Asking for a Friend - Health, Fitness & Personal Growth Tips for Women in Midlife

Ep.117 What Your Poo Is Telling You: Gut and Digestion Strategies with Anna Mapson

• Michele Henning Folan • Episode 117

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We've all been there. A gurgly gut at the wrong time or place. Maybe you've experienced constipation that has lasted for days, or unexplained bloating and gas that makes you feel like you're six months pregnant. These can be occasional annoyances, but some women live with these symptoms on a daily basis. We are often quick to say it's irritable bowel syndrome, but how do we really know?

Anna Mapson, a registered nutritional therapist specializing in IBS and gut health, offers her invaluable insights into the complex world of gut issues. Anna breaks down the often misunderstood symptoms of Irritable Bowel Syndrome (IBS) and shares how gut health intricately ties into our overall well-being. From understanding triggers like dietary habits and stress to exploring the significant gut-brain connection, Anna provides a comprehensive guide to navigating the maze of digestive health issues.

Lastly, we tackle the long-term impact of childhood experiences on our eating habits and relationship with food as adults. Discover practical advice on managing IBS through dietary strategies, including the importance of maintaining a food diary and the benefits of supplements and fermented foods. Anna also introduces her three-month "gut reset" program, designed to offer personalized health assessments and regular consultations aimed at improving your digestive health. Don’t miss this episode filled with expert advice and practical tips for better gut health and overall well-being.

You can find Anna Mapson at:
https://www.goodnessme-nutrition.com/hello/
https://www.instagram.com/goodnessme_nutrition/
Listen to Anna's podcast, Inside Knowledge, wherever you get your podcasts

If you go to Anna's website, she offers free non-food strategies to get the process started in your gut health journey.

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Are you ready to reclaim your midlife body and health? I went through my own personal journey through menopause, the struggle with midsection weight gain, and feeling rundown. Faster Way, a transformative six-week group program, set me on the path to sustainable change. I'd love to work with you! Let me help you reach your health and fitness goals.
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Michele Folan:

You've tried it all Keto, weight Watchers, atkins. Maybe you've even tried one of the GLP-1 shots. Then there's Orange Theory and other high-intensity cardio. That's, I don't know, I think, kind of boring, and the results Meh.

Michele Folan:

I, too, struggled to figure out what was going to work for my midlife body. We are not necessarily to blame, though. Diet culture threw us a curveball, and what may have worked in our younger years may not be the secret sauce for success now. What I have found is that many of my clients have been under eating, which blunts our metabolism. We're doing too much cardio when we need to be lifting weights. What if I told you that you could eat all the food groups, including carbs? Eat more than you're likely consuming now, and wrap a bow on it with 30-minute at-home workouts for any fitness level. Have I piqued your interest? It doesn't have to be complicated or expensive, but you do need to take the first step. Go to the show notes of this episode or send me an email at mfolan that's F as in Frank O-L-A-N fasterway at gmailcom. Health, wellness, fitness and everything in between. We're removing the taboo from what really matters in midlife. I'm your host, michelle Follin, and this is Asking for a Friend Ever been out and thought, oh my gosh, I am going to poop my pants?

Michele Folan:

We've all been there. A gurgly gut at the wrong time or place. Maybe you've experienced constipation that has lasted for days, or unexplained bloating and gas that makes you feel like you're six months pregnant. These can be occasional annoyances, but some women live with these symptoms on a daily basis. We are often quick to say it's irritable bowel syndrome, but how do we really know? Anna Mapson is a registered nutritional therapist with many years of clinical experience. Her expertise in IBS, SIBO, nutrition, diet and lifestyle help her clients who are tired of living with the unpredictable and often painful symptoms bloating and excessive gas and cramps. She is the founder of Goodness Me Coaching and the host of the Inside Knowledge podcast. Anna Mapson, welcome to Asking for a Friend. Thank you Lovely to be here. Yeah, nice to have you here too, and I would love for you to tell everyone where you live, because you have a lovely accent.

Anna Mapson:

Yeah, I'm based in Bristol in England, uk, wonderful.

Michele Folan:

Do you mind just filling the audience in on a little bit more about you and also your career path?

Anna Mapson:

Sure, I have been a nutritional therapist for coming up to eight years now and I started off just more general nutrition. But over the time I was working with more and more clients where digestion and gut health seemed to be really the thing that people were struggling with the most and a lot of what we eat, you know, unless we're properly digesting it and breaking it down, can be an issue. So I just got more and more niched down into kind of gut health and then it was very specific, just IBS. So I don't work with IBD or other, I don't specialize in those conditions. So it's kind of niched down over the years to IBS. And prior to becoming a nutritional therapist I used to be a management consultant and work in financial services.

Michele Folan:

I wanted you on the show for several reasons. Number one gut health is a buzzword these days, honestly, because we talk a lot about the gut-brain connection and when the gut isn't working properly it can really affect you as a whole person. So that's the first thing. Second thing is the prevalence of gut issues, particularly for women. I think it's not often talked about because the symptoms are embarrassing, it's not fun to talk about, it's usually not brought up at book club or out to dinner because again, it's about bloating and gas and diarrhea and all of that stuff we're going to have today and I think, because it is super common, we have a blanket determination that it's always irritable bowel syndrome. Can you kind of walk us through what the different issues can be if you are experiencing these uncomfortable symptoms?

Anna Mapson:

Yeah, there's different types of IBS that we normally categorize IBS down into more diarrhea predominant symptoms or constipation predominant symptoms, and it's tricky to get a diagnosis because it is normally an exclusion of other conditions. So in order for your doctor to say yes, you've got IBS, they have to also rule out other conditions that present with very similar symptoms, like celiac disease, inflammatory bowel disease, maybe diverticular disease. These things can also flare up and come and go and also be influenced by food and stress and immune health, and so it's really hard to pinpoint. It's just IBS, and I say just like in inverted commas, because actually the symptoms can be incredibly life-altering. It can. I've worked with people who you know haven't been able to leave the house because they're so worried about incontinence and needing like you are saying, needing to rush behind a bush and go to the toilet quickly. These. These are real problems that affect people's lives, and also the pain is another thing. So that's a real common symptom across IBS.

Anna Mapson:

No matter what sort of presentation you come with, is this abdominal pain, and when we're looking at a sort of IBS diagnosis, that's one of the main things that will be present. So normally you have to have some sort of change in your bowel habits over three months like occurring at least once a week. So with constipation, it might be that you have this. You don't go more than three times a week, for example, whereas with diarrhea, predominant people could be going.

Anna Mapson:

I've worked with people who have seven or eleven trips to the bathroom every day, with watery diarrhea and everything in between. So sometimes it flits from one to the other and you don't know what's happening. So it's a whole range of symptoms and because it's called irritable bowel syndrome, syndromes are like a collection of symptoms that we don't really know what the cause is, collection of symptoms that we don't really know what the cause is. That's the other problem is you get this IBS diagnosis but it doesn't lead you to a clear treatment plan, because one person could have a completely different set of symptoms, triggers and just their experience of it's completely different to their neighbor who might also have IBS but be living a completely different lifestyle and eating different foods because that's what suits them.

Anna Mapson:

So it's it's difficult and, like you said, it's really embarrassing because people don't really want to talk about it unless it's someone you're very familiar with, right like a sister yeah, yeah your best friend or someone else or, you know, your mom, maybe those things are yeah, those kind of conversations about having really odorous gas or, nearly, yeah, having incontinence, those kind of things you don't share with your acquaintances or work colleagues.

Michele Folan:

No, depends how close you are to your work colleagues, I guess so you did say this that you can have kind of the array you can go from being constipated to having diarrhea, so it is something that can go both ways.

Anna Mapson:

Yeah, there's a third type of IBS, which is mixed, where people sometimes have constipation and sometimes have diarrhea, but broadly most people tend to just have constipation or just diarrhea. The thing that gets confusing is occasionally people will get overflow diarrhea, so they're actually constipated with hard stool stuck in the colon and then they're getting diarrhea. So they think, oh, I'm, I'm moving between diarrhea and constipation, but actually they're still constipated. It's just that there's this hard block of stool and the rest of the like liquid is spilling around the edge and presenting as diarrhea. So this can be very confusing because actually getting your bowels moving and taking a laxative potentially might be what you need. But you think if you've got diarrhea that's the last thing you're going to want to do. But actually it might be clearing the blockage, getting things regulated and more normal. Then that can make you feel a lot better.

Michele Folan:

So yeah, Okay, and then we talked about food and maybe stress as being triggers. Are there environmental triggers at all with irritable bowel?

Anna Mapson:

I mean, often it can be genetic as well, so there can be things that get passed down through your family. Maybe your family have a reduced stomach acid production gene or they might have a slow motility gene, so these kind of things can run in the family. But there's a little bit about how you are brought up around food. You know what your attitude is like, that nature nurture presentation as well in terms of the environment, I suppose, like your lifestyle can be a factor. So when you eat and how you eat is really key as well. People who rush their meals don't chew their food very well. Maybe you're eating in the car or standing up in the kitchen. You never sit down. These kind of things can also lead to IBS type symptoms. I wouldn't say they would necessarily be a cause of IBS, but they would definitely add to the picture.

Michele Folan:

I did have a question, so you brought up low stomach acid and that could potentially be a genetic issue. What are the symptoms of low stomach acid? How would you know that you have that in particular?

Anna Mapson:

Low stomach acid could be, as I'm shown by burping a lot after meals, could be a lot of bloating and gas, could be feeling like your just food sits quite heavy in your stomach for a long time and one of the main causes of that would be stress. I would say so. When we go into like a fight or flight mode, our body is primed for running, or you know that fight, flight, freeze response. We're not ready to digest our food, so the body prioritizes getting blood to your muscles. Opening your eyes, like putting your body on high alert, and the things that are dampened down is our rest and digest mode, like hormone production and digestion, so all the blood will go away from the gut and then that could affect the production of stomach juices. So your digestive enzymes and stomach acid because that's not the priority, as your brain is telling your body, we're in danger. We need to stop. Therefore, we don't need to digest this large meal that we've just eaten, but over time that can lead to more fermentation gas, like stomach cramping and just feeling like oh you know, sluggish digestion. Even if you have loose stools and food's moving through you quite quickly, you can feel like everything is um kind of heavy and not digesting well.

Anna Mapson:

So those yeah, this low stomach acid is normally triggered by the gut brain connection, like you're saying at the beginning. That that nervous system connection. Is there any treatment for that? Well, try, trying to engage your brain in digestion is quite a good first tip. So I like to get my clients to start thinking about their meal 30 minutes before they eat and by doing that you're engaging your brain in thinking about digestion and actually it can trigger.

Anna Mapson:

About 20% of your stomach acid is in this cephalic stage of digestion, which is kind of when your brain is kicking off, thinking about the smells, the texture, like what it is you're going to eat. If you're someone who cooks, you're kind of naturally doing that. But when we get a lot of ready meals from the supermarket or perhaps you know someone else has made the food for you, which is lovely, but often we don't take time to do that, we just pick it up and eat it and so, yeah, that can really help. So, and also doing some deep breathing before the meal. It might just be three deep breaths or maybe one minute of calm breathing, but it just tries to get you out of that high nervous system alert and into more calm, like ready to digest.

Michele Folan:

You did bring up. We did talk about environmental a little bit. But can your childhood eating habits contribute to GI issues in adulthood?

Anna Mapson:

Possibly. I think things that get passed down would might maybe be around where you eat. So sometimes you sit in front of the TV and eat and on the sofa and just the positioning of our body, like physically, is hunched over instead of sitting upright and tall and letting the food go down. So those kind of habits we pick up from home also maybe how quickly you eat.

Anna Mapson:

So I had a client who whose parent was quite restrictive with what the children were allowed to eat. They were quite controlling and so they grew up having to eat really, really fast in order to eat what it was before it was kind of taken away and so that person had to. She felt like she had to eat all the time to get it down and actually was over eating because those kind of habits or those like learned eating patterns. So I think definitely how, yeah, our food script, if you like, that is created when we're children, has got a huge impact on our relationship with food what foods are allowed, what's good and what's not, what's healthy, whether you get treats for being good as well is quite a big thing. So we can all think about that. You know, if you have your own family like how you want to replicate it or not replicate what you grew up with.

Michele Folan:

Oh, and I think that is such a great point because we all take that stuff with us into adulthood, whether it's good or bad. I know growing up we were never made to sit and eat everything on our plate. My parents were hey, you just try everything. We call it the polite bite. Just try it, you may like it this time. That's what my dad used to always say. You may like it this time, but if you don't like it, then go make yourself something else.

Michele Folan:

There was never a additional meal made for someone if you didn't like what mom made that night. So anyway, there is SIBO, yes, and if you could explain what SIBO is and what the symptoms are? I know this does come up occasionally on the show and I want to make sure everybody understands what it is.

Anna Mapson:

Yeah, small intestine bacterial overgrowth is an excess of microbes living in your small intestine. So we do have some naturally in our small gut and they're there doing a good job. But if you have too many and that can be for a variety of reasons they can contribute to bloating gas, especially like smelly gas, abdominal pains and cramps so very similar symptoms to IBS, and actually there's a range of different studies. But between 4 and 78 percent of people who have IBS are actually likely to have SIBO, which is quite a lot. So sometimes the dietary manipulations that you can do for IBS don't always work, because it's actually caused by the microbes. So these microbes typically create three types of gas, either hydrogen, methane or hydrogen sulfide, and they can be yeah, like I said quite smelly or cause you to actually change the transit time of food as well. So methane affects the nervous system of the gut, so the smooth muscles that push the food through and also help the gut stay clean. Methane slows that process down and so therefore you end up with more overgrowth because you've got more time as the food and the bacteria are traveling through. So it's kind of a complicated condition and not everybody knows about it and I don't know where you are I mean in the UK as well. It's quite patchy in terms of whether your doctor will have heard of it. Gastroenterologists won't always test for it, so it's very hit and miss, depending on your medical team, as to what treatment you get.

Anna Mapson:

How do they test for SIBO?

Anna Mapson:

It's a breath test, so it sounds a bit weird that you can breathe out gases where the gases are in your digestive system.

Anna Mapson:

But essentially you fast. Well, you have to do a prep diet for 12 hours so you don't eat any fiber and you just eat chicken rice and white rice and potatoes very boring diet, just 12 hours though. Then you fast for 12 hours and this means that you have no fibers in your small intestine, so everything from the day before should have moved all the way through. Then you drink a little sugary solution and measure your breath at a set interval so it's either every 15 minutes or some companies use every 20 minutes and then what you're doing is measuring how much of this methane or hydrogen you are breathing out, and then that will tell you how much of the overgrowth you might have, because humans are not supposed to have high levels of methane in the breath or hydrogen. So we can measure in the breath, and then that gives us a sense of how many parts per million of each of this gas is in your breath, and then that leads to know what kind of treatment you might give, and what would that treatment be for SIBO?

Anna Mapson:

There's different approaches depending on whether you're working with a doctor, first of all, so doctors can prescribe specific antibiotics that are known to kill off gastro overgrowths. So there's a really a couple of common ones. And then there's also alternative treatments for people who don't have access to a doctor, so supplemental herbs, so things like oregano, berberine or allicin again depending on the type of gas that you have, the levels that you have and what else you're doing with your diet. So all of those things would contribute. But I think knowing that you've got SIBO in the first place kind of can help with a treatment plan, because, like I said at the beginning, with IBS you don't really have a clear treatment plan, but with this it's something that you can tackle. But SIBO is normally a symptom of something else. How did it overgrow in the first place? What would be the cause? And that's like going up a level to try and identify how you can improve your digestion.

Anna Mapson:

Yeah, oh, man Do you want me to say the typical kind of causes for SIBO.

Michele Folan:

Yeah, absolutely, Now you've got me. I'm like the wheels are turning here, Anna yeah.

Anna Mapson:

I mean, it can be caused by a whole range of things, but well, one of the common causes is a previous food poisoning incident. So if you had a really bad episode of diarrhea and vomiting, maybe you ate some bad shellfish or a dodgy bit of uncooked chicken that this then leads your body to produce to wash out the toxins. So that's how you get the diarrhea your body's trying to get rid of it, and, as it's creating this immune response, your body is also creating antibodies to the toxin that is there, and then this antibody is very similar. So the top, the antibody, also works on a protein called vinculin that is responsible for the motility of the small intestine, so this can damage. This antibody to the toxin can also damage your motility sometimes. So this is where food poisoning and sometimes it is called post-infectious IBS, and that can be a common cause of SIBO, and it might be two years after the event, up to two years later. That's when the SIBO really starts.

Anna Mapson:

It can also be caused, though, by adhesion, so like physical structural things that slow down the small intestine. So perhaps your, the sides of your intestines are sticking to another organ inside and it, or there's a loop like um, like a little bulge in the small intestine, a pocket, and bacteria is collecting there, or maybe a growth, or the small intestine has got smaller in some way. It's got um, like a stricture. So there are lots of reasons why it might slow down.

Anna Mapson:

Sometimes, like under functioning, thyroid can also slow down because it helps with our metabolism. So when that's going slow it may also slow down your smooth muscle and the digestion. Yeah, there are a huge range of causes and you might not even know what caused it. So people often say I need to know, like where did the SIBO start? And you might never know, but at least if you've kind of gone through some of the checklists of things that are under your control, you know around eating patterns, things that you can do to try and help yourself get really strong and eat a good broad range of foods and sort of build yourself back up again.

Michele Folan:

Is a colonoscopy ever warranted to make a diagnosis?

Anna Mapson:

So a colonoscopy will only look at the large intestine and the latter part of the digestive tract. So that is very good for identifying polyps or maybe any growths or looking if there's any damage in terms of inflammation. That sort of thing is normally what will be picked up on a colonoscopy with a SIBO. Sometimes they will do an endoscopy like going down your throat and we'll do a biopsy on the first part of the small intestine. But because it's such a long tube it's eight meters or so long, eight feet long, and it yeah, you won't get through all of it. You can't get to all of it.

Michele Folan:

Okay, I read on your website about the FODMAP diet, so if you could tell me exactly what it stands for and how it targets certain issues. So it's almost like an elimination diet in a way, but you explain it because I won't do it justice.

Anna Mapson:

Yeah, no, it is. It's an elimination diet for people with IBS and it's very well researched. So it's an acronym that stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. So you don't need to remember all the terms. But it's just different types of starches and they are found in lots of healthy foods. You know lots of vegetables and fruits, so apples, chickpeas, dairy like milk, wheat and cauliflower mushrooms, a lot of red peppers. You know a lot of these foods we would encourage people to eat all the time. They're not bad for you at all, it's just for some people.

Anna Mapson:

These particular types of carbohydrates can draw water into the small bowel, like it osmotically just draws the water in, and that can cause bloating and loose stools and then they travel to the large intestine and bacteria will ferment them, causing more gas and again, maybe more diarrhea or bloating. So it can. They can be very uncomfortable in certain people who are sensitive. So the diet takes all of these out for two to six weeks and then, one by one, we reintroduce them in order to see if there's a particular trigger that is your problem. So it's a very careful approach and a lot of people just do the restriction bit and they don't do the reintroduction phase.

Michele Folan:

Oh, really, because they have results. Then they're like well, I'm not going to mess with it. Yeah, I went through the list and I was like wait, onion and garlic. I mean, I think I cook with onion and garlic almost every single night and I just think about ah, how do I? So if I were to try this and I'm probably giving too much information, but I've been having some gut issues here and I had Anna booked before I started having my issues so I'm really interested in this topic for some personal reasons, but also because I hear a lot of women talking about it. So I just want to clear that up. Okay, do you recommend, then, like a food diary for people?

Anna Mapson:

I first of all recommend yes, starting off, just getting a baseline. So what would be helpful is to write down everything you're eating for a couple of days and write down things like your bowel habits, like how many times did you go to the toilet. If you use the Bristol stool stool chart, it's quite a good representation of the poo. So, if you don't want to describe it, this bristol stool chart lists out seven different types of common, common types of poo. So from very hard, small pellets that's type one to very loose, watery stools that's type seven and you can just rate your poop how many times did you go a day and what type was it? Because that also then just gives you a picture of what's right, what's happening now. And then the elimination diet people should follow for around two weeks, up to six weeks, and that's often if you, you know, maybe you have a weekend away and you can't really follow it properly, or the first week you're just finding out like what works and how to do it. So typically my clients do it for maybe three weeks. If you don't feel better after that time, then you don't need to go through the reintroduction process. If you don't feel better whether you're eating them or not eating them. You may as well be eating them if you feel better and you think actually this has really got my symptoms under control. I've got less bloating, I'm sleeping better. You know I'm not going to the toilet, it's not, I'm not sitting on the toilet for hours anymore.

Anna Mapson:

Then you can start to reintroduce them one by one. So there's all these different categories of foods. So onions you mentioned would be one category, garlic is another, wheat is another, and then there's other vegetables or fruits, for example grapefruit. So all four of those are high in fructan, which is the O, the oligosaccharides in the FOD map. But you have to test all four of them separately because they're all slightly different. So it's quite a process each reintroduction. You would start with a very small amount, a bit more the next day and a little bit more on day three, and then, if you so, by day three you're eating a really good portion, like with onions. You might start with just two tablespoons, like a tablespoon of onion in your meal, and then on day three you're kind of eating half an onion or like, even if it's very small onion, maybe a whole onion cooked. So then you can test if you're happy with it. Does your gut react to it or not? And if it doesn't, then onions are okay and you can eat them freely. They're not a problem.

Michele Folan:

Okay, I know how you focused on the onions, yeah.

Anna Mapson:

Well, it's hard to avoid them. Like you said, I have had a client recently and she has just found that actually onions and also stone fruit are her big problems and she was eating them all the time. Didn't even think onions would be an issue, and actually all the other FODMAP foods like beans and pulses and cauliflower and apples, they have not been a problem for her at all, it was just onions. So now, knowing this, she can get on and live without onions.

Anna Mapson:

It is tricky, like I said, if you go and eat it is, people sometimes use the green bits of spring onions or chives to get a kind of oniony flavor, and with garlic they use garlic infused oil, which again gives you the flavor without actually eating the garlic.

Michele Folan:

So there's a couple of work arounds for most things you can't eat all right, well, well, not even that's my issue, but that flagged in me because I'm going oh my God, yeah, it's the basis for Italian cooking, Indian cooking.

Anna Mapson:

Garlic would be a lot in South Asian food as well, so it's really hard to avoid onions and garlic. We tend to love them, yeah.

Michele Folan:

And I'm a cook. So yeah, I was curious can poor sleep worsen your symptoms?

Anna Mapson:

Yes, it definitely can.

Anna Mapson:

So there is evidence that when you don't sleep well or you're very, very tired, you have worse anxiety, that you feel more pain, and those two things can really be a problem in IBS. So there's a big overlap with people who have IBS and high anxiety or low mood as well, partly to do with well, maybe to do with this gut brain connection that we mentioned. The nerve that connects the guts to the brain is really a super high way of information and if you're not feeling good mentally or emotionally, that has a big knock on impact and so that obviously then disrupts your sleep as well. And then, when you're very tired, you tend to crave sugary foods that are going to give you that energy boost, and those foods can, for some people, be a real IBS trigger as well. So you crave the stodgy foods. Maybe you just eat more toast because you can't be bothered to cook and you just want a quick hit, so you have some chocolate on a biscuit and extra caffeine as well. So, yeah, there's definitely an overlap between sleep and the gut health.

Michele Folan:

I would say, right, that makes total sense. I just had a guest on the podcast and we were talking about alcohol. Yeah, I'm wondering what effect alcohol has on gut health.

Anna Mapson:

Well, it's not great for your gut health. I'm going to be honest. Unfortunately, my clients always say this am I allowed to still drink? So whilst I drink alcohol, I'm not against it in any way. We just know it's not good for you more generally to have in large amounts. Alcohol itself is kind of reused as an antimicrobial. You know, antibacterial hand wash, that kind of thing. We use alcohol to kill off microbes. But also it just irritates the lining of your gut. So people tend to underestimate the impact of alcohol on their IBS.

Anna Mapson:

I would say, when we go back to that FODMAP diet where you're trying to restrict things that can trigger it, you can only have one very small glass of white or red wine and one very small beer, like a small can. So part up over and above that you will be incurring symptoms. I would say normally, and even sometimes, just a small glass of wine can be a real trigger and often, you know, women or, yeah, people tend to rely on it to unwind after a day of work and think, oh, it's good for me, it relaxes me, it helps me sleep, but it doesn't really help us sleep that well. I'm sure you went into that last week. It's more of a sedative and not actually something that gives you a good restful night. But yeah, it can lead to symptoms, I would say, for a couple of days afterwards. And people don't want to believe that a few beers on Saturday is still giving you problems on a Monday or Tuesday, but it I do see a correlation between the more people drink and symptoms.

Michele Folan:

Yep, all right Again, that makes sense. I'm buying what you're selling. What supplements do you recommend? Do you recommend any probiotics or prebiotics?

Anna Mapson:

Depending on each client. Yes, so sometimes people will do well from adding in microbes, so live bacteria, like in a probiotic. A longer term approach, though, is to use fibers and prebiotics that actually feed the good gut bacteria. So if you've got a very low fiber diet and you're just adding in probiotics, they're not going to want to hang around because you're not feeding them. So you need to still have fiber in your diet, and this is where increasing lots of pulses, whole grains, fruits and vegetables is so good, which is why that FODMAP diet is not great long term.

Anna Mapson:

So, following introduction of good bacteria, or like feeding them as well, sometimes I will use supplements to reduce them down, like I mentioned with the SIBO, to actually get rid of high overgrowth of microbes. But that's generally after people have had a test and we know that that's what the problem is. And then other supplements that are sometimes used in IBS. One is psyllium husk, which is actually quite well researched for IBS constipation and diarrhea predominant symptoms and can be very helpful. You can just get it as a powder and start off with a small amount so you can test your tolerance to it, but it helps to form a soft but well-formed stool, so it's, it's useful or other things like magnesium oxide is not very well absorbed but can be very useful for some people with constipation because it draws water in and softens it up. So I'd say it's very different for everybody. There's no one good IBS supplement because of everybody's different symptoms.

Michele Folan:

There's been a real trend in eating fermented foods, so kimchi, sauerkraut, some pickles that go through the fermentation process, and then kombucha. When would those be helpful with someone with IBS?

Anna Mapson:

They're helpful for most people, I would say, but you might want to start with a small amount and see if it makes things worse. Particularly with SIBO, people may find that adding in extra bacteria can make their bloating a little bit worse, but not always. And the good thing about these live or probiotic foods is that they are adding a bit of diversity and generally they come in good food. So, like kimchi or sauerkraut, you know you're getting the fiber from the cabbage and the vegetables, and with the kefir you've got calcium in your milk. So there's, they're generally pretty healthy foods, I would say, and traditional forms of, yeah, food preservation are good for us. Yeah, but you don't have to have you eat a whole jar of sauerkraut or down a whole pint of milk. It's a small amount, is good to just add in, and they're cheap to make as well, which is what I like. You can make your own sauerkraut very, very easily, so it can be beneficial and cost effective.

Michele Folan:

Or we can buy it in a jar. Yeah, or you can buy it.

Anna Mapson:

That's just what I do, yes.

Michele Folan:

If you don't have time, that's another thing. I cook, but I'm not fermenting my own sauerkraut.

Anna Mapson:

Well, if you buy it, it needs to be the live one, so not pasteurized, otherwise it doesn't have any of the live microbes left. Yes, it's the expensive stuff which I have found.

Michele Folan:

It's not the cheap stuff you buy in the bag in the meat department. How do you work with clients, Anna? What kind of programs do you offer?

Anna Mapson:

I have three-month. I call it the gut reset. So I start off with an hour and a half really digging down into their whole health history, understanding clients' digestion, all their symptoms. I have a lot of conversations about bowel habits, smelly gas, like what does your poo look like, and get very comfortable with talking about these things. But I also ask questions about skin health.

Anna Mapson:

You know movement, aches and pains, mental health you know just everything that might be relevant, as well as menstrual health and how that can impact on your digestion. And then then I, over the three months, work with people by speaking to them weekly to begin with and then it's fortnightly, so you get a lot of time together to work out what's working, giving people meal plans to help implement it, and and actually that's where I think most people get a lot of the benefit is the weekly calls, because we're talking about how to do it. There's loads of blogs read, you know, telling you what you could be doing for IBS, but it's actually how to implement it in your life. That's the tricky bit, and so that's what I help people with.

Michele Folan:

Um over three months and then did you have? You had like a, a free offer or something on your on your site yeah, I've just got like.

Anna Mapson:

The first download is sometimes where I think people could start, which is non-food related IBS strategy. So there's five non-food tips for IBS and that's a good place to start, before you even start changing your diet and cutting things out and going dairy and gluten free, and all of that is just to think about how you're eating, like sleep, some of the things we've been talking about. That can make a real difference. Then you can move on to other dietary interventions that are maybe more tricky or more longer term, but sometimes those simple things can be a good start.

Michele Folan:

Yeah, that is a good start, good baseline at least to get. Can you share a client success story? I?

Anna Mapson:

have had yeah a number, I'd say everybody.

Anna Mapson:

I can't guarantee anything in three months, so when people come to me they're always like is it possible to get everything gone in three months?

Anna Mapson:

But I have had some amazing success stories where people have been on such a restricted diet, maybe eating only a handful of foods.

Anna Mapson:

There's a guy I worked with who was in a lot of pain and he was probably only eating 10 foods on repeat, day after day after day, and going through a really careful reintroduction process, explaining a lot about how the foods would be potentially affecting your gut and then looking for those symptoms, and actually he found that he all the foods he'd been scared of were not really the issue and there were more you know lifestyle things that also were playing into it. And he really got back to eating a great range of foods and absolutely started loving cooking again, like becoming interested in eating. That's the problem. Socializing a lot is around going out for drinks, meeting for a meal, and so when you can't eat food that everybody else is eating, it is very isolating and lonely and that kind of thing is really rewarding for me. I love it when people can just get back in touch with food and back in touch with socializing or kind of get back to living their lives again.

Michele Folan:

That must make you feel really good when you have a client that is able to start enjoying their lives again. Yeah, because they're not worried about going out for one and having those symptoms, but also the social interaction yeah, that's very special.

Anna Mapson:

And being able to leave the house, you know, without fear of incontinence, is another problem. That when you know what your food triggers are and you can avoid them. Another problem that when you know what your food triggers are and you can avoid them, then you're able to eat more freely and to again enjoy going out, or just know that you can go to the shops without having to take a change of clothes with you.

Michele Folan:

Oh come on the stuff we have to deal with. I'm telling you what is one of your core pillars of self-care. What do you do for yourself, Iona?

Anna Mapson:

I really enjoy Irish dance, so that is my hobby and I've been doing it for six years and I've always loved dancing. I started when my children were. They both used to dance and now only the older one does. She's much better than me, but I just do it because I love it, and so finding like a physical thing, activity that I love, has been one of the really important parts of my self-care as I age and getting through this stage of life. Yeah, exercising, but doing it not just for exercise sake but for in order to get fit, so that I can be a better dancer.

Michele Folan:

Oh, that's awesome. My girls did Irish dance when they were kids and, yeah, it was really fun. Actually, I know one, my oldest daughter, she's 29. And if you ask her she'll probably get on top of a bar and do and do a little Irish dance. Still, she, she hasn't forgotten a step.

Anna Mapson:

Yeah it's. It's quite a good um fitness because it really does keep you fit, uh like it's so high impact and so it's quite motivating because I train with a lot of younger people, teenagers or people in their 20s, you got to think that the impact is is good for your bones and, yeah, staying, you know working on your muscles and all that, so you're probably doing a really good thing for yourself.

Michele Folan:

Anna Maps, and where can listeners find you and your podcast?

Anna Mapson:

I have a podcast called the Inside Knowledge for People with IBS and that's available on Spotify, Apple Music everywhere you normally get podcasts and also my website is goodnessme-nutrition. com and on Instagram I'm goodnessme underscore nutrition.

Michele Folan:

Anna, I so appreciate your expertise. This was very enlightening. I am going to guarantee you that you really helped a lot of my listeners today, because I know that this is way more prevalent than we talk about, and so good for you for doing such amazing work. Thank you, it's been great.

Anna Mapson:

Thank you very much.

Michele Folan:

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