Dietician Sasha Watkins is a big advocate for good nutrition coming from natural, unprocessed food and has spent years working with healthy eating education for the whole family, nutrition research, gut health, allergy, and weight management. As she releases her new line of IBS friendly foods along with Head Chef Matt Williamson, we caught up with her to ask her about the foods that trigger symptoms of IBS and what sufferers can do to try and prevent a reaction.
Sasha Watkins, Field Doctor
What symptoms should you look out for if you think you might have IBS?
Irritable Bowel Syndrome, or IBS, is a common digestive condition that may affect more than 1 in 10 people1 in the UK. There is no specific cause for the condition and it may be a combination of food and stresses that trigger painful IBS symptoms. These commonly include stomach pain or stomach cramps, bloating, wind, diarrhoea and/or constipation. You may also experience symptoms like nausea, tiredness or a lack of energy, backache, anxiety, depression, impaired sleep, passing mucus and a lack of control around your bowel motions. Although there isn’t a quick fix for IBS, there are many things you can do to get on your way to tackling the daily discomfort that it can bring. A good starting point would be to keep a record of what foods, events or activities trigger your symptoms and then monitor any changes you make. By changing only one thing you can better understand what has helped. A good way to do this is via a food and symptoms diary, which can be found in the following link https://cdn.shopify.com/s/files/1/0271/2662/8450/files/FD_food_mood_symptom_diary.pdf?v=1631184693.
Is it something you are born with or something that can develop at any age?
IBS is not a condition that you’re born with but is something you can develop at any age. Symptoms will often start between the ages of 20 and 30 and we often see more women than men reporting symptoms. The exact cause of IBS is unknown, but it has been linked to the likes of food poisoning, oversensitive nerves in your gut, stress or a family history of IBS.
How can low FODMAP meals help alleviate the symptoms of IBS?
The low FODMAP diet is a special type of diet that avoids foods high in FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) and is shown to be effective in reducing common IBS symptoms, such as bloating and abdominal discomfort.
FODMAPs are found in a wide range of foods, such as fruits, vegetables, bread, cereals, nuts, legumes, and food additives. These foods are poorly absorbed in the small intestine, ultimately triggering symptoms for people with a sensitive gut or IBS.
The diet has been shown to be effective in 3 out of 42 people if done under the supervision of an IBS dietitian. A dietitian can help tailor the diet to your individual needs and ensure you follow the diet safely and properly. What’s important to understand though is that it’s not a diet for life. Foods high in FODMAPs are prebiotics and provide important nourishment for your gut bacteria. Research has shown that levels of some good bacteria do decline on the low FODMAP diet. The end goal is also to work out what your key triggers are and to get back to a varied and a nutritious diet as possible.
Other than changes in diet, is there anything else sufferers can do reduce the likelihood of a flare up?
There is a no one-size fits-all approach to dealing with IBS. Aside from making changes to your diet and working out what your food triggers might be, there are other factors such as stress and lifestyle that may be the root cause of your IBS symptoms. Take time to relax, make sure you’re getting enough sleep, try meditation, mindfulness or yoga and exercise regularly. Simple steps like taking a gentle walk after lunch or dinner can really help.
I would also recommend thinking about how you eat. Start by having regular meals each day and try not to skip any meals or eat late at night. Smaller meal sizes may ease symptoms and taking time to eat your meals; chewing your food well.
What tips do you have for IBS sufferers who eat out a lot?
Eating out can be stressful when you have IBS. Planning can help you to manage your symptoms by choosing the restaurant wisely and considering what you will eat before you get there – many restaurants share their menus online to make this process easier. When you get there make friends with the restaurant manager or chef to discuss your needs. I would recommend telling them you have “food allergies” instead as it is easier to understand, and most restaurants will have something in place. Choose simple items on the menu, as this can help avoid trigger foods and be prepared to say no to things on the table (chips, breads, crackers). Last but not least, stay calm, relax and enjoy - anxiety can also lead to an IBS flare up.
What can happen if someone has prolonged periods of IBS? Is there any long term damage to the gut?
From research, there doesn’t appear to be any physical damage to the gut with IBS, but prolonged periods of IBS can have a tremendous negative effect on your quality of life due to the debilitating nature of the IBS symptoms. IBS symptoms can stop people going to work, seeing friends or even having an intimate relationship.
My advice is to not be afraid to ask for help. Many people leave their symptoms for years and years as they are either too embarrassed to talk about them or they are unaware that there is something they can do to improve symptoms. Spending hours researching on Google or purchasing online intolerance tests won’t help either. There is a lot of misinformation out there, so be picky about what advice you follow. I would suggest contacting your GP to get a proper diagnosis of IBS and rule out any other conditions with similar symptoms (e.g. coeliac disease). Reliable sources of information include; NHS website, NHS health care practitioners, The IBS Network, Guts UK and the British Dietetic Association.
We’ve got all the information and links in the resources section of our website. (link https://www.fielddoctor.co.uk/pages/resource-hub)
Please tell us what prompted you to develop your own line of meals.
Our proposition with field doctor from the outset was and still is simple – to create food which allows people to take control of their health through convenient and delicious meals. With a belief in food as medicine, and the desire to show that the ‘one size fits all’ approach doesn’t work when it comes to nutrition, our meals were born from passion and expertise.
IBS sufferers will be the first to tell you that it’s a minefield to work out what triggers symptoms. Together with the IBS Network, we carried out some research in 2021 and discovered that over half (54 per cent) of those surveyed lived in constant fear of eating something that will trigger their IBS symptoms and 42 per cent felt they would never be able to eat normally again.
The low FODMAP diet has been a fantastic dietary intervention to help sufferers manage their symptoms and to better identify their personal triggers. However, the diet can be hard to follow. At Field Doctor we decided to create convenient, nutritionally balanced ready-meals to help with the elimination stage of the diet and develop our low FODMAP range, which now comprises of 21 different meals. People with IBS are often tired and in constant pain, so a convenient, delicious and safe meal option ticks a lot of boxes.
Beans and pulses are known to create bloating and gas which are an IBS sufferer's worst enemy, so is it more difficult being vegan on a low FODMAP diet when these are some of the main sources of protein?
Yes, it can be challenging to follow a low FODMAP diet if you are also vegan, but small amounts of some beans and pulses are permitted on the low FODMAP diet. For example, you can have up to 42g of canned chickpeas and 46g of canned lentils with the liquid poured out. Other good, plant-based protein sources include up to 170g plain tofu and 100g plain Tempeh. It’s advisable to see a dietitian to ensure your diet is nutritionally balanced if you’re looking to start the low FODMAP diet.
There appears to be an increase in people who suffer from digestive complaints, if the free from aisles in supermarkets are anything to go by, so is this because there are so many more processed foods as opposed to fresh to choose from?
This may or may not be surprising, but half of all food bought by families in the UK is now ultra-processed and these foods are often high in fat and sugar and low in fibre, which can exacerbate IBS symptoms further. It’s fantastic that there is so much more choice for those looking to avoid certain gut triggers but many of the free-from foods are also highly processed. The pandemic has certainly made things tougher for IBS sufferers too. According to our research with The IBS Network, 44 per cent say their IBS got worse during this time and it has become harder to see a GP or dietitian. As a result, more people are trying to manage their symptoms themselves and commonly resort to changing their diet by heading to the free-from aisles.
What is next for the brand?
With IBS affecting up to 1 in 10 people3 in the UK, we want them to know that they can get support and help. Many people are suffering in silence and not prepared to seek help, so we’re focused in raising awareness of the condition and directing people to where there can seek help. To take it to the next level, we understand that our passion for wellness needs to translate into the tech world as well. We have recently launched a resource hub (https://www.fielddoctor.co.uk/pages/resource-hub) where people can go to find information to support their condition, be it how to follow the low FODMAP diet, where to get more information on gluten intolerance, how to eat more sustainably, or how diet can support other factors, like the menopause.
In addition, we are going to be launching a digital consultation which will help curate a personalised range of food based on an individual person’s specific health condition, dietary choices and overall health goals.
We are also developing a new range of food to meet the needs of other conditions where food can have a positive impact on people’s health that we are on track to launch in this year.
About Field Doctor
Delivered directly to your door, Field Doctor offers nutritionally balanced frozen meals and are believed to be the first and only brand in the UK to have launched a range of low FODMAP meals.
Field Doctor currently offer 21 FODMAP meals, from Sweet Potato and Spinach Korma, to Teriyaki Salmon and Whole Grain Rice, Smokey Chipotle Meatballs and Red Pesto and Roasted Vegetable Penne.
Field Doctor is available nationwide in the UK and can be ordered online at www.fielddoctor.co.uk.
For further information, or to trial Field Doctor, please contact Field Doctor press office [email protected] / 01189 475956
1 https://www.cghjournal.org/article/S1542-3565(12)00308-4/fulltext
2 https://pubmed.ncbi.nlm.nih.gov/28592442/
3 https://www.cghjournal.org/article/S1542-3565(12)00308-4/fulltext
Tagged in IBS