Zahra Tromsness
Registered Dietitian
Signs that you may have IBS
1min read

Signs that you may have IBS

Experiencing digestive problems and unsure if they are symptoms of IBS?

Watch this video to learn about the signs to look out for that indicate you may have IBS.

#dietitian #IBS #IBSsupport #IBSsymptoms #digestivehealth #digestion #fodmap #lowfodmap #guthealth #nutrition #loveyourgut

Common IBS Symptoms
1min read

Common IBS Symptoms

Are you experiencing symptoms described in this video?

These are signs that you may have Irritable Bowel Syndrome (IBS).

If you have been diagnosed with IBS by a gastroenterologist, please reach out so I can help you find relief from your symptoms through your lifestyle and diet.

#dietitian #ibsdietitian #IBS #IBSsymptoms #IBSdiet #IBSrelief #ibsawareness

Lactose Intolerance 101
4mins read

Lactose Intolerance 101

Lactose Intolerance

Lactose Intolerance is the small intestine’s inability to fully digest lactose, a sugar contained in milk and dairy products. The disorder is a common digestive issue and while typically harmless, its symptoms can be very uncomfortable.

When your body doesn’t have enough of the enzyme lactase, produced in the small intestine, this often results in lactose intolerance. Even low levels of lactase will allow you to digest milk products. But if your levels are too low you become lactose intolerant, leading to symptoms after you eat or drink dairy products. Symptoms often include intestinal bloating and cramps, nausea, flatulence, and diarrhea.


Lactose, the main sugar found in milk and other dairy products, is broken down by the enzyme lactase, which is produced by cells in the inner lining of the small intestine. Lactase separates lactose into two parts, glucose and galactose. These simple sugars then get absorbed into the bloodstream. Without lactase, lactose cannot be digested or absorbed.

If you're lactase deficient, lactose passes into the colon instead of being broken down and absorbed. In the colon, bacteria interact with undigested lactose, producing the signs and symptoms of lactose intolerance.

Lactase levels are high in infants, allowing them to digest milk. However, in some ethnic groups, lactase levels decrease after weaning. These decreased levels result in older children and adults in these ethnic groups being unable to digest lactose. However, most people of Northwest European descent produce lactase into adulthood and are thus able to digest dairy products for life.

Temporary lactose intolerance can develop when the lining of the small intestine is damaged by a disorder, such as an autoimmune disease or intestinal infection. After recovery from these disorders, most people are able to digest lactose again.

Risk factors

Factors that can make you more prone to lactose intolerance include:

  • Premature birth: Babies born prematurely might have lower levels of lactase because the small intestine doesn't develop lactase-producing cells until late in the third trimester.
  • Increasing age: Lactose intolerance typically presents in adulthood. The condition is atypical in babies and young children.
  • Ethnicity: Lactose intolerance is most prevalent in people of American Indian, Asian, Hispanic, and African descent.
  • Diseases affecting the small intestine: Lactose intolerance can present after intestinal issues such as bacterial overgrowth, celiac disease and Crohn's disease.
  • Certain cancer treatments: If you've had surgery, radiation or chemotherapy for cancer in your GI or you have intestinal complications from these treatments, your risk of developing lactose intolerance increases.


High concentration of undigested lactose draws fluid into the small intestine, causing diarrhea. The lactose then moves into the colon, where it is fermented by bacteria, producing gases that cause bloating, stomach cramps and flatulence. Additional intolerance symptoms can involve nausea and occasionally vomiting.

An adult may experience bloating and cramps, nausea, flatulence, rumbling or burbling sounds in the bowel (borborygmi), diarrhea and an urgent sensation of a bowel movement. Symptoms usually begin between 30 minutes and 2 hours after you have consumed food containing lactose.

Sometimes, severe diarrhea prevents proper absorption of nutrients because they are eliminated from the body too rapidly. However, loose bowel movements that result from lactose intolerance due to insufficient amount of lactase are typically mild.

Lactose intolerance affecting the production of lactase that occurs after an illness, injury or surgery involving your small intestine can be more severe.


A diagnosis of lactose intolerance is made in consultation with your dietitian or physician, recognizing that your symptoms appear after you have ingested dairy products.

If a 3- to 4-week trial period of a dairy free diet clears up your symptoms, and symptoms return again after reintroducing dairy products into your diet, the diagnosis is confirmed.

Specific tests are necessary in rare cases, but in some people, diagnosis can be confirmed with a hydrogen breath test or lactose tolerance test.

To learn about dietary management of lactose intolerance click here.

Bloating 101
4mins read

Bloating 101


IBS affects one in seven people and is often accompanied by gas, bloating, pain, constipation, or diarrhea. Many people are uncomfortable talking about their digestive challenges, but this is a very important conversation to have with your dietitian.

So, let’s dive into some pointers to help you manage bloating.

What is Bloating?

Abdominal distention or "feeling bloated" is a very common symptom most people have experienced at some point in their lives. Bloating occurs when the gastrointestinal (GI) tract is filled with air or gas. When you are bloated, your stomach feels tight and full as if you’ve eaten a big meal.


Common symptoms of bloating include excessive gas, discomfort, and even pain, in your stomach. You may also experience burping and flatulence frequently or have intestinal rumbling and gurgling.


The most common triggers are often associated with food and eating, and can include indigestion, constipation, or excess gas building up in the stomach and intestines. Food intolerances or allergies, eating too fast, overeating, excessive alcohol consumption, and nutrient deficiencies can also cause bloating.

Other common causes of bloating include smoking, pregnancy, menstruation and/or PMS (premenstrual syndrome), and drugs that aggravate the stomach such as ibuprofen.

The following health conditions may also cause bloating:

  • SIBO (small intestinal bacterial overgrowth)
  • GERD (gastroesophageal reflux disease)
  • IBS (irritable bowel syndrome)
  • Celiac disease
  • IBD (inflammatory bowel disease)
  • Gastroparesis; bacterial or viral infection
  • Endometriosis
  • Diverticulitis
  • PID (Pelvic inflammatory disease)
  • liver disease
  • Gallstones
  • Hernia
  • Diabetes
  • Kidney failure
  • Anxiety or depression

When to see a doctor

Although rare, bloating could be a sign of something more serious. Contact your doctor if you have excessive or persistent bloating and gas that is accompanied by any of these symptoms:

  • Blood in your stool
  • Diarrhea
  • Noticeable weight loss
  • Severe abdominal pain
  • Fever
  • Nausea
  • Feeling faint or passing out
  • Vomiting lasts longer than 24 hours
  • Heartburn that is getting worse
  • Inability to eat or drink
  • Chest pain
  • Heart palpitation
  • Shortness of breath
  • Vaginal bleeding (between your periods, or if you are postmenopausal)

Foods that may cause bloating

Generally speaking, high fibre foods can cause bloating particularly in those who do not eat them regularly. 

FODMAPs also commonly contribute to bloating. FODMAPs are specific carbohydrates present in a variety of fruits and vegetables as well as wheat and milk. These carbs are not well absorbed in the small intestine and are then rapidly fermented by bacteria in the colon. This causes a host of intestinal issues in people with sensitive guts.

Groups of FODMAPs and food examples in each group include:

  • Oligosaccharides, found in onions, garlic, legumes, beans and wheat
  • Disaccharides, including lactose in milk, yogurt and ice cream
  • Monosaccharides, such as fructose found in honey, apples and pears
  • Polyols or sugar alcohols found in nectarines, plums, apricots, cauliflower, and also chewing gums, candies and artificial sweeteners.

Other foods that can cause bloating may include:

  • Fatty or greasy foods (fast food)
  • Soda/pop and carbonated beverages
  • Salty foods (high sodium) such as processed foods, canned soups, and frozen entrees.

Following a low FODMAP diet can be an effective way to decrease bloating. In this diet you restrict FODMAPs that are fermented by gut bacteria. The fermentation process causes gas to be released and distension of the gut that leads to bloating.

Work with a Specialist Dietitian

If you want to try out a low-FODMAP diet, it's best to consult a dietitian that specializes in that diet. In this new age of information, we are bombarded with LOADS of content and support services available. However, too much information can be overwhelming and just cause confusion. Remember that the low FODMAP diet is strictly for short term use. In addition, it's critical to ensure you're getting enough nutrients since you'll be avoiding or reducing important food groups. So instead of stressing over what to eat wondering when your symptoms will flare up next, talk to a specialist dietitian trained in IBS management.

Understanding FODMAPS
3mins read

Understanding FODMAPS


Treatment of IBS differs from person to person. For some people, dietary changes can go a long way in helping ease symptoms. What you eat and how you eat can affect your symptoms. While it may not be possible to completely prevent IBS symptoms, you may find that certain foods are triggers. If particular foods or types of stress appear to bring on the problem, avoid them if possible. To help identify which foods cause your symptoms, I suggest keeping a food diary and working with an IBS expert. Because the symptoms of IBS vary, approaches to dietary modifications need to be customized to the unique needs of an individual with the help and supervision of a certified IBS dietitian.

Up to 75% of people find relief from IBS symptoms by restricting their intake of foods that are high in certain carbohydrates collectively called FODMAPs, or, in other words, by following a Low FODMAP diet. The Low FODMAP diet is an evidence-based diet and research has demonstrated that it is one of the most effective ways of managing IBS.

What Does FODMAP Stand For?

FODMAP is an abbreviation for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols.

FODMAPs are a group of short-chain carbohydrates that are poorly digested and absorbed in the small intestine. These carbs then travel into the large intestine where they are fermented by the resident bacteria. The production of gas by these bacteria combined with the hypersensitivity in people with IBS is a major contributor to symptoms. Following the Low FODMAP approach does not cure IBS, but it allows for the successful management of symptoms for many patients.

What Are FODMAP Foods?

Examples of foods that contain FODMAPs:

What is a Low FODMAP Diet?

A Low FODMAP diet involves three phases:

  • Elimination: In this phase, which can last from 3–8 weeks depending on your response to the diet, you eliminate all high FODMAP foods from your diet.
  • Reintroduction: Once the elimination phase is over and your symptoms have returned to baseline or are significantly improved, you can start reintroducing FODMAP foods into your diet one at a time, about every 3–7 days. This can help you identify which foods trigger symptoms.
  • Personalization: The Personalization phase involves returning to a regular diet as far as possible, limiting only the FODMAP foods that cause IBS symptoms. Eventually, you may be able to incorporate all or most FODMAPs back into your diet without symptoms.

FODMAPs are in many foods and deciding what is "safe" to eat on a Low FODMAP diet can be a difficult task. Getting help from an expert can help you with this journey. Also, it is important to note that Low FODMAP diets are restrictive and should be temporary. Removing FODMAPs from your diet long-term can increase your risk of nutritional deficiencies. This is why a certified IBS dietitian’s supervision is important. We are here to ensure the safe implementation of the diet and to avoid nutrient deficiency.

A word of caution: If you suspect that you may have IBS, consult your doctor first. Some other gastrointestinal diseases or medical conditions such as bowel cancer, Celiac disease, inflammatory bowel disease or endometriosis cause symptoms that are similar to IBS. Your doctor may refer you to a gastroenterologist for further investigation before deciding if the Low FODMAP diet is right for you.

Understanding IBS
3mins read

Understanding IBS

What is Irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic, often debilitating, functional gastrointestinal (GI) disorder affecting as many as 13-20% of Canadians at any given time. The lifetime risk for a Canadian to develop IBS is 30%. IBS is the most common disorder diagnosed by gastroenterologists and is a common reason why many people visit their primary care physician. IBS can begin in childhood, adolescence, or adulthood, and can resolve unexpectedly for periods throughout an individual’s lifespan, recurring at any age.

IBS is generally classified as a functional disorder because it impairs the functioning of the body’s normal activities, such as the movement of the intestines, the sensitivity of the nerves of the intestines, or the way in which the brain controls some of these functions.


What Causes IBS?

While the exact cause of IBS is not clear, we do know that IBS is a multifactorial disorder that likely involves an interaction between the GI tract, bacteria in the gut, the nervous system, and external factors, such as stress.


Possible causes include:

  • Emotional factors such as stress, anxiety, depression, and fear
  • Dietary issues such as food allergies or sensitivities, or poor eating patterns
  • Drugs such as laxatives and antibiotics
  • Bile acid malabsorption
  • Lack of physical activity
  • Chronic alcohol abuse
  • Abnormalities in GI secretions and/or digestive muscle contractions
  • Acute infection or inflammation of the intestine, such as traveller’s diarrhea
  • Neurological hyper-sensitivity within the GI nerves


What Are IBS signs and Symptoms?

Individuals might have different combinations of symptoms, with one symptom dominating while the other digestive symptoms may occur randomly and unpredictably. These unpredictable bowel experiences can lead to a high degree of anxiety for the IBS patient and can significantly decrease a person’s quality of life.

In many people with IBS, the digestive tract is especially sensitive to many stimuli. People may experience pain caused by intestinal gas or contractions that other people do not find distressing. Pain manifests in many ways with IBS. The abdominal pain related to or relieved by having a bowel movement can be ongoing or episodic, present sharply and resolve rapidly, occur occasionally or frequently, and move from one location in the bowel to another very quickly. Digestive pain often occurs following a meal and can last for hours. Those who have IBS tend to have a quicker and more intense reaction to digestive tract pain stimuli than those who do not have IBS.

Other common symptoms of IBS include change in stool frequency or consistency (such as constipation and diarrhea), abdominal distention, the sensation of incomplete emptying after defecation, cramping, bloating, belching, flatulence, nausea, headaches, fatigue, difficulty sleeping, depression, anxiety, muscle aches, and difficulty concentrating.


IBS has different sub-groups, which are associated with stool consistency.

  • IBS-D is when the digestive system contracts quickly, transiting products of digestion rapidly through the digestive tract, resulting in diarrhea.
  • IBS-C is when the digestive system contracts slowly, delaying transit time for products of digestion, resulting in constipation.
  • IBS-M is when the transit time throughout the digestive tract fluctuates, causing patients to experience a mix of both diarrhea and constipation, often alternating between the two.
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