Digestive troubles, the hot topic of the moment it seems.

Irritable Bowel Syndrome (IBS), mixed in with fructose, lactose, or a wheat intolerance all seem to be discussion points both among patients, colleagues, and the media alike…where to even start?!

A common theme I see when patients come to me is that they are particularly stressed thinking that there is no variety in the foods left to eat after sourcing a list of “foods to avoid” in relation to dietary triggers for IBS.

The triggers for something like IBS that lead to the uncomfortable gas and bloating people experience have quite an additive effect; so if you are sensitive to all of the nutrient components listed above, you may not be able to have a wheat based cereal topped with fruit compote and cows milk for breakfast, a vegetarian focaccia with pumpkin and capsicum for lunch, followed by a stir fry with typically problematic vegetables such as mushrooms and cauliflower for dinner; However, this does not mean you can not eat any of these foods ever, it just means you should make note to eat smaller portions, and not eat them all on the same day (people usually complain that by the end of the day they are a lot more bloated than at the start of the day).

The mix of asparagus, mushrooms and cauliflower could be too much for some people.

The mix of asparagus, mushrooms and cauliflower could be too much for some people.

Large servings of wheat based sandwiches in the context of a diet already high in other trigger foods can contribute to bloating and digestive troubles.

Large servings of wheat based sandwiches in the context of a diet already high in other trigger foods can contribute to bloating and digestive troubles.

If you do any research on IBS you will typically find lists of foods to avoid that fit into what are collectively known as FODMAPs. However this list of foods is constantly being updated as more research is undertaken, and therefore it is important to seek professional assistance from a dietitian on this to ensure you are not avoiding foods unnecessarily.

Additionally, what I have found is that there are actually a few triggers to look out for prior to even going down the FODMAPs path. I can’t even begin to count how many patients have come back telling me how grateful they are for getting their lives back after simply modifying these triggers:

Here are 5 food groups I’d suggest you look at as your first line of attack should you have constant stomach problems:

Spicy foods.

spicy asian meals with chilli

spicy asian meals with chilli

Large high fat meals (could be in the form of fried foods or simply high fat sauces and meats used in cooking).

High fat meals

High fat meals

High fibre foods (particularly insoluble e.g. bran fibre, as well as those that are particularly gaseous such as cauliflower, cabbage, and legumes).


Caffeine (mostly coming from beverages).




As mentioned above, it is important to note that the load of food or food substance will make a huge difference to your response too,  so if you have a large high fat and spicy meal or strong tall take away coffee, it is no surprise that you will be likely to see stronger effects, compared to if you consumed a small spicy soup, or an instant coffee in the morning.

Half serve size may be less problematic than a large serve of a meal.

Half serve size may be less problematic than a large serve of a meal.

With all this in mind, think about if it was after your last Indian meal, fast food attack, or strong coffee break, that you seemed to have stronger gastric or bowel responses. …It could be worth changing over that double strength coffee to an instant coffee for a while and noting the differences..

I should note that most people, irrespective of being diagnosed with IBS or not, do not break down effectively many of the FODMAP food groups due to a lack of enzyme being present. The key foods within the food groups that seem to pop up on repeat as problematic include:

Fructans – Cauliflower, cabbage, onion, and garlic.

Galactans-  Chickpeas, kidney beans, baked beans etc.

Lactose – Milk and ice cream.

Fructose- When in excess to glucose due to the transport system our body uses during digestion which are not efficient when glucose is not present in an equal ratio. This is mainly in honey, fruit preserves, and apples or pears. In Australia, we don’t find High Fructose Corn Syrup like you do in many of the American products which prevents this from being such a problem.

Polyols- Found in many artificially sweetened products.

Hummus made of chickpeas can be quite problematic for sensitive individuals.

Hummus made of chickpeas can be quite problematic for sensitive individuals.

The sixth culprit is not actually food related, it is stress. For anyone that has read my book, The Clean Separation, you would already be aware of just how great a physical impact stress has on your gut health. Your gut health is connected to your immunity, and anecdotally speaking, I have found that for most people, when they have a healthy and strong gut, they don’t seem to suffer from as many troublesome digestive issues (unless of course they have a complete clinical deficiency in an enzyme for one particular nutrient that has been tested for).

I thought I would include an exert from The Clean Separation for anyone interested in understanding this concept in more depth:

Your gut health is another important factor that can influence your mood, nutrient digestive ability, and internal inflammation. The connection between gut health and immunity has been acknowledged within Chinese medicine for years, however it has only recently started to be supported through evidence-based research, which has lead to it being more widely accepted within Western medical practices (Cryan & O’Mahony, 2011; Konturek, Brzozowski & Konturek, 2011).

External to the brain, your gastrointestinal system is the most densely populated area within your body with neurotransmitters and neuro-peptides. This may help explain why extreme stress can lead some people to having bowel motion changes. Serotonin, your mood elevating neurotransmitter, is actually higher in concentration within your gut, than your brain.

A healthy gut lining is important to prevent inflammation, as well as enhance nutrient absorption from the food that you consume.

As a result of all of the above mechanisms, maintaining a healthy gut lining is extremely important whilst trying to elevate your mood and forever keep your body healthy both physically and mentally.

Probiotics are live microorganisms found within particular foods that help promote good gut health. Consuming probiotics is thought to increase the “good” bacteria within your gut and assist in maintaining an optimal balance between the good and the bad bacteria that are present.

One recent study showed that mice who were fed a particular strain of probiotic showed significantly fewer stress, anxiety and depression-related behaviors than those that received a feed without the probiotics. The study also showed that these mice had significantly lower levels of the stress induced hormone, corticosterone (Bravo, 2011).

Another study that was performed clinically, looked at both animals and humans, and their changes in psychological health measures after 30 days of administration of a probiotic formula. They too found that there was a significant reduction in the anxiety like behaviors in the animals (rats), and alleviation in psychological distress parameters in the humans (Messaoudi, et al. 2011).

Foods that are rich in probiotics include yoghurts with live active cultures, kefir (which is often found commercially as a yoghurt style drink), buttermilk, some blue and aged cheeses, as well as non dairy products such as fermented foods i.e. sauerkraut (fermented cabbage), kimchi (Korean spicy cabbage), tempeh (a fermented soybean product), miso, and soy sauce.

Just as with many of the dairy products, the process of manufacturing the food can kill the probiotic strains, it is important to look for words such as “live” “active” “raw” “unheated” or “unpasteurized” (if sold this way in your country) on commercial brands of these non-dairy foods, should you not be making them from scratch yourselves.

Fermented products can be made at home, utilizing simple processes. There are many resources available online that can assist you in understanding the process, should you be interested in learning more about this. Below is a list of useful online tools that may be of interest should you like to investigate preparing fermented and cultured products yourself.

Step by step beginners guide to preparing cultured vegetables. 

Video tutorials on how to make kefir, yoghurt, kombucha and a range of other cultured foods.

You can also subscribe on this same website and gain access to free e-books with a variety of recipes and ‘how to” manuals.

A directory on where to find kefir grains around the world (for free or the cost of postage).

Prebiotics on the other hand are non-digestible, or selectively digestible, carbohydrates that fuel the growth of the healthy bacteria in your gut. For this reason, consuming both, foods rich in probiotics, as well as those rich in prebiotics, can be beneficial to your gut health.

Many prebiotics are soluble fibers that are fermented by the bacteria in your gut to produce short –chain, fatty acids, which have a range of beneficial effects on your body. These short chain fatty acids are known to reduce inflammation, and play a role in digestive health and reducing the incidence of bowel cancer.

Prebiotics have been shown to improve insulin sensitivity, slow glucose absorption, and thereby aid with blood glucose control. They also can improve blood lipid (fat) profiles by increasing HDL, your healthy (heart protective) cholesterol, and reducing LDL, your bad cholesterol, and triglycerides (Cani & Delzenne, 2009). 

Removing some high fibre options doesnt mean you have to cut out all your sources of pre-biotics.

Removing some high fibre options doesnt mean you have to cut out all your sources of pre-biotics.

We actually had an interesting discussion at the seminar I attended last week on this topic; Some people were confused between being told to cut down on some of the higher fibre containing foods if they had digestive  problems, because this would simultaneously reduce their intake of pre-biotics; As well as those being told to remove products with lactose which they thought would simultaneously remove probiotics (I suppose they were thinking about the Greek yoghurt here).

I sat there biting my tongue as the discussion took place, because in my mind, there is always a way of getting around the nutritional problems to get in what you need. For example:

  1. Purchase a coconut milk kefir product to get your probiotics in without the lactose.
  2. Consume a small amount of Greek yoghurt (which typically has most of the lactose pre-digested anyway), and just don’t consume it alongside other foods that you find problematic.
  3. Consume a BARLEYmax based cereal or rice based product that is wheat free but rich in resistant starch (a prebiotic).
kefir that can be made up yourself at home.

kefir that can be made up yourself at home.

As you can see..there is ALWAYS a way, you just need to take a step back to think about it for a moment (or come to talk to someone who can do that for you).

So there you have it, jut a start into the digestive health paradigm.

I can go into the FODMAP discussion in another post if you like (this one was definitely getting too long!),

Hope this gives some people are starting point,

And remember, getting stressed about your food is not going to help..it actually could be the key trigger to making your digestive problems worse. So if in doubt, ask (and that being true with anything in life!),

If you are interested in the whole gut health, stress and diet relationship, I would strongly recommend you check out The Clean Separation.

Would love to hear your thoughts,

For now,

The Travelling Dietitian x

About The Author

Kara Landau aka "Travelling Dietitian" is an Australian Accredited Practicing Dietitian based in New York City. She is a world explorer, healthy foodie, social butterfly, and barre class lover. When she isn't trying new cuisines, researching new product innovations in the health food space, or speaking to the media on behalf of her food industry clients, she can be found quietly conjuring up her next idea in how to make this world a healthier and better place.

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