I’m a nutritional therapist. I meet a lot of people with gut issues – chronic loose stools, constipation, wind, bloating, heartburn, unexplained stabbing pains in the abdomen and stomach. Within five minutes of meeting we can be having a very open and detailed conversation about poo consistency, frequency, smell, continence (do you make it to the loo on time?).
There is ALWAYS a box of tissues in my office. Talking about this can be very upsetting. Often this is the first time many people have had a chance to share in graphic and painful detail what has been happening to them. Many have suffered for years in silence and feel great shame and pain. Their guts they say are “ruling my life”. Some can’t share a bed or office with other people. Some have shut down entire social lives because of their symptoms. Although they may have seen their doctor many times, the traditional 10-minute appointment hasn’t given them the space to talk about their guts openly. Many have been diagnosed with irritable bowel syndrome (IBS), a label bestowed when doctors can’t find anything visibly wrong with the gut on a colonoscopy, a diagnosis which leaves many in limbo and frustrated. They are often told to “just live with it”.
So I was intrigued when I recently met Jane Haynes, a London-based psychotherapist and author of recently-published book - If I Chance to Talk a Little Wild – to discover a whole chapter entitled Gutted: The Loneliness of Pain where she writes graphically about the taboo subject of the bowels, and her own decades living with IBS.
Jane has lived through the decades of different approaches to IBS, the special diets, the raw diet, the cooked food diet, the one where the tomato “is akin to poison” while in another it is touted as the best thing. She points out that the latest hypotheses suggesting that IBS is connected with brain, spine, nervous system, and gut microbiome (our gut bacteria) balance. And this is where it gets really interesting to hear about IBS from a psychotherapist.
Jane describes the pain she lives in chronic company with as bowel contractions on the pain score level of child birth. She talks of the bowels being the most demeaned part of the body surrounded by shame and taboo. With the gut-brain connection becoming more recognised - there is a vagus nerve connecting the two - it is now becoming more accepted that early trauma can be a part of the picture. This is the category Jane identifies with.
She recounts her fear of colonoscopy and details the experience of having one after procrastinating for 10 years (camera up anus, paper pants and all that). In the end, she finds it wasn’t as bad as all that. Though the diagnosis was that all looked OK, so she was back at the IBS diagnosis.
In my experience of working with real people (as opposed to lab rats!) IBS is triggered by a whole raft of issues. You need to work through the whole list, as several factors are at play, and a different set for each individual. I often find the gut has a tipping point. It may function OK with one issue, but when several come together it’s like the perfect storm. The list includes breadth of diet, speed of eating, timing of eating, the type of birth you had, if you were breastfed, response to stressors in your life, how many exposures to antibiotics you have had, if you have a latent parasite or yeast infection, individual food intolerances, heavy drinking (many people are in denial on this one). This is the short list – every case is different. The most difficult cases are the ones where you work through all these, including using stool testing for clues, and still the symptoms persist. This is the point where I start to wonder if your gut is reacting to unresolved childhood trauma and I would recommend working with a talking therapist
The more people who are prepared to talk about IBS and the link with trauma, as one of the triggers, the better – and Jane does a daring and welcome job of this.
If I Chance to Talk a Little Wild, A Memoir of Self and Other by Jane Haynes, published by Quartet Books.