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Gas and Bloating Relief for Clients with IBS

January 5, 2016 | 17 Comments | SAFM Team

Too many practitioners jump to probiotics for initial IBS relief.  This is a mistake because, in some cases, they can actually make your patient’s or client’s symptoms worse!   The majority of true IBS is caused by an overgrowth of predominant/beneficial bacteria in the gut (see more below).  Adding more microbes to the mix with probiotics too early can exacerbate – vs. fix – the problem!  There is an effective order of operations’ needed to help clients with IBS to heal without suffering worse along the way.

First of all:  get them some relief!   Peppermint, ginger, and fennel are all carminative herbs which help the GI tract to release trapped gas and eliminate bloating and cramps by relaxing the muscle wall of the intestines.  Activated charcoal is also effective at absorbing excess gas in the gut ( just make sure it’s taken away from all other supplements and medication, ideally right in between meals, as it will bind other substances as well).  My favorite, specific supplement recommendations include a mixture of these elements e.g. Gaia Herbs’ “Gas and Bloating” formula and Heather’s Tummy Tamers. *

For most IBS patients and clients, a comprehensive digestive enzyme formula may further improve gas/bloating.  When there is inflammation in the GI tract or microbial imbalances, digestive secretions can be impaired.  This is even worse when a person is chronically stressed.  The result may be suboptimal digestive enzymes.  If food is slow to be digested or remains semi-digested, this presents a particularly rich and hearty food source for bacteria which will increase and extend their gas production overall.  Excellent basic, full spectrum digestive enzymes are Renew Life’s “Digest More”  and Enzymedica’s “Digest”.   Suggest a full week-long trial of using a digestive enzyme at the beginning of every meal.  If they help, these are safe and smart to continue throughout the entire IBS healing process.

The next high-impact remedy your patient or client needs is slow, conscious and mindful eating.  Such a simple concept!  Yet so seldom a habit for many of us.  I talk to my clients about the importance of what I call Eating Hygiene.  Check out this article I penned for my clients on how and why to eat this way.  In particular for patients and clients with IBS, frequent eating or “grazing” can keep them from healing (by impairing cleansing waves that supports immune system action necessary to retain bacterial balance).  In some cases, these simple habit changes are enough to bring substantial symptom relief.  Truly!  You are welcome to share this article freely with your clients as well.

Gas and bloating are common symptoms of irritable bowel syndrome (IBS).  Contrary to common myth, IBS can indeed be resolved fully.  The majority of IBS (not all, certainly) is caused by small intestinal bowel overgrowth (SIBO) which is when endemic microbes housed in the colon migrate up into the small intestines (via a faulty ileocecal valve).  Further up in the GI tract, these wayward bacteria find wildly abundant food sources from our semi-digested meals and give out massive amounts of gas from their digestion.  Their gas byproducts can also trigger chronic diarrhea (if primarily hydrogen), constipation (if primarily methane), or an oscillation between the two.  As a result, our clients with IBS struggle with gas, bloating, and cramps.   Diets that reduce fermentable fiber can also bring dramatic relief for the short-term, while healing is taking place.

If you want to learn more about SIBO and helping you patients and clients to overcome IBS entirely, you’ll love the Disease Begins in the Gut 202 course.   If you are relatively new to GI physiology and dis-ease, I highly recommend the Disease Begins in the Gut 101 first, as a detailed introduction to GI function and healing.  We cover the physiology, the medical myths, symptoms,  labwork validation, and detailed steps of how to help.  These are the types of clinical courses that you can choose to customize your  SAFM Semester experience.

  • Note:  because carminative herbs cause the GI tract to relax, they can exacerbate acid reflux (GERD).  For gas/bloating in these clients, I recommend using strongly-brewed ginger tea and whole ginger in food specifically for those clients with uncontrolled GERD.

 

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17 Questions for “Gas and Bloating Relief for Clients with IBS”

  1. 8
    Betsy LeGallais says:
    June 29, 2023 at 9:02 am

    Hi Tracy! I have a client who was told not to take probiotics while taking steroids. Could you explain the possible thought process behind this as the Dr. didn’t really explain why? Thank you so much!

    Reply
  2. 7
    Cynthia Saint Cyr says:
    December 12, 2018 at 6:50 pm

    Hi Tracy! What great information! I have a client who had her gallbladder out approximately 12 years ago and has since then experienced an intermittent “weirdness” in her right mid back worse after fatty foods. Now she is also experiencing foul smelling gas in addition. Any ideas? Thanks for your expert help!

    Reply
  3. 6
    Tonya says:
    May 23, 2018 at 11:31 am

    I am 51, I had a colonoscopy a year and half ago. (I have had about three colonoscopies in my lifetime). I have had IBS with constipation since I was a teenager. After I had that colonoscopy I didn’t have a flare up for a whole year. What could be the reason for that……was it the cleaning out process or something else. It was a wonderful year and I felt so much better. Would love to get back to that.

    Reply
    • 6.1
      SAFM Team says:
      May 31, 2018 at 4:12 pm

      Indeed, getting “cleaned out” can bring some relief for a time; after all, that’s what the body is trying to do when it promotes diarrhea in response to a pathogen (flush out the bad guys!). But if you don’t address the root causes of your unique dis-ease, then it tends to recur. I recommend you work with a functional practitioner to understand more clearly what is at play. Many people with IBS have imbalances/overgrowths of bacteria in a dynamic called SIBO, small intestinal bacterial overgrowth, which can recur. But there can be MANY different causes and combinations of causes at play in IBS. After all, the name “IBS” doesn’t imply an understanding of cause; it’s just a fancy name for a collection of symptoms. You will want to explore your eating hygiene, microbial testing, immune strength (highly dependent no both nutrients and optimal stress management), and digestive strength (also impacted by stress and by thyroid function, among other things). Given the long-standing nature of your challenges, I am particularly suspicious of hormonal imbalance involvement, especially hypothyroid function (perhaps subclinical) paired with some estrogen dominance. I know this might sound complex, but again, a skilled functional practitioner will know exactly what I am talking about and can help you to sort out all of these puzzles pieces. I wish you the best of wellness!

      Reply
  4. 5
    Magdalena Hjalmarsson says:
    April 9, 2018 at 4:53 pm

    Hi Tracy,

    Can you please clarify the difference between IBS and IBD?
    From a simple google search I understand IBD is a classification of symptoms like IBS is however I would like to get clarification from you on the difference.

    Thank you in advance.

    Reply
    • 5.1
      SAFM Team says:
      April 30, 2018 at 11:24 pm

      IBS (irritable bowel syndrome) is a name we give to a collection of symptoms that follow a certain pattern which might be caused by a huge variety combinations of root causes (e.g. SIBO, poor eating hygiene/grazing, pancreatic isufficiency food sensitivities, hypothyroid, high or low cortisol) that affects motility, in part via influence on the enteric nervous system housed in the gut. IBS is a type of dysfunction, but it is Not generally inflammatory in nature; markers of intestinal inflammation such as calprotectin are not elevated in IBS. However, calprotectin IS elevated in IBD (Inflammatory Bowel Disease). IBD may be autoimmune or just immune-mediated, but by definition it’s an inflammatory process originating in the gut itself (e.g ulcerative colitis, Crohns disease). However, a state of IBD might cause symptoms labeled as IBS, so there might be coincidence. This will be helpful: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083258/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486322/ .

      Reply
  5. 4
    Beth says:
    March 27, 2018 at 8:38 pm

    I have had chronic constipation for at least 20 years. I also have multiple sclerosis but I work and am fairly mobile, trying to walk a mile often. The constipation occurred after the birth of my son and being prescribed anti depressants. I adjusted for awhile with yogurt, water and exercise. That did not last long and the constipation returned. I started taking magnesium supplements and that ended the constipation. I then had a colonoscopy 2 years ago and nothing works now. I have seen at least 5 different health care providers. I was told to take. Iralax and ended up with diarrhea and hemmoroids. Glycerine supportories helped briefly and now they only give me diahrrea. I don’t want to see any more GI physicians as that was expensive and horrible.

    I would welcome any advice you might be able to provide. I have ordered Heather’s Tummy Tamer fiber. It is expensive but I am out of ideas and hope.

    I look forward to any help you may offer.

    Sincerely,
    Beth Rickert

    Reply
    • 4.1
      SAFM Team says:
      April 23, 2018 at 10:13 am

      We are not able to give individual guidance or respond to detailed case studies in this format. I will offer the thought, however, that ongoing use of SSRI antidepressants can potentially deplete serotonin which is critical for GI motility. To your point, the types of triage remedies you mention can “force” greater motility but will not address the root cause in terms of giving you balanced, sustainable motility. A good functional medicine practitioner will be able to help you assess your serotonin synthesis and what might be rendering it suboptimal (e.g. suboptimal level of specific nutrients, specific types of microbial overgrowth or imbalance in the gut). You might try the “Find a practitioner” tool at the Institute for Functional Medicine as a starting point resource. I wish you the best of wellness!

      Reply
  6. 3
    Toni Profera says:
    February 26, 2018 at 6:42 pm

    Would the Peppermint in both of the herb blends be the reason not to use on anyone with Acid Reflux? I love this clinical tip!

    Reply
    • 3.1
      SAFM Team says:
      February 28, 2018 at 11:55 am

      Yes! At least initially. But IF you are well addressing the true root causes of the acid reflux proactively (e.g. poor eating hygiene, insufficient magnesium, food sensitivities), a client may actually be fine using this for relief from further downstream cramping and bloating.

      Reply
  7. 2
    Meghna Joshi says:
    July 19, 2017 at 8:24 pm

    Hi Tracy,

    Generally, it is said that grazing is good. Is it specifically for IBS that you should not graze? i am certified from Dr sears wellness institute, which teaches us the Rule of 2’s, one of which is grazing. I am a little confused here. Appreciate your help over this topic.
    Thanks!

    Reply
    • 2.1
      SAFM Team says:
      July 25, 2017 at 11:43 am

      This question is a perfect example of the fact that in MANY areas of wellness, the optimal recommendation is going to vary by person. Depending on their challenges and their goals. To your point, if someone has IBS or is trying to heal from any gut infection or major microbial imbalance, then grazing is not a helpful idea at all because our MMC (migrating motor complex) cleansing wave function does not happen while we are actively digesting food. Someone who has strong insulin resistance, poor blood sugar control, low cortisol, or poor mitochondria function overall e.g. fibromyalgia will likely do better eating at least every ~3 hours (at least as temporary triage while we are working to identify/address root causes and significantly change other lifestyle choices). Someone who has good blood sugar control but who is obese will likely do best with intermittent fasting and long stretches in between meals. We have to think systematically about the body’s unique needs in a given circumstance – a key tenet of functional medicine.

      Reply
  8. 1
    Katie Mahoney says:
    January 8, 2016 at 5:47 pm

    Thank you for our wonderful site, Tracy!
    I’m a Health Coach with a 66 female client who had a colonoscopy in Dec 2015, and since has had diarrhea, around twice a day; she hasn’t had a well-formed bowel movement since! She hasn’t changed her diet, but she was under a lot of stress in Nov, so perhaps it’s a coincidence with the colonoscopy, but she’s concerned she may have picked up something.

    She is not bloated, but does also have gas and “rumbling” after eating now.
    Should she take pro-biotics, or will that exacerbate it?
    Should she take enzymes with meals?
    Should she reduce fiber, or increase for more bulk?
    Should she eat mostly cooked foods, like a GAP diet while healing?

    She is a conscienciously healthy person, who eats well and exercises.

    Thank you for any insight you can offer!
    Katie

    Reply
    • 1.1
      SAFM Team says:
      January 12, 2016 at 4:09 pm

      Hi Katie – thanks for joining in the conversation! Alas, I find it’s quite common for people to struggle with post-colonoscopy disruption to their GI tract for quite some time (in some cases, several months). I don’t think it’s a coincidence, and certainly stress would exacerbate the issue by increasing motility. Dysbiosis is quite common. I do recommend using a probiotic, ideally one that includes the beneficial yeast Saccharomyces Boulardi (assuming she doesn’t have an explicit allergy or sensitivity to yeast). Metagenics Ultra Flora Acute Care or Therbiotic Complete are good choices. I would also use psyllium husks specifically for bulk to try to help form a better stool. Hydration is critical at this stage, perhaps using a reasonable electrolyte mix e.g. Ultima Replenisher, at least in the short-term. Teach her about “eating hygiene” too and choosing to eat only after she has relaxed and calmed her nervous system. We may think of a colonoscopy as being “benign” or exploratory, but from the body’s perspective, it’s an invasion of a cavity that isn’t designed to be penetrated in this way. If she seems undigested food in her stool, then yes, I would add digestive enzymes for now as well. I would continue to eat a diverse diet but avoid grains for now, and yes an emphasis on cooked foods for the short-term will likely bring some ease. If she isn’t feeling dramatically better in ~6 weeks, I would recommend a comprehensive stool test to assess more specifically the lasting impact on gut microbial imbalance (dysbiosis). Hope that helps!

      Reply
      • …
        Katie says:
        January 15, 2016 at 2:07 pm

        Thank you SO very much, Tracy, for all of that insight (and I’ll try to check before I hit the button that I don’t have any silly typos like the first comment of mine with “our” wonderful site in the first line, ha! I really appreciate you taking the time to respond so thoroughly and and believe it will be very helpful!

        Reply

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