Doctor’s Advice on IBS: Your Diet Doesn’t Have to be Perfect

Nick Belden, DC
4 min readJan 4, 2022
Photo by Aleksandr Kadykov on Unsplash

Robert had been dealing with IBS (Irritable Bowel Syndrome) and daily diarrhea for almost his entire life. It got so bad, he had to plan out where every possible bathroom would be when going on long car rides. He even had to turn down some vacations because of his digestive woes. He tried eliminating gluten and he got slightly better. He gave up dairy with only marginal improvement. He even tried one of the most tried and true methods for IBS support, the Low FODMAP diet. Still, he experienced little overall improvement.

Then one day, Robert comes in with some good news. “I haven’t had diarrhea in almost 10 days,” he says with such thrill. “What’d you change, ” I asked. “I found this app that does hypnotherapy specifically for IBS, and after just one session my diarrhea went away” (the app is called Nerva). Robert was still paying close attention to his diet, but he stopped being as restrictive as he’d tried to be countless times in the past. He now enjoyed a few drinks on the weekends and could plan vacations without searching “bathrooms near me” on Google.

IBS is often just as psychological as it is physiological. People say “gut-brain” all the time while neglecting the idea that brain-gut even exists. Robert’s story is the billboard for this. But Robert’s story isn’t alone, since then I’ve encountered many people who struggle to follow their diet “perfectly, ” when they didn’t need to in the first place. They just needed to address their stress or incorporate a mindfulness practice. It’s about time the American “diet” culture got flipped on its head.

What is a Diet?

A “diet” is just the food and drink that you consume. The definition of diet according to Webster’s is, “food and drink regularly provided or consumed.” It does not say “the meal plan you MUST stick to, the way of eating that needs to be followed precisely, these foods are off-limits to eat in your diet.”

I’m not ignorant to the fact that some people have an “all or nothing” mentality to dieting and life in general. No cookies or 3 sleeves. No beer or the whole 12 pack. No donuts or the baker’s dozen. It’s as if they think life is binary, yes or no, 0s and 1s. When in my view, life exists on a gray continuum. The continuum, however, tends to be less exciting than the extremists’ perspectives.

Those in the paleo and autoimmune community prescribe to the idea that even one minuscule bite of gluten or dairy will destroy your brain (If you have Celiac, or any other wheat or dairy allergy, different story). Or “anti-sugar” people who think the slightest application of BBQ sauce to your meal will give you diabetes. These extremist views sell well on the internet, create catchy titles, and try to lure you into subscribing (and ultimately purchasing) to their way of eating. But they’re missing the point. The people saying (and selling) these things are likely the same people who would get a week-long skin reaction from having one donut.

I also understand that for many people, their diet still needs to be tweaked to some degree, you can’t meditate away the side effects of eating 5,000 calories/day in donuts.

Changing Paradigms

The phrase “everything in moderation, including moderation” has almost been thrown around so much that it loses its ultimate value. It’s kind of like when everyone has been talking about this one stock to buy, the value is likely gone. But, unlike some overvalued stocks, the moderation phrase should always command value, especially in nutrition.

When I first started my journey to becoming a physician, I believed your diet had to be 100% on plan to get better. If you ever had a donut, black beans, or peanut butter your gut would be ruined for weeks. There are those with food “sensitivities” who admit to days-long reactions (skin, bloating, fatigue) after consuming even one bite of ice cream, but those are the extreme.

My experience with Robert taught me so much as a gut-focused practitioner, and I am forever grateful he was willing to share what worked for him. After that encounter, I finally started telling patients “you don’t have to perfectly follow Low FODMAP, paleo, or Whole30 to get better.” Maybe for you, your “perfect” diet is the one you try to stick to 80% of the time. So if you eat 3x/day, 7 days/week, that’s 17 meals that are meeting certain criteria. That’s still better than most people!

Even though you don’t have to be “perfect,” dietary habits are still at the core of IBS management. Pairing a diet with the aforementioned mindfulness, and targeted, personalized supplementation (probiotics, enzymes, leaky gut products, herbal antimicrobials) packs quite a punch for supporting your digestive woes. If you find yourself struggling to determine what a “perfect” diet looks and feel like you’re spinning your wheels trying to improve your gut health, check out The HIVE Natural Health Center, where our practitioners understand the nuances of diet and IBS.

As always, Trust in Your Gut.

Disclaimer: The contents of this article are for educational purposes only, and are not intended to diagnose or treat any condition. Do not apply any of the information in this article without first speaking with your doctor.

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Nick Belden, DC

I help health conscious people regain trust in their gut and hormones. Functional Medicine Practitioner. Insta: @dr.nickbelden. Podcast Host: Gut Check Radio