The bloating, the gas, the embarrassing gastrointestinal problems…Click to learn the simple dietary changes that can alleviate IBS symptoms and how certain types of carbohydrates known as “FODMAPs” contribute to gut issues.
IBS Symptoms in Females and What To Do About It
It can come on so suddenly, completely without warning.
You start the day feeling fine and then – BAM! Suddenly you’re experiencing serious abdominal pains and cramping, bloating, diarrhea, or constipation (sometimes both!).
Was it something I ate? you might wonder as you rush to the restroom.
The truth is, just about anything can cause these kinds of digestive upsets, but they’re also common symptoms of IBS. If you’re experiencing them regularly, you could be one of the 10–15 percent of the adult population in the U.S. that suffers from Irritable Bowel Syndrome. In fact, IBS is one of the most common conditions diagnosed by gastroenterologists and primary care physicians, according to the American College of Gastroenterology.
But how can you tell if your upset stomach is really something more serious?
Common IBS Symptoms in Females
Interestingly, IBS is diagnosed more often in women than men in the US — at almost twice the rate.
Doctors aren’t exactly sure why, but some research suggests a connection between the hormones estrogen and progesterone and IBS symptoms in females. In fact, some women report increased IBS symptoms like back pain during their menstrual cycles.
In general, IBS involves abdominal pain and changes in stools. Although anyone can experience pain or bloating from gas after a particular meal, and our stools are constantly changing based on what we eat, IBS symptoms tend to be persistent and frequent.
Overall, Irritable Bowel Syndrome symptoms can include:
Loss of appetite
Anxiety and depression
In fact, the four types of IBS are defined by their symptoms:
IBS-C - predominant constipation
IBS-D - predominant diarrhea
IBS-M - mixed (you suffer both diarrhea and constipation)
IBS-U - undefined
Women who suffer from IBS often find they have certain triggers that bring on an episode, though these can vary from person to person.
Some of the most common triggers include foods high in certain carbohydrates called “FODMAPs” (like onions, garlic, milk, wheat bread, pasta, and apples to name just a few), artificial sweeteners, smoking, carbonated drinks, and alcohol. Women also report more episodes during their menstrual cycles.
Additionally, social and emotional factors like stress and anxiety can be triggers too. And when you’re suffering from uncomfortable digestive symptoms and worried about finding a bathroom, it can create a vicious, stressful cycle.
Are IBS Symptoms Different in Males?
If you’re a man who suspects you have IBS, the list of common symptoms above also applies to you. However, the added complication of the female menstrual cycle isn’t a factor (lucky for you, guys!).
According to the International Foundation of Gastrointestinal Disorders, IBS is underreported in men, so there isn’t as much information about gender differences available. However, if you’re a guy reading this, the following info about the treatment and diagnosis of IBS applies as well!
Other Conditions That Can Be Confused with IBS Symptoms
It’s important to note that IBS is not the same as Inflammatory Bowel Disease (IBD). IBD can manifest as either Crohn’s Disease or ulcerative colitis, but the common factor is an inflammatory response and actual inflammation in the intestines.
IBD can also cause changes in the bowel tissues and raise your risk for colorectal cancer. But usually, in addition to IBS symptoms, people with IBD will experience symptoms like fever, bleeding, weight loss, joint pain, and eye problems.
IBS doesn’t have an inflammatory response associated with it, and in fact, when doctors look at the GI tract of IBS sufferers, it appears normal.
How IBS is Diagnosed
Unfortunately, there’s no quick and easy test to find out if you have IBS. The diagnosis is based entirely on your symptoms, and doctors call it a diagnosis of exclusion — meaning they have to rule out other conditions, like thyroid disorder or IBD, in order to make a diagnosis.
Doctors look to a set of guidelines called the Rome IV criteria (developed over the last 15 years by experts meeting in — you guessed it — Rome!) to help diagnose IBS and other functional GI disorders. The criteria are a way to systematically eliminate other conditions based on your specific symptoms.
IBS is medically defined as recurring abdominal pain linked with changes in bowel movement frequency and form, at least once a week for at least three months.
If You Suspect Your Symptoms Are IBS
The first and most important thing to do if you suspect you may have symptoms of IBS is to get a diagnosis.
Try keeping a record of your symptoms that you can take to your doctor to help her understand what’s going on and make a faster, more accurate diagnosis for you. Your doctor will probably want to take a detailed medical history; this may be important, as there does seem to be some genetic component to IBS, and you’re more likely to have it if a parent does as well. Your doctor may also want to run specific tests to rule out other problems before diagnosing you with IBS.
Once you have a diagnosis, treatment is all about managing your symptoms.
Diet Is Everything For Managing IBS Symptoms
When it comes to IBS, food is medicine. Many IBS episodes are linked to particular food triggers.
Foods that might trigger your symptoms include:
Carbs made with wheat flour, like bread and pasta
Lots of carbonated drinks (the bubbles can cause excess gas)
Artificial sweeteners, especially sorbitol and mannitol
Greasy or very fatty foods
Certain carbohydrates collectively referred to as FODMAPs that include fructose (a type of fruit sugar), lactose (milk sugar), beans, onions, broccoli, cabbage and many more
FODMAPs are foods we eat every day--including some very healthy choices like beans and produce--but people with IBS don’t digest them well. This means that these foods pass into our colon where our gut bacteria starts to ferment them and produce gas. People with IBS experience hypersensitivity in the gut, and any kind of gas production can become uncomfortable and trigger diarrhea or constipation.
For managing many IBS symptoms, females will particularly benefit from trying a low-FODMAP diet. By reducing the intake of these specific foods, research shows that up to 86% of people with IBS experience a significant reduction in the severity and frequency of their symptoms.
Want to know what foods are high or low in FODMAPs? Grab our free cheat sheets!
I always recommend starting a FODMAP elimination diet when you’re ready and then following a protocol to slowly reintroduce foods which allows you to identify your particular triggers--most people can eat some high-FODMAP foods WITHOUT experiencing symptoms.
Once you’ve identified your triggers, you can drastically reduce future bouts of IBS.
In the short term, your doctor may suggest over-the-counter medicines like laxatives and anti-gas pills to help with the symptoms, but these are only treating the result, not the cause of the problem. Doing a temporary FODMAPs elimination diet is a way of discovering the root causes of your discomfort and avoiding them in the future.
In addition, many doctors now recognize a psychological component to IBS and may suggest therapy or counseling to combat stress and anxiety that may make your symptoms worse. There is some indication that antidepressants can help modulate nerve activity in your gut, but these drugs come with their own side-effects, so many doctors are hesitant to prescribe them for IBS.
IBS is chronic, and there is currently no cure. But with the right tools and mindset, you can identify and eliminate your specific triggers to live a much more comfortable life.
Dining out when you're following the FODMAP Diet can be tricky. In this post, I'll give you tips and suggestions for the best things to order at American restaurants so you don't get IBS symptoms. Click through to read more AND to check out the other posts in the dining out series.
Like many of you, when I first heard about the FODMAP diet plan as a way to change my own IBS symptoms, I was overwhelmed. Not just with all the information out there, although that definitely was the case. Sometimes, it was overwhelming how much I didn’t know.
Four years ago, there was very little information to go on, no explanation of the nuances. Suddenly having to change my diet overnight felt very difficult and complex, with no guidance on how to make it work in a practical sense.
There's more info out there now, but I think people can still relate to what I experienced. Also, a lot of the current information is still conflicting or out-dated.
I had to forge my own path. And a huge part of why I do what I do is that I believe that you shouldn’t have to do that to change your life for the better!
(Which is why I started Calm Belly Kitchen!)
Looking back on it, there’s so much I wish I’d known before I started. So many tips and tricks and even affirmations that would’ve made this whole thing a lot smoother—and a lot less emotional.
I've also asked members of the community what they wish someone had told them when they first started out with the FODMAP diet plan. Many of the answers lined up with my experience!
So today, I'm going to share the things that I wish I knew when I first started. Hopefully, you’ll find this useful, no matter where you are in your journey.
#1 Onion and garlic are not absolutely essential for flavor
It seems like such a minor thing now, but this was definitely my number one source of anxiety and fear and stress when I started to grasp what the FODMAP diet really entailed. All those recipes I relied on would have to be modified or thrown out—and at first, I had no idea how to even begin.
(This is also one of the biggest struggles that I hear from folks who send me emails, easily in the top three questions that I receive!)
For years, I made my living as a recipe developer. I love food, and own an embarrassing amount of cookbooks! And I can tell you that giving up onion and garlic is not the end of the world.
Sure, it’s an adjustment, but it’s not impossible. While I, personally, can tolerate a bit of onion, I don’t do great with garlic, and I don’t really keep either of them in the house. It’s worth it, to me, to see the success of following the FODMAP diet plan in my own symptoms.
In a way, whether it’s onion, garlic, or any other food, it really won’t be as bad as you think, giving it up temporarily or even for longer periods of time. I promise.
You can check out this ultimate guide for other ways to flavor food that won’t trigger your IBS!
#2 A major diet change is hard, and it will take you time to get in your groove
Okay, I know I just said that giving up some foods isn’t the end of the world. And it’s not! But any major lifestyle change means changing all of your patterns—even ones you might not be aware you have. It will take time. It doesn’t happen overnight.
Doctors love to give you a little two- or three-page handout that makes it seem super easy to just completely overhaul your diet overnight, but the truth is, not many people can just turn completely change the way that they cook, shop, and eat in one day.
You have to be patient with yourself. You have to give yourself time (and grace!) as you begin the process.
Even though I had cooking skills and already was a healthy eater, I couldn't turn it around overnight. I needed time to get comfortable with the changes in my eating habits.
Whatever you do, don't let beginner overwhelm hold you back from starting.
Just know that it's going to take time to get comfortable, and it's okay to be to be stressed about it when you start. If you mess up, that's okay! Don't beat yourself up—keep going.
#3 Eating in a social setting is less of a big deal than you might think
A lot of people ask me this one, especially as they start to really think about how often we all eat in social settings—restaurants, work lunches, family meals.
When you can control the food, things tend to work fine. But when other people are cooking? That can be a little stressful.
I get it.
If you’re worried about how the changes in your diet will affect eating out at restaurants—whether it’s asking for order changes or worrying about being judged for what you put in your face—that’s normal.
No matter how much we worry that other people are judging us, people are always more concerned about what they are doing, than what other people are thinking. It’s just our nature! We’re all a little self-centered like that.
And if someone does give you grief or side-eye for swapping your asparagus for a side salad? Then they really need to find a hobby.
What you eat isn’t a judgement, or critique, of anyone else’s eating. Refusing a food, making healthier choices, these are all worth it, to make your body feel better.
Prefer to watch? Check out the video below...
#4 You really do need to listen to your body
If you’ve spent any time on this site, then I know you’ve heard this one before. But it’s absolutely true. Listen to what your body is saying—not just with the food, but with all of it.
The great thing about making this kind of diet change is that you have this really excellent opportunity to learn about all the other factors that affect your digestion, besides just the FODMAPs. When you take those away, you start to listen to the other little messages your body is sending.
For example, stress is a big deal for me. It messes with my stomach. Now I can hear that message more clearly, and adjust my lifestyle accordingly.
Another thing I learned was that adjusting the overall volume of food I was eating helped with my symptoms. I was just giving it too much to do! Eating smaller meals, letting them digest well, allowed my body to tell me, hey, you’ll feel less bloated and heavy and gross.
For many of my clients, I often hear that their period sends them a huge message, thanks to fluctuating hormones! As you can see, all of these non-food factors can affect your gut.
Listen to them.
Every body is different. What’s yours telling you?
#5 Sourdough bread is your best friend
For those of you who love bread, this one is really exciting.
(What? Bread is exciting! Especially bread that’s safe and delicious!)
This wasn’t even established when I was first beginning my FODMAP diet journey, but within the last two years, Monash has tested sourdough bread and found that, because of the slow fermentation process, sourdough bread has an extremely low FODMAP content.
The only catch is that it MUST be made using a traditional slow rise process.
Luckily, it’s easy to tell if sourdough is indeed slow rise: Check the ingredients. If the sourdough bread contains yeast or enzymes, then it was not made with the slow rise method.
Traditional slow-rise sourdough requires just three main ingredients: flour, water, and salt. Instead of yeast, a “starter” causes the bread to rise. This happens when natural bacteria occurring in the air slowly ferments by consuming the FODMAPs and other carbohydrates in the flour. This produces gas, which creates the rise in the bread.
Great news if you’ve been missing bread!
#6 You really do need to reintroduce FODMAPs by category
Like most of us, I spent a long time on the elimination phase of the FODMAP diet. Because I was feeling better, and seeing a reduction in my own symptoms, it felt really comfortable just to stay in that highly restricted zone.
And yet it’s really important to test foods and reintroduce them—not just because it’s healthier to have more variety in your diet, but also because that’s the only way you’re going to know your personal FODMAP tolerance levels.
One thing I learned when I did finally reintroduce FODMAPs is that I have a pretty high tolerance for wheat. I can still eat my homemade pizza and croissants, and for me, that’s amazing.
On the other hand, I used to love making sweet potato fries, but now I can only have a few bites. A bigger serving of sweet potato makes my stomach feel heavy and creates unpleasant symptoms the next day. And there’s no way I would’ve known that without reintroducing FODMAP categories one by one.
You might be taking a risk with a certain food during this phase, but the knowledge you will gain will be priceless.
#7 You won’t always feel deprived!
When we talk about diet changes, there is always this lingering worry, this fear of deprivation.
And it makes sense: We’re taking away a lot of common foods that are in favorite dishes, at home and out in the world. It’s a huge adjustment, looking at food in this new way.
Yes, it will absolutely feel like an adjustment. You’re definitely going to hate taking away some foods—but eventually, the feelings of being so healthy and feeling so much better and feeling empowered will begin to outweigh the difficulties.
You may still experience IBS symptoms. That’s totally normal. But overall, you will feel so much better, because you’ll finally have control over how your body feels.
And those are my top seven items I wish I’d known before starting the FODMAP diet!
They’re definitely truths for me, and ones I hear from my clients as well. I hope that they can empower you to begin your FODMAP journey.
If you're in that place of overwhelm...
…sign up for our Free 7-Day Calm Belly Challenge. This mini course helps you set the foundation you need to succeed on FODMAP.
Because you deserve to have a calm belly too!