The 4 Steps On What To Do If You Have IBS – By a Nutritionist

Living with Irritable Bowel Syndrome (IBS) can be challenging! Symptoms can include abdominal pain, bloating, constipation and diarrhoea – all of which can impact your day to day quality of life…

As a registered nutritional therapist, I often work with clients who are struggling to manage their IBS symptoms, and have had very little help from mainstream medicine and support. In this article, I will share my four steps on what to do if you have IBS, based on my experience working with clients and the latest gut health research.

Whether you’re newly diagnosed with IBS or have been struggling with symptoms for a while, these steps can help you take control of your gut health and improve your quality of life. From dietary changes to stress management techniques, these steps are designed to be practical and effective for anyone looking to manage their IBS symptoms.


Step 1 – Get to know your IBS

IBS is categorised into different types according to your symptoms and bowel movements. The 3 main types include:

  • IBS-C (constipation)
  • IBS-D (diarrhoea) 
  • IBS-M (mixed)

Knowing your IBS type can help you identify triggers that may worsen your symptoms, such as certain foods or stress. 

For example, if you have IBS-D, you may need to focus on controlling your bowel movements by picking specific fibres or reducing stimulants, and if you have IBS-C, you may need to increase your fibre intake to help regulate bowel movements.

By knowing your IBS type, you can take a more proactive approach to managing your condition and symptoms. I recommend that my clients keep track of their symptoms and flare-ups on the notes app on their phone, noting down any triggers or changes in environment, stress levels, exercise, food, drink and even what clothing they wear. 


Step 2 – Try simple changes to your diet and the way you eat

For some individuals with IBS, simple dietary changes can make all the difference when it comes to symptom management. However, it’s important to make any big dietary changes under the guidance and supervision of a nutritionist. Dietary changes can often negatively affect symptoms when not done in the right circumstances or under the guidance of a professional.  

Some of the below tips may help reduce your IBS symptoms: 

  • Aim to eat three regular, well-balanced meals a day with one snack if needed between lunch and dinner. Avoid grazing (constantly snacking) and try to leave 3-4 hour gaps between meals and snacks.


  • Avoid eating large, rich meals close to bedtime – 2-3 hours is a good time to have as a break before bed. This is especially important if you suffer from acid reflux or heartburn. 


  • Limit your alcohol intake as alcohol can irritate the gut. Aim to have at least 4 alcohol-free nights per week and stick to low FODMAP options such as 1 glass of red wine or 1 x 30ml serving of a clear spirit with low sugar mixers such as soda water and lime or sparkling water. 


  • If you have IBS-D listen up! Consider reducing your intake of caffeinated drinks, especially on an empty stomach and try to cut down your coffee intake to 1 cup per day after or with your breakfast. Try swapping for herbal teas, a soothing turmeric latte or a healthy spin on a hot chocolate with a raw cacao. 


  • Stay hydrated by drinking at least 2 litres of filtered water per day, hydration levels can have a big impact on bowel function and motility.


  • Avoid frequent consumption of overly rich or fatty foods such as fast food, pies, cheese, creamy sauces, french fries, oily curries, spreads, and fatty cuts of meat such as burgers and sausages. Some people may struggle to digest fats, and for those with IBS-D it might be a trigger food. 


  • Consider HOW you eat- slow down, be present and chew your food as thoroughly as you can to support the digestion process. 


  • Bitter foods before meals- Bitter foods, such as leafy greens, artichokes, dandelion greens, or a shot of apple cider vinegar all contain compounds that stimulate the production of digestive juices, including stomach acid, bile, and enzymes. This can prime the digestive system and improve nutrient absorption, as well as support the growth of beneficial gut bacteria. Aim to consume a handful of bitter foods or a shot of ACV before meals to help stimulate the vagus nerve, which plays a critical role in digestion and gut function. The vagus nerve is responsible for the release of digestive enzymes and the movement of food through the digestive tract, so stimulating this nerve can help improve overall gut health


  •  Consider reducing gluten and dairy- Gluten and dairy are two common food triggers for IBS. Gluten is a protein found in wheat, barley, and rye and individuals with IBS may experience gastrointestinal symptoms when consuming gluten due to its difficult-to-digest properties. Dairy products contain lactose, which when not properly digested, can trigger symptoms such as abdominal pain, bloating, gas, and diarrhoea. Dairy products also contain casein, a protein that can be difficult to digest for some people causing inflammation in the gut, leading to symptoms such as stomach pain and diarrhoea. Overall, gluten and dairy are common trigger foods for IBS due to their difficult-to-digest properties.


Step 3 – Balance stress & prioritise relaxation

The gut-brain axis refers to the bidirectional communication between the gut and the brain. In the context of IBS, this axis has a big role to play in the development and management of the condition.

Communication between the gut microbiome and the brain occurs through various pathways, including:

  • The vagus nerve
  • The immune system
  • The endocrine system

In people with IBS, these pathways are often dysregulated, leading to increased sensitivity to stress and alterations in gut motility and immune function.

Stress is a known trigger for IBS symptoms, and is thought to impact the gut-brain axis through the release of stress hormones, such as cortisol. Stress can also alter the composition of the gut microbiome, leading to dysbiosis, or an imbalance of beneficial and harmful bacteria in the gut.

Understanding the gut-brain axis is key as prioritising stress management techniques and down time can have a really big role to play in the severity of your IBS symptoms.  

Some of my favourite stress management techniques include:

  • Get enough sleep- Sleep and the gut are heavily linked with a lack of sleep having the ability to increase stress levels (1). Aim for 7-9 hours of good quality sleep per night, and consider investing in a sleep tracker to really prioritise your down time and what could be impacting your sleep. I like the Oura ring, which is available at a discounted price here. 


  • Spend time in nature- Spending time in nature has been shown to reduce stress levels and improve overall well-being (2). Try taking a walk outside first thing in the morning and after work for some down time. Call a friend, plug in a good podcast or leave your phone at home and allow yourself to be fully immersed in nature and your surroundings. 


  • Connect with others: Social support can be a great buffer against stress. Try connecting with friends or family members regularly to distract you from any underlying stressors. 


  • Prioritise self-care: Make time for activities that you enjoy and that help you switch off. This could include reading, listening to music, taking a relaxing bath or doing a face mask. It’s important to prioritise self-care to help reduce stress levels and indulge in something that makes you feel good.


  • Exercise regularly: Exercise is a great way to relieve stress and improve your overall well-being. It can help to increase endorphins, which are natural mood boosters, and can also improve sleep quality. However, be mindful of the form of exercise you do as high-intensity exercise can actually exacerbate symptoms in some people with IBS due to the activation of the sympathetic nervous system, which can cause changes in gut motility and blood flow, leading to symptoms such as abdominal pain, bloating, and diarrhoea. High-intensity exercise can also be stressful on the body, and the psychological stress associated with pushing oneself to the limit can also exacerbate IBS symptoms.Opt for lower intensity workouts such as Pilates, yoga and Barre to support your gut and mind.


  • Journal: Writing down your thoughts and feelings can be a good release for pent-up thoughts and emotions. Don’t think too much about what to write, just let it happen. Write whatever comes to mind and remember that no one else needs to read it.


Step 4 – Work with a Registered Nutritional Therapist

Working with a nutritional therapist can be beneficial for those with Irritable Bowel Syndrome to provide personalised dietary and lifestyle recommendations that can help manage symptoms and improve an individual’s overall quality of life. Some of the reasons to consider working with a nutritional therapist for IBS include:

  • An individualised approach: A nutritional therapist can work with you to create an individualised dietary plan that takes into account your unique symptoms, triggers, and nutritional needs. No one individual is the same when it comes to their IBS symptoms. 


  • Education and guidance: Nutritional therapists can provide education and guidance on how to make dietary changes that can help manage IBS symptoms. They can also provide useful tips on meal planning, grocery shopping, and cooking to make the process easier.


  • Trigger foods: A nutritional therapist can help you identify trigger foods that may be contributing to your symptoms. They can also guide you through an elimination diet or a low FODMAP diet to identify specific trigger foods if this is suitable for you and your symptoms.


  • Nutrient deficiencies: In some cases, IBS can lead to nutrient deficiencies, so a nutritional therapist can help you identify and manage these deficiencies through dietary changes or supplementation.


  • Testing: Several forms of testing may be used in clinic to take a deeper dive into what may be going on in your gut. This could include stool, breath and SIBO testing. 


  • Support and motivation: Working with a nutritional therapist can provide support and motivation to help you make lasting dietary changes. They can also help you track progress and adjust the plan as needed.


I am now taking on new clients for my 3 month GUT HEALTH package, available virtually to really get to the root cause of what is triggering your symptoms, allowing you to live a symptom free life. 

Drop my team an email to book in for a free discovery call or alternatively book in here and we can talk through how I can help: 



References: (1) (2)

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Hi there

London Nutritionist Clarissa Lenherr

I’m Clarissa, a registered nutritionist (mBANT) and workplace wellness expert. In my practice, I have helped hundreds of clients reach optimal health through creating sustainable, effective habits and dietary adjustments. My aim is to empower people with the skills, tools and knowledge to take their health into their own hands and feel the happiest, healthiest versions of themselves. Featured in The Daily Mail, Women’s Health, The Telegraph, and more.




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