Episode 174:
Show Notes 


In this episode, hosts Dr Mary Barson and Dr Lucy Burns discuss the common condition of irritable bowel syndrome (IBS) and ways to improve gut health. The hosts share personal experiences and insights into managing IBS symptoms and explore the complexity of gut health issues.

IBS is a common condition affecting 10-20% of the population, with a higher prevalence in women. Traditional treatments for IBS often include a low FODMAP diet, which eliminates fermentable carbohydrates found in certain fruits, vegetables, legumes, grains, and processed foods. However, both doctors advocate for a low-carb real food approach, which focuses on consuming natural, unprocessed foods and reducing the intake of grains and legumes.

Dr Barson and Dr Burns emphasise that IBS is not just a psychological issue; it involves real physiological changes in the gut, like an altered immune system, low-grade inflammation, and increased sensitivity to gut movements, leading to pain and discomfort.

They share anecdotes of individuals who have found relief from IBS symptoms by following a low-carb real food diet, allowing them to reintroduce foods they couldn't tolerate before.

Dr Barson and Dr Burns encourage listeners to try the low carb real food approach for at least a month, highlighting its simplicity and potential to improve gut health significantly.

In the next episode, the doctors are going to explore more gut-friendly foods and differentiate between foods that genuinely help with gut health and those that are more of a trend.

If you’re ready to transform your gut health and bid farewell to irritable bowel syndrome, you can take the first step towards a healthier you today! Join our Four Week Body Rebalance program, designed specifically to nurture your gut health and well-being. Discover the power of real food low carb lifestyle that could be the key to relieving your IBS symptoms.

Visit our website at www.rlmedicine.com/gut to explore more about this transformative program. Don't miss this opportunity to regain control over your digestive health. Remember, you have nothing to lose except your irritable bowel. Embrace the journey to a healthier, happier you!

Episode 174: 


Dr Mary Barson (0:11) Hello, my lovely listeners. I'm Dr Mary Barson.

Dr Lucy Barson (0:15) And I'm Dr Lucy Burns. Welcome to this episode of

Both (0:20) Real Health and Weight Loss!

Dr Mary Barson (0:23) Good morning, gorgeous listeners. I am joined by the effervescent, fabulous, gorgeous in green. Dr Mary. Welcome, gorgeous one. How are you this morning?

Dr Mary Barson  (0:33)  Good, thank you. And in green, I'm often in green. I was chatting to a lovely woman today who is actually doing one of our programs. But we were chatting, and she said that she just doesn't feel bloated anymore. Having done, in this case, our 12 Week Mind Body Rebalance, our beautiful people are doing that, and we're approaching halfway through now. And this just doesn't feel bloated. And it got me thinking that I used to be really bloated all the time, as well. And I have like uncomfortable gut feelings, but I just thought it was part of life. And certainly, you know, if I had a lot of junk, it would get worse, but it was just always there. And I think I have just forgotten because it's been so long that I don't have that anymore. I just feel good. And I'm taking a moment to just be grateful for the fact that I feel good. And it's great.

Dr Lucy Burns  (1:30)  It's so interesting. It's again, it reminds me a little bit of that thing. You know, sometimes we're sitting outside, and we've got a pool filter that's going, and I don't notice it until it stops. And when it stops – Ah, that's better. And gut pain can vary between that. Or for some people, it's excruciating, and you know, impacts their quality of life. But yeah, like you, I always had a little bit of what I thought was IBS, irritable bowel syndrome. So yeah, it's a great topic. Why don't we talk about that today? Because I think out there in the world, there are lots of people who have been diagnosed with irritable bowel and have varying treatments. So why don't we actually chit-chat about what irritable bowel actually is?

Dr Mary Barson  (2:16)  That sounds good. I've been diagnosed with irritable bowel, I assume, so I think I've ever forgotten about but way back in the day. Yeah, I got a diagnosis of irritable bowel syndrome. I'm very pleased to report that it doesn't bother me at all anymore. But yeah, let's talk about that. Okay, I like this. It's something I can actually get very, very excited about. Alright, so irritable bowel. Well, first of all, I suppose you say it's incredibly common. IBS is really common. Possibly 10 to 20% of the population worldwide have got irritable bowel syndrome. And it seems to be more common in women, who aren't entirely sure why we do have a few ideas why, but it's not entirely sure why. And I don't know about you, Lucy, but as a GP, a third all the time, people would come in, we've got complaints all the time. Obviously, not all of them were irritable bowel syndrome, but irritable bowel syndrome was a very, very common cause of gut discomfort.

Dr Lucy Burns  (3:11)  Yeah, and I guess, you know, the name gives it away in irritable bowel, which means it's right for people. There are many different presentations. So certainly, some people have got pain, so cramping. Lots of people have bloating, some people have diarrhea, and some people have constipation, and lots of people have alternating diarrhea and constipation. Which again, you know, again, I just think about the old days. I spent a lot of time in constipation land before my new way of eating, and I now look back and think I'd say for breakfast because I knew if I didn't eat this for breakfast, I would have constipation. I ate all bran, which, if anybody, I mean, you possibly all know, it's really like horse food. It's basically bran. It's really processed into these sort of, like, sticks, little pills. Yeah, yeah. It's like these little sticks of bran that god awful tasteless, which I would then, you know, have with milk and then some sort of tinned fruit to make it vaguely palatable, and usually a flavoured yogurt. And I remember joking with my friends, saying, you know, when I get old and end up in a nursing home, I'm going to have to make sure that I'm fed this every day because otherwise, I'll be in a world of pain with my poop.

Dr Mary Barson  (4:35)  So you don't want to be in a world of pain with your poop? It's very not at all. Yeah, no, no. Yes. Yeah.

Dr Lucy Burns  (4:41)  Not at all. So the interesting thing, of course, is that we do prescribe more fibre for things like irritable bowel, but in many cases, it actually doesn't work, in fact, can make the problem worse. So, you know, Dr Mary, I would love your thoughts on this and why this happens, and I guess what we think the cause of irritable bowel is.

Dr Mary Barson  (5:07)  I mean, I can't. I never really do take off my doctor hat, and I'm not going to take it off now. So I suppose that's the first thing I'd like to say, but if you're worried about your gut health, if you've got issues with constipation, diarrhea, gut pain, or other things, just go to your doctor, because occasionally, it can be something serious, and that needs to be like excluded and treated. And generally speaking, actually, it's only once we've excluded all the dangerous stuff, okay, like, right? Well, we don't know what it is. So we get the chair uncomfy. It's not Crohn's disease. It's not celiac. It's not ulcerative colitis, it's not cancer, it's not any of these things. Okay. Now, it's irritable bowel syndrome. So it's just this like a sort of little like kind of bucket that we put it in a diagnosis of exclusion is what we like to call it in medicine. So yeah, it sounds bad, not sure what it is. So we'll call it this. And we've just described irritable bowel syndrome. So go to your doctor. This would be the first thing, and for a long time, we doctors, in our infinite wisdom, called it a functional disorder, and functional disorder, meaning that you know, we've ruled out everything else is just in your head, it's in your head. And irritable bowel is partly in your head, we now know. Much more recent research has totally debunked this. The research is now pointing to a variety of actually quite subtle sort of changes that underlie the development of irritable bowel syndrome. It's a bit frustrating because we don't have this one perfect test that we have. But in the research world, we know that there are quite a few things going on. Stress definitely makes it worse, but it's not just in your head. So, people with irritable bowel syndrome have to have an altered immune system, like in their bowel. So the way that their body is interacting with the food that they eat, the way that their body is managing their immune system down at their gut is often quite sort of wrapped up and is different. And that there is this constant but low-grade inflammation. So it's an inflammatory process that's going on all the time there. And there also seems to be an increased sensitisation to what would be normal kind of signals. People with irritable bowel feel pain. So, what might be just normal movement of the gut can be interpreted as a painful feeling for people with irritable bowel syndrome. And we now know that they actually seem to have more nerve fibres around the guts. So it's really it's a very, very interesting condition, I think, and kind of complex. Fortunately, it's not severe in the fact that you know, it doesn't seem to be life-limiting, but it can cause huge amounts of distress for people, like really, really significant distress on a spectrum from people who are mildly annoyed to people whose lives are really adversely affected by this. So it's complicated. genetics plays a role, but also our environmental factors must set us up for this.

Dr Lucy Burns  (8:04)  Absolutely. And I think the interesting thing that you just pointed out, then, was the increase in nerve fibres. So even when, you know, we, our brain is interpreting it as pain. It is, it's painful, it's not the person is just a bit, you know, pathetic or weak. It's not about that. It's about they have more pain fibres than you know, the person next to them who doesn't get pain from their gut mobility or motility, which I guess is the better phrase. And I think also, there's a good, you know, as you've mentioned, there's lots of different causes. But there are also people who have different motility with their guts. So there, instead of your gut, just doing its peristalsis, which is just this sort of little bubbling along of moving your food and your water through your large bowel, they can get like a rat. So it's a bit like the stop-start of an accelerator, which means that they end up with this sort of really painful peristalsis.

Dr Mary Barson  (9:05)  Yes, it's kind of weird, but it's real. It's really common. But there are things that you can do that can really dramatically improve the function of your gut and also the quality of your life. I mean, this is an enormous topic because we'll do live and podcasts on this if we want to, but let's not pass. I'll do that. Yes, I think we could certainly like drive home, I think the most important punchy points here. So traditional treatments for irritable bowel syndrome would be perhaps putting people on a low FODMAP diet. Many of you may have heard this. It's had a lot of research attention in recent years. So FODMAPs it's such an unwieldy name, but I frequently get it wrong. So I'm gonna I'm gonna go for it here. Let's see a low FODMAP diet.

Dr Lucy Burns  (9:56)  Go for it. Go for it, Miss. You can do it!  

Dr Mary Barson  (9:59)  Fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Did I get it?

Dr Lucy Burns  (10:06)  You did! You did. Excellent. Yes. So it's fermentable. One sugar, two sugar or many sugars. Polyols is the sort of summary. Yeah, that's right. So the translation, yeah, is that it's fermentable carbohydrates. So it's usually the carbohydrates that, you know, that are not, so fibres, essentially the ones that are not really absorbed by our guts. So they just sit there fermenting, which, as we know, a little bit of fermentations, good, create short-term fatty acids, which are great for our bow. The Goldilocks, seriously, Goldilocks is the key here. Too much of this is really unhelpful. Basically, you've got like a little brewery going on in your gut, and you're just making gaseous stuff.

Dr Mary Barson  (10:56)  Which can stretch the gut wall and cause issues and pain. And it also causes more fluid to flow into the gut, which can really cause that diarrhea. So and, these FODMAPs' natural life is part of our foods, but they are found in certain kinds of fruit, veggies, legumes, quite high grains. Yep, grains are quite high, some dairy products, and actually quite a lot of processed foods as well. And people, you know, they can get information about what these foods are, then they can put themselves on a low FODMAP diet and see if things get better. And for a lot of people, they do, and it's a perfectly reasonable thing to do. But it's not the only way to go. Think back to that, that there's that low-grade inflammation that is part of the process, the altered immune system, that stress also, psychological stress has a significant role to play. If you go to the basics of real food, you know, real food, not processed food, food as close as possible to its natural state, and then taking out those foods that are naturally lower in carbohydrates, that actually, anecdotally, people get an enormous amount of relief just from that without having to worry too much about FODMAPs and FODMAPs. And getting complicated instructions from dieticians about lowering their FODMAPs, that low-carb real food is often enough in and of itself. 

Dr Lucy Burns  (12:26)  Absolutely. And the one interesting thing about the FODMAP diet, if you like, it's actually meant to be like an elimination and a reintroduction diet. It's not meant to be something that people stay on forever. So you are meant to go on to this. And again, it is it is quite complicated. And most people need a dietitian to supervise it. Although there are a couple of apps, Monash Medical Center, where the whole thing research began, has an app about it. But even then, it's not something that you're meant to be on for the next 40 years. But at its heart, I mean, part of the benefit, if you like, of a low carbohydrate lifestyle is that you do, and this is both a benefit and a criticism from people is that it does reduce the amount of fibre that you have in your diet. It does reduce the amount of fibre that people have that comes from particularly grains, breads, and rice, particularly brown rice. But legumes in particular, you just reduce the amount of fibre, it's a no fibre diet, like this is I think something that I would defend to the death, that a low carbohydrate lifestyle is not no fibre, you can get plenty of fibre from your vegetables. And the most incredible thing is that people who have low FODMAP, who haven't been able to tolerate onion or garlic because it's higher in FODMAPs, can suddenly tolerate those again.

Dr Mary Barson  (13:54)  We hear it all the time very, very much talking about, you know, case study level dieter. One of my beautiful members, (my beautiful members) one of our beautiful members, was talking about this test on Monday. She used to have severe food intolerances related to IBS and really restricted diet to the point of actually being quite miserable with the amount of foods that this person could eat had been whittled down to like rice and chicken. It wasn't a particularly happy way to live, but transitioning to low-carb real food and then the healing that has gone along with that, that now she can eat a whole range of foods that she would never have been able to eat before. You know there are certain things that still will trigger her, like grains, for example, aren't her friend, but she can eat an enormous range compared to what she was at foods and feels really, really good. So her resilience, her guts, resilience has really improved. We do see this a lot like there is something very healing about real food, and we know exactly what it is like. This is anti-inflammatory. It's the food we're meant to eat. It helps heal our bodies. It nourishes our body with all the right micronutrients, and we can heal. And it can be such an effective treatment for people with gut issues.

Dr Lucy Burns  (15:08)  Absolutely. And it's so sort of simple, it's simple and boring, or to the point is simple, so simple, boring. But that real food, low carb, real food is is really the key. You know, there are some tweaks that people may need to make for their own individual circumstances. As we talked about a couple of weeks ago, in the nuance of weight loss, it's the nuance of gut health as well. But the broad brushstrokes of gut health are two, honestly, two, particularly legumes, I think they're just diabolical for gut pain. But there are also some other really, really obvious characters that are involved, which, again, you know, sugar-free chewing gum, which is very popular, it's full of silver toll. And silver toll is really, it's one of the phenols that we talked about in the fight. It's the P of the FODMAP. Really, really unhelpful for our gut

Dr Mary Barson  (16:03)  Yes it is. As soon as people figure out that one, and they can cut out the sugar-free to a gut and the sort of dollars issues, they often feel a lot better. I'd say that the best way to see if this works for you is just to try it, try it and see. It's so healthy, it's so healing, it's feeling, it's delicious, you're not hungry, you've really got nothing to lose. But I try it for probably four weeks, I would say give it a go for 30 days before, you know, around about that 30-day mark before you know whether or not it works for you. And I think he could be extremely pleasantly surprised. I actually can remember, I have this very clear memory of after I had my first foray into this real food nutrition. And I've told this story before I won't go into it. But I got peer pressured into this into this particular, you know, real food challenge. And I was a few weeks in, and I just remember sitting down and just being astounded that I felt good. And I like had this edge. I just said it to tell everyone around me. I was just as I was at my computer writing up my case notes. I was working in community medicine. And my lovely colleague was next to me. And I was like, I feel good. And she's looking at me slightly. No, like, No, I feel really good. Like, I actually feel good. And she is just giving me the side eye.

Dr Lucy Burns  (17:29)  That’s called the soccer edge on you.

Dr Mary Barson  (17:31)  Which she didn't need to get. But I could suddenly remember it was like, yeah, it looks like the pool filter. But it turned off, or I literally just started hitting myself with a hammer. And I didn't, I realised the first time I'd been hitting myself with a hammer, and I didn't even know.

Dr Lucy Burns  (17:45)  Yeah, absolutely. And I love the way you said just, you know, do it for a month. You know, and for anybody who's wanting more info on that, you know, we have a program, the Four Week Body Rebalance. And if you're looking for more information on this related to your gut health, then you can go to one of our web pages www.rlmedicine.com/gut. And, you know, check it out. But I think at the end of the day, you've got nothing to lose except your irritable bowel. I mean, how good would it be to lose that? Absolutely. It's so fascinating because again, you know, when we think about the complex nature of what causes irritable bowel, and you mentioned earlier about the upregulation of your pain receptors, and the proliferation of nerve fibres, the body is so friggin clever because it can down-regulate those as well. And it can downgrade nerve fibres, they can regress. If you've got more than you need, more than that is helpful. And you take away the thing that is triggering them, and then they disappear. So you can absolutely, really and truly heal your gut.

Dr Mary Barson  (18:59)  With simple, simple tools, you absolutely can.

Dr Lucy Burns  (19:03)  Absolutely. I think there's this is a great topic, and we should do another episode next week on gut health because what I'd like to explore next week is all the gut-friendly foods that we're being encouraged to eat. And there's some misery. Some misery, the misery

Dr Mary Barson  (19:22)  Mystery about the misery.

Dr Lucy Burns  (19:24)  Yeah, because again, you know, it's the flavour of the month – gut health – the flavour of the decade, flavour of the millennium, and there's like everything. There's the real, real deal and the misery. Gorgeous ones. We'll see you next week.

Dr Mary Barson  (19:42)  We'll cut through some victory next week.

Dr Lucy Burns  (19:44)  Excellent. Take good care. Bye for now. Bye.

Dr Lucy Burns  (19:52) So my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr Lucy Burns…

Dr Mary Barson: (24:06)  and I'm Dr Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com

Dr Lucy Burns: (24:16)  And until next time…

Both: (24:18) Thanks for listening!

Dr Lucy Burns: (24:20) The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

DISCLAIMER: This Podcast and any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice, and are provided for general information purposes only. All care is taken in the preparation of the information in this Podcast.  Real Life Medicine does not make any representations or give any warranties about its accuracy, reliability, completeness or suitability for any particular purpose. This Podcast and any information, advice, opinions or statements within it are not to be used as a substitute for professional medical, psychology, psychiatric or other mental health care. Real Life Medicine recommends you seek  the advice of your doctor or other qualified health providers with any questions you may have regarding a medical condition. Inform your doctor of any changes you may make to your lifestyle and discuss these with your doctor. Do not disregard medical advice or delay visiting a medical professional because of something you hear in this Podcast. To the extent permissible by law Real Life Medicine will not be liable for any expenses, losses, damages (including indirect or consequential damages) or costs which might be incurred as a result of the information being inaccurate or incomplete in any way and for any reason. No part of this Podcast can be reproduced, redistributed, published, copied or duplicated in any form without the prior permission of Real Life Medicine.