IBS and Perimenopause 7 Important Ways a Dietitian Can Help

Gut Health and Menopause

Today, we are going to talk about gut health in women as we age, and I am going to focus on IBS and perimenopause.

Are you a woman in middle age and find that your gut is crying out for help? I have been working with gut health for over 13 years, and I am also a woman in midlife who has IBS. In addition to my training as a dietitian specializing in GI conditions in women, I offer real-life experience with not only what works for me but also hundreds of clients that I have worked with to help!

Do you know the best foods for digestive nutrition and how to heal your gut naturally and help your gut age gracefully? What about how other lifestyle factors impact GI health?

Today, more research shows how our health habits affect our digestive wellness! And how our GI tract affects the rest of our body!

It can be challenging to keep up with all the latest research and separate facts from fiction. There is a lot of old information compared to current science.

How Many People Are Affected by Digestive Nutrition & Gut Health Issues?

About 70 million people are affected by GI health conditions. The impact on our quality of life, productivity, and financial cost to us people and our employers is over 100 billion dollars annually, just in medical expenses alone. GI issues affect about 75% of women.

This does not include time lost from work because of illness, which would make these conditions much more costly. I don’t want to use all my vacation days not feeling well. And it does not include quality-of-life issues.

Digestive health conditions include irritable bowel syndrome (IBS), gastric esophageal reflux disease (GERD), diverticulosis, celiac disease, inflammatory bowel disease or IBD (which includes both Crohn’s and ulcerative colitis), small intestine bacterial overgrowth (SIBO) These are the most common ones, and there are other less sommon ones.

It is estimated that about 10-15% of the population has IBS, and out of the people who have IBS, about 60-65 % them are women. And as we get older, our GI tract gets older with us, and this may create a variety of challenges, which we will discuss in this post. Here is a little more about IBS in this article posted from the Mayo Clinic.

Why Your Gut Changes in Middle Age

Middle-aged women notice gut changes as we get older. Here are some of the possible reasons that this happens:

• Our aging gut includes slowing of digestion as it may take longer for the food to go through our GI tract, reduced digestive enzyme production, and a potential reduction in stomach acid.
  
  The slowing of our digestion may lead to increased constipation, a higher likelihood that food could get caught in diverticula, and gastroparesis, which is the reduced motility to move food down the GI tract. As we get older, our muscle mass decreases, so we face metabolism shifts, which can also affect gut health.
  
• Hormonal shifts: Hormone changes that contribute to both menopause symptoms and perimenopause symptoms that are partially due to the decline in progesterone and estrogen and their effects on gut motility, inflammation and gut health, and the gut microbiome (see more about microbiome changes below). This article has more information on hormones and the changes in the microbiome.
  
  The hormone changes in our body also affect the smooth muscles that move the food down the digestive tract, which affect gut motility.
  
• Gut Microbiome Changes: Gut bacterial composition is associated with decreased diversity as we age, which happens not only with hormonal changes but also with our lifestyle habits (see below for more.)
  
• Lifestyle habits can negatively impact healthy gut bacteria and GI Health. These include eating too many ultraprocessed foods and decreased movement of our bodies. Stress and lack of sleep can also play a role in a healthy gut.
  
• As our gut health decreases, it can also affect our gut-brain axis, which is the communication between these two parts of our bodies. So, decreased gut health can lead to decreased brain health.

Knowing these changes that take place can help us create a plan to work through these to maintain digestive health with a personalized nutrition plan for women, no matter what our age.

Common GI Issues in Middle-Aged Women

Here are some common GI conditions and their symptoms:

• Chronic Constipation in Middle Age: Often a primary complaint due to slower motility and hormonal changes. However, some constipation can be due to a specific GI condition. This can lead to irregular bowel movements and digestive discomfort.

• Bloating & Gas: May have an increase in prevalence. Bloating in menopause can potentially be linked to dysbiosis, which is an imbalance of gut bacteria, SIBO symptoms in women, or slower transit. The bloating and gas can lead to abdominal pain.
  
• Heartburn/GERD: Can worsen, or perimenopause heartburn may appear for the first time due to aging or other underlying health conditions. Untreated acid reflux can lead to serious health consequences if not managed adequately.
  
• IBS Flare-ups or New Onset IBS: Hormonal fluctuations can trigger or exacerbate IBS symptoms.
  
• Increased food sensitivities: Some women over 40 report new or worsening reactions, and some of these new food intolerances may lead to increased gut permeability.

Diet and Lifestyle Strategies for a Happier Gut

Here are some foods to improve your gut health and lessen the effects of digestive issues, and help promote other essential areas of women’s health and nutrition.

Remember that what works for one person may not work for all, which makes the need for individualized nutrition guidance from a registered dietitian essential.

These include gut-friendly foods like prebiotics from plant food, along with probiotic foods are important things to include. Click on the links below to find out more about these and more!

• Fermented Foods Rich in Probiotics
  
• Diversity of Fruits and Vegetables Rich in Prebiotics Plant-based for gut health provides the nutrients that our gut needs.
  
• Diet Rich in Fiber (getting a variety of whole grains). Having a fiber focus using a variety of diverse plant fibers, which include both soluble and insoluble, is key to bowel regularity and microbiome health. It is important to gradually increase fiber by a few grams a day so your body can get used to it.
  
  Dietary intake provides more benefits than taking a fiber supplement alone.
  
• Healthy Fats Rich in Omega-3 Fatty Acids. These and other healthy fats help promote gut health.
  
• Learning If You Have Food Intolerances & How to Cope With Them
  
• Getting Good Gut Health Nutrients like polyphenols
  
• Limiting ultraprocessed foods and foods that contain food preservatives.
  
• Mindful Eating: Slow down, chew thoroughly, reduce stress around meals.
  
• Hydration: hydration for gut health is crucial for digestion and fiber’s effectiveness.

Other Lifestyle Factors Important for Gut Health

• Stress Management: The gut-brain connection is vital to our overall gut health.
  
• Movement: Gentle, regular exercise supports gut motility.

Why Choose a Dietitian with Specialized GI Training for Your Midlife Gut?

In a previous post, I mentioned some of the specialized training to look for when choosing a registered dietitian nutritionist when working on improving your gut health. It is important to consider the training and education, especially for complex digestive issues.

If you are a woman in middle age, it is also important to work with someone who specializes in working with women as we age and someone who understands how hormones impact our gut health. A registered dietitian nutritionist who has been specially trained in gut health can work with you and your gastroenterologist to differentiate between common age-related changes and more serious underlying conditions.

Unfortunately, when people pick someone without the proper training in digestive wellness, especially those who order tests that may not show what they say they will or sell expensive supplements that may do more harm than good, people may end up paying for these and not get the results that they hope to receive.

Some of the trainings to look for include Monash FODMAP trained dietitians in the low FODMAP diet, SIBO advanced coursework and expertise, Inflammatory Bowel Disease training and management for women which the University of Michigan’s annual training for GI nutritionist called Food: The Main Course to Digestive Health, post-menopausal gut health, dietitian certifications, specialized women’s health dietitians, such as the new GI credential with the Academy of Nutrition and Dietetics.

Taking the Next Step Towards Digestive Wellness

I hope that this post on IBS and perimenopause, along with information on other GI issues, has been helpful. And that you found some gut health solutions on how our middle-aged gut changes are beneficial. In addition, some of the nutrition and other lifestyle changes may allow you to improve your gut, but if you need additional assistance finding a gastroenterologist who specializes in GI health, along with a GI dietitian who works with women’s gut health support may be critical to help you find the root cause to your issues.

7 Ways a GI Dietitian Can Help You Improve Your Gut Health

1. Teach you more about soluble and insoluble fiber and how much you need for your health condition.
   
2. Discuss with you the nutrients that are important for your GI issues.
   
3. Teach and help you utilize mindful eating.
   
4. Help you plan meals rich in fruits, vegetables, and other plant-based foods rich in prebiotics to help you promote healthy gut bacteria.
   
5. Guide you on fermented food choices that are rich in natural probiotics for your health.
   
6. Encourage you to maintain your healthy gut changes in middle age and stay motivated.
   
7. Communicate with your doctor if needed.

I have provided you with resources to find a highly qualified registered dietitian who is trained in these areas that you need, not just in this post, but in the previous post above on some training for GI dietitians where I also provided some questions that you may want to ask to see if they can help you on your digestive health journey to help you with your long-term gut health.

I hope that whoever you schedule your consultation with to provide you with the holistic wellness that you need. In the upcoming weeks, I will be sharing information on an online GI course for middle-aged women.

In this course, a few of the things that we will focus on will include more detail on digestive issues in middle-aged women, hormonal imbalances, and their role in digestive wellness, gut microbiome support, bloating relief suggestions, and constipation remedies.

More details will be coming soon. Meanwhile, you may like to sign up for my 5-day free class to fight inflammation, which you can sign up for on my home page or any blog post. And being on that last, you will hear when the upcoming GI course with the emphasis on plant-based eating and women’s health is up and ready!

I want to leave you with one last thought:

“As we journey through life, may our digestive wellness be the quiet strength that underpins a remarkable quality of life, allowing us to age not just beautifully, but gracefully.