up.

The midnight reset:

1. Use the bathroom if needed

2. Do the 4-7-8 breathing pattern from Part 2 (4 rounds)

3. Sip a small amount of room temperature water

4. If cramping: heating pad for 10 minutes

5. Do the ear massage for 2-3 minutes

6. Return to bed only when symptoms have calmed

The return to sleep protocol: Don’t look at the clock. Don’t check your phone. Keep lights as dim as possible. Focus on slow breathing rather than trying to force sleep. Your body knows how to sleep—you just need to get your anxious mind out of the way.

Morning Timing: Setting Up Success

What time you wake up affects your gut for the entire day. Your digestive system thrives on consistency.

The rule: Wake up at the same time every day—yes, even weekends. Set your alarm and get up, even if you had a rough night.

Why it works: A consistent wake time anchors your circadian rhythm. After 2-3 weeks of this, you’ll find it easier to fall asleep at night, and your gut will become more predictable.

Morning bathroom routine: Give yourself time. Don’t rush out the door. Your gut often wants to empty in the morning, and rushing or skipping this can throw off your entire day. Wake up 30 minutes earlier if you need to.

The Nap Question

Should you nap if you have IBS and poor sleep? Here’s the nuanced answer:

Short naps (20-30 minutes) before 2 PM: Generally fine. These can help with fatigue without disrupting nighttime sleep.

Long naps or naps after 3 PM: Usually make nighttime sleep worse, which then makes your gut worse. Avoid these.

If you’re exhausted: A 20-minute nap is better than a 2-hour nap. Set an alarm. Don’t let yourself fall into deep sleep during the day.

The Supplement Question

I’m often asked about melatonin, magnesium, and other sleep supplements for IBS. Here’s my take:

Melatonin: Can be helpful for some people, but start with a low dose (0.5-1mg) and take it 2 hours before bed, not right before. Some people with IBS find it helps, others find it worsens gut symptoms. Try it for a week and track results.

Magnesium: Particularly magnesium glycinate, can help both sleep and IBS-C. Take it 1-2 hours before bed. Avoid magnesium citrate at night—it can cause urgent bowel movements.

Herbal supplements: Valerian, chamomile, and passionflower may help some people. But always check with your doctor about interactions with other medications.

The truth: Supplements are Band-Aids. They might help short-term, but the behavioral strategies above will give you more sustainable results.

Your 2-Week Sleep Reset Plan

Don’t try to implement everything at once. Here’s your roadmap:

Week 1:

• Days 1-3: Establish your 3-hour pre-sleep eating window

• Days 4-7: Add the 1-hour wind-down routine

Week 2:

• Days 8-10: Implement the consistent wake time

• Days 11-14: Add the evening vagus reset to your routine

Track your sleep quality and morning gut symptoms each day on a scale of 1-10. Most people notice changes within the first week.

What’s Coming in Part 4

In our final installment, I’ll put everything together: the food diary, the stress management, the vagus nerve work, and the sleep hygiene. You’ll get a complete protocol for rewiring your gut-brain connection and breaking free from the IBS cycle for good.

We’ll also cover the timeline—how long it takes to see changes, what “progress” looks like, and how to know if you need additional support.

In this post, you’re going to learn how to actually use that highway to send calming signals to your gut.

The key player? Your vagus nerve.

This is where things get practical. No complicated protocols, no expensive supplements. Just simple exercises that can shift your nervous system out of fight-or-flight and into rest-and-digest mode—right when you need it most.

What Is Vagal Tone (And Why Should You Care)?

Think of your vagus nerve like the brake pedal on your stress response. When it’s working well (high vagal tone), you can calm down quickly after stress. Your digestion works smoothly. You feel resilient.

When vagal tone is poor, you stay stuck in stress mode. Your gut stays sensitive and reactive. Even small triggers feel overwhelming.

The amazing news? Vagal tone is trainable. Just like you can strengthen a muscle, you can strengthen your vagus nerve’s ability to calm your system.

People with IBS often have lower vagal tone, which means their nervous system struggles to shift into the parasympathetic (rest-and-digest) state. But with consistent practice, you can improve this—and see real changes in your symptoms.

Read on for: The 5-Minute Morning Vagus Reset, The SOS Technique: When You Feel a Flare-Up Coming, and more.

Want the full picture? Paid subscribers get unlimited access to every article, deep dive, and IBS strategy I publish, for just $2 a week. That’s less than a coffee a week, and a whole lot better for your gut.

The 5-Minute Morning Vagus Reset

Start your day by priming your nervous system for calm. This takes just 5 minutes, and many of my clients report it changes the entire trajectory of their day.

Here’s the routine:

1. Cold Water Face Splash (30 seconds): Splash cold water on your face, especially around your eyes and cheeks. Or hold a cold, wet washcloth over your face for 30 seconds.

Why it works: Cold stimulation on your face activates the vagus nerve through something called the “dive reflex”—an ancient mechanism that immediately shifts you into parasympathetic mode.

2. Humming or Singing (2 minutes): Hum your favorite tune, sing in the shower, or just make a low humming sound. Feel the vibration in your throat and chest.

Why it works: The vagus nerve runs right past your vocal cords. The vibration from humming or singing directly stimulates it. Bonus: this is why some people find that singing or humming helps calm their stomach.

3. Gargling (1 minute): Gargle water vigorously enough that your eyes might water a bit. Do this twice.

Why it works: Like humming, this activates the muscles at the back of your throat that are connected to the vagus nerve. It’s simple, but surprisingly effective.

4. Deep Belly Breathing (1.5 minutes - about 6 breaths): Place one hand on your chest, one on your belly. Breathe in slowly through your nose for a count of 4, letting your belly rise while your chest stays relatively still. Pause for 2 counts. Exhale slowly through your mouth for a count of 6.

Why it works: The exhale is longer than the inhale, which signals safety to your nervous system. Belly breathing engages your diaphragm, which has direct connections to the vagus nerve.

Do this routine right after waking up, before you check your phone or start thinking about your day. You’re setting the baseline for your nervous system.

The SOS Technique: When You Feel a Flare-Up Coming

You know that feeling—your gut starts to signal trouble. Maybe you feel cramping, or that urgent sensation, or just a wave of anxiety about your symptoms. This is your emergency vagal activation technique.

The 4-7-8 Breathing Pattern:

• Inhale quietly through your nose for 4 counts

• Hold your breath for 7 counts

• Exhale completely through your mouth for 8 counts (making a “whoosh” sound)

• Repeat 4 times

This pattern is specifically designed to activate your vagus nerve and trigger the relaxation response. The extended hold and long exhale are key.

Add this tactile element: While doing the breathing, press firmly on the roof of your mouth with your tongue, and press your thumb into the palm of your opposite hand. This gives your nervous system additional sensory input to focus on, which can interrupt the symptom-anxiety spiral.

Many people report that symptoms either don’t develop fully or are significantly less severe when they catch them early with this technique.

The Valsalva Maneuver: For Constipation-Predominant IBS

This one is specifically helpful if you struggle with IBS-C or have trouble with bowel movements. It stimulates the vagus nerve in a way that can promote motility.

How to do it:

• Take a deep breath

• Bear down gently as if you’re trying to blow up a balloon but your mouth is closed (don’t actually strain hard)

• Hold for 10-15 seconds

• Release and breathe normally

Do this 2-3 times when you’re trying to have a bowel movement, but avoid doing it if you have hemorrhoids or high blood pressure.

Why it works: This briefly increases pressure in your chest and abdomen, which stimulates the vagus nerve. After you release, there’s a rebound effect that can help promote gut motility.

The Ear Massage: The Weird One That Works

This sounds strange, but your ear contains a branch of the vagus nerve, and stimulating it can have surprisingly powerful effects on your gut.

Here’s how:

• Use your index finger to gently massage the inside of your tragus (that little triangular flap in front of your ear canal)

• Use small circular motions for 30-60 seconds on each ear

• You can also gently pull on your earlobes, or massage the area behind your ears

Do this anytime you feel tension or before meals. Some people find this so effective they do it during meals to help digestion.

The Post-Meal Posture Protocol

Remember from my first series how eating position matters? Here’s the vagal-activation upgrade:

After eating:

1. Sit upright in a chair with your feet flat on the floor

2. Place both hands on your belly

3. Take 5 slow, deep belly breaths

4. Then sit quietly for 10 minutes (read, listen to music, or just be)

5. Avoid looking at screens during this time

This ritual tells your nervous system: “We’re safe. We can digest.” Over time, your body learns to associate eating with this calm state rather than with stress.

The Social Connection Hack

Here’s one that doesn’t feel like an “exercise” at all: positive social connection activates your vagus nerve.

Genuine laughter, warm conversation, feeling connected to others—these all increase vagal tone. This is why stress eating alone often feels worse than eating the same food with people you care about.

Practical application: When possible, eat meals with people who make you feel comfortable and safe. If you’re eating alone, call a friend or watch something that makes you laugh genuinely.

Your Vagus Nerve Training Schedule

Don’t try to do everything at once. Here’s a realistic progression:

Week 1: Just the morning routine. That’s it. Build the habit.

Week 2: Add the SOS breathing technique when you notice symptoms starting.

Week 3: Add the post-meal posture protocol for one meal per day.

Week 4: Add the ear massage whenever you think of it throughout the day.

After a month, these practices should feel natural. Many people notice changes in their symptoms within 2-3 weeks of consistent practice.

The Long Game

Here’s what you need to know about vagus nerve work: consistency matters more than intensity. Doing the 5-minute morning routine every day for a month will have more impact than doing 30 minutes of vagal exercises once a week.

Your nervous system learns through repetition. You’re essentially teaching it a new default state—from chronically stressed to resilient and responsive.

What’s Next

In Part 3, I’m diving into sleep, because no amount of vagus nerve work can compensate for poor sleep. Sleep is when your gut-brain axis does its maintenance and repair work.

I’ll cover the specific sleep strategies that work for IBS, why your gut symptoms might be disrupting your sleep (and vice versa), and how to build a sleep routine that actually supports healing.

Understanding the gut-brain connection isn’t just interesting science—it’s the key to breaking free from the vicious cycle that keeps so many people trapped in IBS symptoms.

The Two-Way Highway You Need to Know About

Your gut and brain are connected by the vagus nerve—think of it as a fiber optic cable running between your brain and your digestive system. But here’s the surprising part: 90% of the signals travel from your gut TO your brain, not the other way around.

This means:

• Your gut is literally sending messages that influence your mood, anxiety levels, and stress response

• Your brain is sending signals that change how your gut moves, how sensitive it is, and even what bacteria thrive there

• It’s a feedback loop, and in IBS, it’s often stuck in the wrong direction

When you’re anxious, your brain sends “danger” signals to your gut. Your gut responds by:

• Speeding up or slowing down movement (hello, diarrhea or constipation)

• Becoming hypersensitive to normal sensations (making everything feel worse)

• Changing the balance of bacteria in your microbiome

• Increasing inflammation in your intestinal lining

But here’s where it gets tricky: when your gut is unhappy, it sends distress signals back to your brain, which triggers more anxiety, which makes your gut worse, which makes you more anxious...

You see the problem.

Want the full picture? Paid subscribers get unlimited access to every article, deep dive, and IBS strategy I publish, for just $2 a week. That’s less than a coffee a week, and a whole lot better for your gut.

Why This Cycle Is So Hard to Break (And Why It’s Not Your Fault)

I meet so many people who feel like they’re failing because they “can’t just relax” or “can’t stop worrying” about their symptoms. Let me be clear: this is not a willpower issue.

Your nervous system has essentially learned an incorrect pattern. It’s like a smoke alarm that’s too sensitive—it’s trying to protect you, but it’s misfiring constantly. Your gut has become hypervigilant, and your brain has learned to treat normal digestive sensations as emergencies.

This is called visceral hypersensitivity, and it’s one of the hallmarks of IBS. You’re not imagining your symptoms. You’re not weak. Your nervous system is genuinely perceiving real signals, but it’s misinterpreting their importance.

The good news? Just like your nervous system learned this pattern, it can learn a new one.

The Three Types of Stress Affecting Your Gut Right Now

Not all stress is created equal when it comes to IBS. Understanding which type you’re dealing with helps you choose the right intervention:

1. Acute Stress (The Meeting, The Deadline, The Argument)

This is short-term, intense stress. Your body goes into fight-or-flight mode, which literally diverts blood flow away from your digestive system. Digestion stops being a priority.

What happens in your gut: Cramping, urgent diarrhea, or complete shutdown of bowel movements. The acute stress response can trigger symptoms within minutes.

2. Chronic Stress (The Ongoing Situation, The Unresolved Problem)

This is the low-grade stress that never fully goes away—job stress, relationship issues, financial worries, or just the stress of living with IBS itself.

What happens in your gut: Changes in gut bacteria composition, increased intestinal permeability (”leaky gut”), altered motility patterns, and heightened pain sensitivity. This is the type of stress that rewires your gut-brain axis over time.

3. Anticipatory Anxiety (The “What If” Stress)

This is the worry about symptoms before they even happen. “What if I have to go to the bathroom during the meeting?” “What if I can’t find a restroom?” “What if I have a flare-up?”

What happens in your gut: This type of anxiety can actually trigger the symptoms you’re worried about. Your brain’s prediction of danger makes your gut respond as if the danger is real. It becomes a self-fulfilling prophecy.

The Symptom-Anxiety Spiral: Breaking It Down

Here’s how the cycle typically plays out:

1. You have an IBS flare-up (maybe triggered by food, stress, or hormones)

2. The discomfort creates anxiety about when it will happen again

3. The anxiety keeps your nervous system on high alert

4. The high alert state makes your gut more sensitive and reactive

5. Normal sensations feel more intense, triggering more anxiety

6. The cycle reinforces itself

Each rotation of this cycle makes both the gut symptoms and the anxiety stronger. The longer it continues, the more “grooved in” the pattern becomes.

But here’s the critical insight: you can interrupt this cycle at any point. You don’t have to fix everything at once.

Your Starting Point: The Awareness Practice

Before I dive into specific techniques (that’s coming in Parts 2 and 3), you need to build awareness of your own patterns. For the next week, try this simple practice:

The Three-Question Check-In

Three times a day (morning, midday, evening), pause and ask yourself:

1. How is my gut feeling right now? (Rate 1-10)

2. How is my stress/anxiety level right now? (Rate 1-10)

3. What happened in the last 2 hours? (Note any events, foods, or situations)

Write these down. Don’t judge them. Don’t try to fix anything yet. Just observe.

After one week, look for patterns:

• Does gut discomfort spike after certain types of stress?

• Does anxiety increase after certain gut symptoms?

• Are there times when your gut is calm even when you’re stressed (or vice versa)?

• What’s the typical time delay between a stressful event and gut symptoms?

This awareness is foundational. You can’t change a pattern you can’t see.

What’s Coming Next

In Part 2, I’ll cover specific vagus nerve exercises that can literally calm your gut in minutes. These are physical techniques that interrupt the stress-gut cycle at the biological level—no meditation cushion required.

In Part 3, I’ll tackle sleep, because poor sleep is both a cause and consequence of IBS, and fixing it can break multiple vicious cycles at once.

In Part 4, I’ll put it all together with a comprehensive protocol for rewiring your gut-brain connection over time.

The Truth About Healing

Here’s what I want you to remember: The gut-brain connection is powerful, but that power works both ways. The same mechanisms that make anxiety worse for your gut are the mechanisms you can use to make your gut better.

You’re not stuck with this cycle forever. Understanding it is the first step to changing it.

Everything you’ve come to know and love is right here waiting for you: the same no-BS approach to living well with IBS, practical strategies, real talk, and plenty of delicious low-FODMAP recipes. Just in a new, calmer corner of the internet that I think you’re going to love.

And as always, if you ever decide Substack isn’t for you, you can unsubscribe anytime. No hard feelings, ever.

While you’re getting settled, two resources worth bookmarking if you haven’t already: my Substack home page, where you’ll find all the latest content and links, and my Deliciously Low FODMAP recipe club, where you’ll find hundreds of my gut-friendly recipes just waiting for you.

Check out IBS Game Changer on Substack

Jump into the Recipe Club

Thank you for being part of this community. The best is yet to come.

Talk soon! 💛

That’s exactly why I’ve organized the Deliciously Low FODMAP recipe club into curated collections. No more scrolling endlessly. No more second-guessing whether a recipe is safe for you. Just good food that is easy to prepare and features common ingredients, right at your fingertips.

See All Recipe Club Collections

Browse Collections Built Around Your Life

Whether you’re cooking for yourself, feeding a family, or hosting friends, there’s a collection for you:

🥗 Salads — Fresh, satisfying, and anything but boring

🍲 Soups — Comforting, nourishing, and perfect for meal prep

🥦 Vegetarian — Hearty, plant-based meals that don’t skimp on flavor

🌿 Plant-Forward — Because eating more plants should feel like a pleasure, not a punishment

🍗 Delicious Dinners — Weeknight-friendly meals the whole table will love

🥑 Keto-Friendly — Low-FODMAP and low-carb, working together beautifully

🌾 Gluten-Free — Because your gut deserves a break in every possible way

🥂 Appetizers — From casual snacking to elegant entertaining, we’ve got you covered

🍰 Desserts — Yes, you absolutely can have dessert. Yes, it’s delicious.

And that’s just the beginning — new collections are added all the time as the club grows.

Your Gut-Friendly Cookbook, Always Open

Think of the recipe club as your personal low-FODMAP cookbook — one that’s always being updated, always organized, and always designed with your healing journey in mind. Every recipe has been thoughtfully developed so you can cook with confidence, knowing your gut is going to thank you.

Whether you’re just starting out on the low-FODMAP diet or you’ve been at it for a while and need fresh inspiration, the collections make it easy to find exactly what you’re looking for. Fast.

Ready to explore? Come find your next favorite recipe in the Deliciously Low FODMAP recipe club. Your next delicious, gut-friendly meal is waiting. 🌿

Republished with permission of Sarah Aitken

Discouraged. It’s an emotion I’ve been experiencing while dealing with a serious website problem for the last week.

I took a moment to really look at that word. It means lacking courage. Feeling scared.

Embarking on radical lifestyle change (for most people, eating in a way to reverse insulin resistance IS a radical change) requires courage. Will it work for me? Will I be able to stick to it? Can I design an eating plan that feels sustainable so that I can remain on it forever? I had a setback. Will I ever get back on track?

Taking a leap of faith requires courage. Getting back on track requires courage. Sticking to something in the face of adversity requires courage.

Courage means you are not allowing circumstances to get the best of you. It is making the right decisions in the face of fear. It is getting back on that horse and trying it again. It is taking risks and dealing with uncertainty. It is making “bravery” a habit.

Being courageous doesn’t mean you are not afraid. It means you are doing something even though it scares you to do it.

Here’s some great news: courage can be learned and cultivated!

Here are 8 ways to overcome the feeling of “discouraged” when fear has you stuck:

1. Acknowledge that when you feel discouraged, it is not because you can’t do something, it’s because you are letting fear stop you from trying again. Face the feeling of fear. Sweeping it under the rug gives it power. Courage is not about eliminating fear, it’s about moving forward in spite of fear being present.

2. Confront the feeling and become curious about it. What is it about the present situation that is scaring you? What would happen if you felt more courageous about it? Could it be that you are protecting your ego from experiencing failure? The reality is, continuing to try in spite of setbacks and failures makes you stronger and more resilient.

3. Get comfortable with being uncomfortable. Dale Carnegie once said, “Do the thing you fear to do and keep on doing it...that is the quickest and surest way ever yet discovered to conquer fear.”

4. Make doing brave things a habit. Consciously strengthen your courage like a muscle by practicing it. In her book Fear Is Not An Option author Monica Berg recommends making a list of things that you would do if you weren’t afraid. If you made a list, what would it look like? Could you start doing some of those things now?

5. Fear is often a pretend worry about something that MIGHT happen, but which is not actually happening right now. What are some other outcomes that are just as likely? Give equal airtime to alternate thoughts regarding the future and stay grounded in what is happening right now.

6. Embrace failure! Success is much less about succeeding perfectly and much more about tolerating the failures along the way. Get curious about failure – see what you can learn from it. Build your resilience muscle!

7. Don’t aim for perfection. Approach the problem with a beginner’s mind. Let go of expectations of how it’s going to go and get curious about it. Stop worrying about the outcome.

8. See fear as an opportunity instead of a roadblock. Fear can even be a handy guide, showing you the areas of your life that need some work.

For me, just writing this article has helped me feel less discouraged about my website problem. I feel a little more courageous, and I’m glad that one silver lining is that once the problem is fixed, I will be all the more able to overcome the next challenge with less fear.

The value to you lies in its actionable approach:

1. Personalized Discovery: The guide encourages you to reflect on which triggers affect you most, helping you pinpoint your unique IBS profile.

2. Comprehensive Trigger List: It covers food choices, eating habits, hydration, allergies, FODMAPs, exercise, stress, sleep, hormonal changes, and travel—giving you a holistic view of potential IBS triggers.

3. Clear Solutions: For each trigger, the document offers specific, easy-to-implement fixes (e.g., eat less processed food, establish meal routines, moderate exercise, manage stress, improve sleep hygiene).

4. Empowerment: By learning your triggers and applying the suggested strategies, you gain more control over your symptoms, potentially reducing reliance on medication and improving your quality of life.

5. Support Resources: The guide points to additional support, such as the IBS Game Changer program and weekly tips, for ongoing help and motivation.

Overall, this document is valuable as a step-by-step toolkit to help you identify, understand, and manage your IBS triggers, putting you in control of your health.

Grab the Guide & Get Started!

Looking for more great tools and resources like this one? Subscribe and don’t miss a thing!

This therapeutic practice not only helps relax tense muscles but may also alleviate some of the digestive discomfort associated with IBS. In this blog post, I explore some of the ways deep tissue massage can support IBS symptom management, giving you one more tool in your toolbox to find a holistic path to comfort and well-being.

Benefits of Deep Tissue Massage

1. Stress Reduction: Stress is a known trigger for IBS symptoms. Deep tissue massage can help reduce stress by promoting relaxation and lowering cortisol levels, which may help alleviate IBS symptoms such as abdominal pain, bloating, and discomfort.

2. Muscle Tension Relief: People with IBS often experience tension and tightness in the muscles of the abdomen and lower back due to chronic discomfort. Deep tissue massage can target these areas to release tension, improve circulation, and promote better mobility, potentially reducing the severity of IBS symptoms.

3. Improved Digestive Function: While direct evidence is limited, some individuals may find that deep tissue massage helps improve overall digestive function by stimulating the parasympathetic nervous system, which controls rest and digestion. This can lead to better digestion and potentially reduce symptoms such as constipation or diarrhea.

4. Pain Management: Deep tissue massage can help manage pain associated with IBS, including abdominal discomfort, cramping, and lower back pain. By targeting trigger points and releasing tension in the muscles, massage therapy can provide temporary relief from these symptoms.

5. Enhanced Mood and Well-being: Living with a chronic condition like IBS can take a toll on mental health and overall well-being. Deep tissue massage can promote the release of endorphins, which are natural mood elevators, leading to feelings of relaxation, contentment, and improved quality of life.

It’s essential to consult with a qualified massage therapist who has experience working with clients with gastrointestinal conditions like IBS. Additionally, while massage therapy can provide symptomatic relief, it’s important to combine it with other strategies such as dietary modifications, stress management techniques, personalized coaching, and medical treatment as needed for comprehensive management of IBS symptoms.

Have a question you’d like to have answered? Email me at hello@ibsgamechanger.com.

Perseitol, unique to avocados, behaves similarly to sorbitol in the gut. More study of this unique polyol and its potential to trigger IBS symptoms is needed, so Monash refrained from reclassifying avocados as low FODMAP for the time being. They did, however, increase the low FODMAP serving size so you can now confidently eat 1/4 - 1/3 of an avocado (up to 2.1 ounces), and that is still considered low FODMAP.

This discovery highlights the complexity of food science and emphasizes the importance of ongoing research in FODMAPs and IBS management. I am thankful Monash University continues to prioritize this science for all of our benefit!

For those missing avocados, I recommend doing your own tolerance testing to see if you truly can increase your avocado intake without triggering symptoms.

Need help figuring out how to do this? Stop guessing. Start knowing. Identify your personal IBS triggers with a proven, systematic approach.

Get the IBS Food Detective Guide

Stay tuned for more updates as the Monash team continues to delve into FODMAP science! Read the full article, including all the science, on the Monash Low FODMAP blog.

Looking for Low FODMAP recipes that include avocado? Head on over to my recipe club and type the word “avocado” in the search box. Voila! All my recipes that include avocado. You’re welcome. :-)

Understanding Anxiety

At its core, anxiety is the response to a perceived threat, often related to an uncertain future event. Chronic anxiety, a mental condition characterized by excessive apprehension, is marked by real or perceived threats, leading to avoidance behaviors and physical symptoms such as increased heart rate and muscle tension. Anxiety disorders, including generalized anxiety disorder, panic disorder, PTSD, and social anxiety disorder, affect a significant portion of the adult population in the United States and around the world.

The Link Between IBS and Anxiety

Research indicates a clear link between IBS and anxiety. Approximately 44% of individuals with IBS also experience an anxiety disorder, compared to only 8% of those without IBS. Recent studies suggest shared genetic pathways between IBS and certain mental health conditions, emphasizing the close connection between the gut and the brain.

The Gut-Brain Connection

The gut-brain connection, a bidirectional communication system between the gut and the brain, plays a crucial role in regulating digestive functions, mood, and stress responses. Altered communication in people with IBS may lead to abnormal sensory processing, unpredictable gut functions, and visceral (organ) hypersensitivity, causing you to feel pain and other symptoms.

Breaking the Anxiety-IBS Cycle

The anxiety-IBS connection often creates a challenging cycle that people find difficult to break, leading to feelings of frustration and hopelessness. Treatment for IBS should include dietary and lifestyle changes, in addition to psychological interventions to address both physical and psychological aspects, and only in a few cases, medication.

Targeting the Gut-Brain Connection

Addressing both anxiety and IBS involves a holistic approach. Mindfulness, mind-body exercises, meditation, gut-directed hypnotherapy, and gut-directed Cognitive Behavioral Therapy (CBT) can target the gut-brain connection. On the mental health side, working with specialized professionals like therapists or psychologists helps address anxiety, while collaborating with a nutritional health coach can help you develop strategies for a healthier gut.

8 Things You Can Do Right Away to Help

Tackling the overlap between anxiety and IBS requires effort and multiple different strategies. While the journey may take time, gaining control over both aspects is possible, allowing you to live more fully. If you’re navigating IBS and anxiety together, know that support and effective interventions are available, giving you a path toward a more balanced and fulfilling life.

Here are some things you can do right away that may help both anxiety and IBS:

1. Meditation/guided visualization for relaxation and stress/anxiety reduction; consider using the Nerva App from Mindset Health, which is gut-directed hypnotherapy that has been studied and shown to be extremely effective.

2. If you drink caffeinated beverages, wean yourself off ASAP. Caffeine is a stimulant that in and of itself can cause anxiety. It’s also a gut-specific stimulant, and those of us with IBS don’t need gut stimulation for the most part. I suggest switching to pure ginger tea, which has excellent anti-inflammatory and antioxidant properties.

3. If you drink any sort of carbonated beverage (especially sugary or caffeinated sodas), wean yourself off ASAP. Carbonated beverages can cause GI irritation, gas, and bloating, and potentially exacerbate IBS symptoms. Switch to plain water (hot or cold).

4. If you drink alcohol, wean yourself off ASAP. Alcohol itself can cause anxiety (especially as a rebound after over-drinking), and it can irritate the GI tract, and change your gut motility (leading to diarrhea or constipation), it’s a diuretic that leads to dehydration (particularly bad if you suffer from constipation), it’s actually poison and your digestive system doesn’t need anything getting in the way of doing its good work.

5. Get some exercise even if it’s just around the house! If at all possible, get outside in some sort of nature (even seeing just one tree!). If you can’t get out, then put some plants in your house so you can look at them while you walk around the house. This has been shown to reduce stress and anxiety almost as well as a walk in nature. If that’s impossible, even pictures of nature can be helpful! Just put them where you can look at them and do some visualization of being there in nature.

6. Journal – keep track of everything that goes into your body (food, drink, supplements, pills, all of it). And document your symptoms every day too. This will help you start to see patterns that trigger flare-ups, which in turn may trigger anxiety. You can use a blank journal or something like this Gut Health Journal. (If you sign up for coaching with me, I will send you my own journal—but really anything will work!)

7. A Low FODMAP diet can be key to reducing flare-ups and the associated anxiety that comes with those flare-ups. The diet is used to calm your system down and then, through a series of tests you conduct yourself, to determine your personal FODMAP sensitivity profile so you can reintroduce as many of the foods that once triggered you as possible. Want more information about the Low FODMAP diet? Check out my Low FODMAP FAQ.

8. Get connected with a health coach for guidance and support. This can help you get to resolution much faster than trying to do it all alone.

Have a question you’d like to have answered? Email me at hello@ibsgamechanger.com

Selected sources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733421/

2. https://www.nature.com/articles/s41588-021-00950-8

Link note: This post may contain affiliate links for you to easily purchase items that are linked. I may earn a small commission from qualifying purchases, but none of this costs you a thing, so feel free to use the links! In addition, for some items, I have provided a special discount code for IBS Game Changers, so be sure to use the code when you purchase an item to get the discount that has been arranged just for you.

No, it does not! Read on to learn why and to understand how to identify the best cheeses for you to enjoy.

According to Monash University, a dairy product qualifies as low FODMAP if its lactose content is 1 gram or less per serving. This can be determined by assessing the Total Carbs, which includes both Carbohydrates and Sugars, as indicated on the cheese label. This is great to know because it means that whether a cheese has undergone lab testing or not, you can gauge its FODMAP content by examining the nutrition label.

If the Total Carbs on the nutrition label amount to 1 gram or less per serving, you can reasonably conclude that the dairy product is low FODMAP per serving. This aligns with Monash University’s guideline of a low FODMAP serving containing 1 gram or less of lactose.

Individuals with IBS are often advised to adopt a “lactose-free” approach, leading to the exclusion of milk and cheese from their diets. However, it’s important to note that a low FODMAP diet is not synonymous with being entirely lactose-free. (While some people with IBS may also be sensitive to dairy itself, this is a different issue.)

Nevertheless, not all cheeses are created equal in terms of their compatibility with the low FODMAP diet. This article aims to serve as a helpful guide, navigating you through the intricacies so you can make informed choices that align with both your preferences and your gut health.

Can You Eat Cheese on a Low FODMAP Diet?

Navigating the FODMAP content of cheese can be a bit intricate, but fear not – by the end of this article, you’ll have a clear understanding of what you need to consider when selecting your cheese, whether it’s undergone lab testing or not.

Numerous cheeses have been tested for their FODMAP content, and you can easily access this information through the Monash App on your phone. To make things even more straightforward, here’s a list of cheeses that have been tested and confirmed to be low FODMAP in a serving size of 1.4 ounces (40 grams):

• Brie

• Cheddar

• Feta

• Goat cheese (such as Montrachet)

• Havarti

• Monterey Jack

• Mozzarella

• Swiss

What About Cheese That Hasn’t Been Tested?

Now, let’s address the cheeses that haven’t undergone lab testing, which includes some of my favorites, such as blue cheese, Gruyere, Jarlsberg, Parmesan, Fontina, and Provolone, just to name a few. You are probably wondering if these cheeses are on the Low FODMAP menu.

The answer is: YES!

You absolutely can include these cheeses in your diet. As always, the key is to be a vigilant label reader and remember you’re looking for total carbohydrates and relative serving size.

It’s worth noting that when you purchase cheese from a specialty cheese store, the cheese is typically cut to order and won’t carry the nutrition label. What you learn from reading labeled cheese can be applied to these cut-to-order cheeses as well. Just keep serving sizes and weights in mind.

Decoding FODMAPs In Cheese

When it comes to cheese and FODMAPs, the primary concern is lactose. Learn more about Lactose and its effect on those of us with IBS in this excellent article written by my brilliant sister, Sarah Aitken, RN, MS, WHNP/FNP, MHP, NBC-HWC.

Here’s the key to figuring out the serving size of untested cheese yourself: if the Total Carbohydrates and/or Total Sugars on the nutrition label amount to 1 gram or less per serving, you can confidently consider that the cheese is low FODMAP per serving. This aligns with Monash University’s threshold for a low FODMAP serving regarding lactose, which is 1 gram per serving. So, by keeping an eye on these numbers, you can make informed choices about the FODMAP content in your cheese, ensuring a gut-friendly indulgence.

Read Those Cheese Labels!

Let’s take a look at the label of traditional Danish blue cheese. Notice that the Total Carbohydrate per serving is listed as zero. Sometimes this may also be listed as < 1 (less than one). Zero does not mean there are zero carbs at any serving size, but it DOES mean there is less than 1 gram of carbs per serving (which is 1 ounce in the case of most cheeses). This indicates that you can enjoy this particular blue cheese, adhering to the recommended serving size, even during the strict elimination phase of a Low FODMAP diet. And you may find, over time, you can tolerate larger serving sizes of cheese if you are not significantly triggered by lactose. (Need help figuring this out? Check out my Game Changer Program right here!)

In every case, when the Carbohydrates and Sugars—collectively referred to as Total Carbs—are under 1 gram per serving, they align with the low FODMAP designation established by Monash University, the gold standard for the FODMAP content of food.

If you come across blue cheese, Gruyere, or any other cheese in a recipe, a simple calculation of serving sizes will reveal whether the recipe falls within the low FODMAP category, specifically concerning the cheese. Whether you’re referencing the nutrition label at home or doing this on the spot while shopping, a quick math check ensures you stay in tune with your FODMAP-friendly choices.

How Dairy Becomes Low FODMAP

Some dairy products are treated to reduce their lactose content, making them suitable for individuals with lactose intolerance or those following a low FODMAP diet. These products are labeled “lactose-free” even though most of them do contain lactose but they have been augmented with enzymes to break the lactose down as you eat it. Processes such as fermentation, aging, and specific enzyme treatments can also break down lactose before it even gets to your mouth.

As cheese ages, bacteria and enzymes used in the fermentation process actually consume some of the lactose in the cheese to fuel the fermentation. This results in lower levels of lactose in the final product. So, in general, the longer a cheese is aged, the lower the lactose in the cheese. Both soft and hard cheeses undergo distinct changes as they age, and they share the commonality of containing low FODMAP amounts. Examples of aged cheeses include cheddar, Gruyere, Brie, Swiss, Parmesan, and so many more.

So, eat and enjoy every bite because you can!

Sometimes when we have food issues, we get stuck on thinking about all the things we can’t eat. And, we end up “painting ourselves into a corner” and eating the same thing over and over again. This is monotonous and boring. And it means you suffer, your gut biome suffers, and it can lead to “cheats” that cause major flare-ups.

How can you change that cycle? Embrace the abundance of foods you CAN eat! Use the Monash FODMAP app on your phone to explore foods you haven’t considered. Dive into my recipe club and be a little adventurous! Make sure you have plenty of variety in every meal and snack—even if it’s not a large quantity of any one thing.

Discover hundreds of easy and delicious low-FODMAP recipes.

Say goodbye to endless scrolling. The club lives on Patreon, where hundreds of low-FODMAP recipes are sorted into collections and filters so finding exactly what you want is fast, easy, and even a little fun. Think of it as your virtual cookbook—and everything in the cookbook is safe!

Here’s what awaits you in the club:

• Exclusive recipes: Be the first to try my latest delicious low-FODMAP creations!

• Simple & Easy: My recipes continue to focus on readily available ingredients and effortless preparation, perfect for family-friendly meals (no more separate low-FODMAP meal prep!).

• Hundreds of existing recipes: Gain access to my entire library of low-FODMAP recipes, all conveniently organized.

You can join for free or sign up for only $5/month. Your support fuels my passion for creating new, delicious, and easy-to-make low-FODMAP recipes just for you.

Are you ready to discover an abundance of deliciousness?

Rediscover the joy of eating and nourish your body on the road to feeling better. I’d love to have you in the Deliciously Low FODMAP recipe club.

Your healing journey deserves to be delicious. 🌿

Join the Recipe Club!

Let’s go on this delicious low-FODMAP journey together.

The various characteristics of fiber determine how it works inside your body, what it does once it reaches your gut, and how well it’s tolerated when you have Irritable Bowel Syndrome (IBS). Experts like to divide fiber into two basic types: insoluble and soluble. Generally speaking, insoluble fiber doesn’t dissolve well in water, and soluble fiber does.

Why is fiber so important for people with IBS, and which kind is best?

1. Regulating Bowel Movements: Fiber, especially soluble fiber, can help regulate bowel movements by adding bulk to stool, making it easier to pass. For those with IBS who experience constipation or diarrhea, fiber can help normalize stool consistency and frequency.

2. Relieving Constipation: Many people with IBS suffer from constipation, and fiber can help soften stool and promote regular bowel movements, making it easier to pass stool without straining.

3. Alleviating Diarrhea: While insoluble fiber can exacerbate diarrhea in some individuals with IBS, soluble fiber can help absorb excess water in the colon, which can help alleviate diarrhea and reduce urgency.

4. Supporting Gut Health: Fiber serves as a prebiotic, meaning it provides nourishment for beneficial bacteria in the gut. These bacteria help maintain a healthy gut microbiome, which is important for overall digestive health and may contribute to symptom relief in IBS.

5. Reducing Bloating and Gas: While some types of fiber can contribute to bloating and gas in individuals with IBS, soluble fiber is less likely to cause these symptoms. Additionally, fiber can help promote regular bowel movements, reducing the likelihood of bloating and discomfort associated with constipation.

6. Managing Weight: High-fiber foods tend to be more filling and can help you feel satisfied with smaller portions, which may aid in weight management. Maintaining a healthy weight is important for overall health and may help manage symptoms of IBS.

If you have IBS, it’s essential to be cautious about the types and amounts of fiber you consume, as some types of fiber can exacerbate symptoms.

Soluble Fiber Takes The Cake

Soluble fiber is gentle on the gut and helps regulate both diarrhea and constipation, so it’s the type of fiber to look for when you have IBS.

Good sources of soluble fiber include:

• Oatmeal

• Barley

• Quinoa

• Flaxseeds

• Chia seeds

• Sunflower seeds

• Macadamia nuts

• Sweet potatoes (cooked and peeled)

• Tofu (always choose firm tofu, which is low in FODMAPs, not Silken Tofu, which is higher in FODMAPs)

• Coffee (YES! Coffee has fiber!) I always recommend decaf coffee if you have IBS, as caffeine is a gut stimulant and irritant

Low-FODMAP Fruits and Vegetables: There are many fruits and vegetables that are low in FODMAPs and are good sources of fiber. These include:

• Berries (such as strawberries, blueberries, raspberries)

• Oranges

• Grapes

• Pineapple

• Kiwi

• Broccoli

• Avocado (keeping in mind the low FODMAP serving size)

• Carrots

• Cucumbers

• Bell peppers

• Spinach

• Zucchini

Seeds and Nuts: Some seeds and nuts can be high in insoluble fiber, which may aggravate IBS symptoms. However, certain seeds and nuts are lower in insoluble fiber and can be well-tolerated, such as:

• Pumpkin seeds (pepitas)

• Sunflower seeds

• Almonds (in small quantities)

• Walnuts (in small quantities)

Gluten-Free Whole Grains: Some people with IBS find that reducing gluten in their diet can help alleviate symptoms. While not everyone with IBS needs to avoid gluten, incorporating gluten-free whole grains can be beneficial. Examples of gluten-free grains include:

• Brown rice (white rice is not considered a whole grain)

• Quinoa

• Buckwheat

• Millet

Fiber Supplements: If it’s difficult to get enough fiber from food sources, you may consider adding a soluble fiber supplement to your daily routine. It’s important to start with a small dose and gradually increase it to avoid triggering symptoms.

Additionally, staying well-hydrated is crucial when increasing fiber intake to prevent constipation.

A couple of readily available soluble fiber supplements can be found on Amazon at the links below.

• Psyllium husk

• Acacia Senegal, also known as gum arabic, acacia fiber, or acacia gum

You can also purchase fiber and all kinds of other supplements through the IBS Game Changer Dispensary directly with a 15% discount and free shipping on orders over $50.

IBS Game Changer Dispensary with 15% Discount

If you follow my blog and use my recipes, you’ll see I use Psyllium Husk as a stabilizer in some of my recipes, such as my Amazing Seed Crackers. So, it’s not just a supplement!