Being a Supportive Health Professional in IBS - A Dietitian Perspective

When it comes to irritable bowel syndrome, patients experience a lot of discomfort - not only physically, but mentally and emotionally too. There is so much stigma and judgement attached to IBS. Not only does the stigma come from family, friends, and colleagues, but it can also come from health professionals at times. But trust me, IBS is not “all in your head!”

Of course, this negative attention is hurtful and can leave an emotional scar. All the added anxiety and emotion can even make IBS symptoms worse! Feeling alienated and unheard leads many people to the internet and social media, searching for anything that can give them answers. And too often, those so-called answers are drastic, non-evidence based, and unnecessarily restrictive!

How can health professionals support people with IBS?

The recent 'IBS In America Survey' conducted by IrritableBowelSyndrome.net shows that 34% of those living with IBS felt they need more emotional support and tools to cope with stress and their IBS.

So how, as health professionals, can we be better at emotionally supporting our patients? I share below how healthcare professionals can support patients - these tips are great for family and friends too!

Slow down the science talk

As healthcare providers, we are taught to educate and tackle misinformation head-on using scientific evidence. We enter into appointments with our patients with our “science ammo” locked and loaded. But does that really work?

Spewing scientific evidence and citing research studies doesn’t exactly say “come on in, you’re accepted and heard here.” In fact, the message it can send is more often “everything you’re saying is wrong and you don’t know anything about your IBS.” Sure, that’s extreme and I’m sure the majority of health professionals have every intention of being compassionate. That’s why most of us entered into the field to begin with. However, our intentions and our actions don’t always match up - at least not in the eyes of our patients!

The reality is, if someone is set on following a specific protocol to fix their IBS (no matter how “out there” it is), they’ve generally put some thought into it. They have beliefs and fears that have lead them to the place they are now. Therefore, it is much more powerful to understand WHY a patient makes their health decisions than to jump in prematurely with the science talk.

Health care practitioner tip: Save the science until you understand a patients concerns so you can support them better emotionally.

Patient tip: Don't be afraid to ask for what you need! "Today, my biggest concern is..." - if your health care practitioner gets off track - gently remind them why you're here today. They work for YOU! However, they're human too - so show them the kindness you'd like to receive.

Understand the patient’s story

For many of my patients, I am the first healthcare provider that they get to spend more than 30 minutes with. They’ve often NEVER had the opportunity to fully share their story. Patients are used to repeating their most worrisome symptoms, but things tend to stay pretty surface level from there.

In my own experience, storytelling is one of the most powerful parts of the healing process. It’s no wonder people turn to blogs and social media; it helps them feel connected. It helps them feel like they are heard and understood when they’ve never felt that way before. But as professionals, we know the information they find is not always in their best interest.

There’s a pretty simple fix - start listening and connecting! And I don’t mean just being silent and nodding along until you get the chance to jump in with facts. I mean truly listening and asking questions that prompt patients to provide the full version of their story. Ask “Where did this start for you? What is it like for you to live with IBS?” These questions are deep and cumbersome and sometimes make patients feel uncomfortable. But generally, that discomfort comes from the fact that they’ve never had someone ask it before. Simply give them a moment to collect their thoughts and before you know it - a story unfolds!

Health care practitioner tip: Let patients tell their story and be attentive to beliefs and fears that emerge. For example, are they adamant that gluten is the problem? Ask where they have gotten this information from without being judgemental. Many times I notice that people don’t always know where they’ve picked up a belief - they might say things like “well gluten is just bad for us - isn’t it?” This is where we can understand health beliefs and question fears. Simply asking - do you think this is true? Gives the opportunity to see where the beliefs come from and discuss science in a way that ACTUALLY addresses patient concerns.

Patient tip: Ask your health care professional - could we take some time to review my case from the beginning? I think it will help you better understand my concerns. If there's no time in your appointment today - ask the health care professional when they can make time.

Deal with the stuff you can’t see and touch

Even though I specialize in food, my approach to IBS management is very holistic. In our practice we also emphasize health outcomes that we can’t see and touch quite as easily as food. This includes everything from stress and anxiety to sleep patterns and self-care.

In the same IBS survey discussed above, 40% of respondents felt they needed help with discovering coping strategies for stress management. Again, this is a significant statistic. In today’s world, a large portion of the population (both with and without IBS) lead stressful and busy lives. However, the more we push ourselves to accomplish, the more we struggle to relax and cope.

As a dietitian, I make it a priority to discuss this very important area of health with my IBS patients and start with a basic plan. When appropriate - connecting patients to other team members like psychologists, therapists, and GI specialists can help to address all the other aspects of IBS management.

Health care practitioner tip: Ask your patients how they cope with stress - what positive and negative coping behaviors do they have? Where does the stress come from? What works for them? What doesn't? What tools do they need to feel better? (Therapy, support groups, yoga, and mindfulness-based stress reduction are all evidence-based options!)

Patient tip: Talking about stress is hard - even acknowledging the role stress could play in symptoms is hard! Be open to exploring this - when you're ready of course!

What you can do to get the emotional support you need

At the end of the day, your health care team should be an advocate for your care. It may take a balance of asking for what you need or finding a health care practitioner to provide that support for you. Don't forget allied health team members - often times we get to spend more time with you than your doctor or gastroenterologist - and can be that source of emotional support and advocacy you need!