Female, aged 66, contacted me after struggling with IBS-D for most of her life. She had recently tried a low-FODMAP diet guided by a dietician but was not finding any real relief so decided during lockdown to try and get to the bottom of what could be causing her symptoms. The client was starting to get anxiety whilst out walking her dogs as she often got 'caught short' and felt she couldn't go out for long periods of time.

After a full consultation via Zoom, due to lockdown and location, we agreed to look at her food diary for a couple of weeks to see if there was anything obvious in her diet and lifestyle that could be playing into this picture. The client actually ate well but did eat a lot of fruit (and not much veg), snacked on biscuits and cakes at tea time, drank a lot of coffee, had increased her alcohol intake during lockdown and regularly drank a squash that contained sweeteners (all of which can have a laxative effect).

Assessment - we decided to initially reduce all of the above foods and drinks mentioned, increased vegetable intake (to start with we focussed on low-FODMAP vegetables) and ensured she was eating a good quality protein at every meal and snack. We swopped her squash to cherry juice and encouraged her to always have water with her and some nuts to avoid going for long periods of time without eating.

I also encouraged the client to continue with her exercise routine of yoga and pilates and also asked her to include 5-10 minutes of de-stressing every day using an app like Headspace or Calm. Stress plays a huge role in digestion so this is always an area we also focus on.

Whilst the client reported seeing some benefits after 3 weeks of following the above, she actually had started to become a bit constipated so she was keen to try and get to the root cause of her 'troublesome' diarrhoea. She therefore decided to invest in a stool sample.

Results - as well as having dysbiosis (a reduction in microbial diversity and a combination of the loss of some beneficial bacteria) the client had many bacteria present in levels that have the potential to cause diarrhoea!

So, as well as encouraging the client to continue with increasing diversity and colour in her diet (to feed and support her commensal bacteria) she embarked on a protocol of therapeutics that support a healthy microbiome and increased commensal bacteria. She also took the probiotic Saccharmomyces boulaardii. After a couple of months of following this regime we cut back on these therapeutics and went on to ones that support the mucosal barrier that line the gastrointestinal tract.

After three months she was having much better weeks and was producing type 2/3 on the Bristol stool scale but most importantly, she could control her bowel movements (which as you can imagine was a great relief!). The client continued to send me food diaries which she found very useful. This is a service I've recently introduced whereby clients can message me and get feedback daily (within reason!) which they have found very useful - at the end of the day, too much of anything, or eating fried, greasy food can also cause diarrhoea so it's worth checking your food intake too!

Outcome - the client is happy that she no longer has urgency when going to the loo but we are still working towards to the perfect poo (number 4 on the Bristol Stool Scale if you're interested) so for the last few weeks we have been trialling a new product that has not quite hit that mark yet but we are getting there - as you can see, this is not an overnight fix....

However, the client has her life back in that she was able to volunteer over the Summer with great energy and can walk the dogs with the knowledge she won't get caught short. She is also now much more knowledgeable about what foods cause her issues (cauliflower and too much alcohol) which has come about by regularly keeping a food diary. I must say she has been the most dedicated client on this front!

All cases are different, as everyone is individual, but it is why having the time to investigate health histories, coupled with functional testing (in this case a stool sample) is so brilliant. Functional testing is expensive but look at it as an investment in your health. Whilst we can often make amazing changes through diet and lifestyle, sometimes you have to dig deeper and see what's really going on inside. By investing in testing and a nutrition programme that is fully supported, you can get some life changing results.

If you can resonate with this story please book in for a free discovery call and start the 4 step programme for yourself.