Regaining Your Appetite With IBS: Step-By-Step Action Plan.

This is not just some random tips, it is a comprehensive guide.:

• I will take you in a simple step-by-step approach to identify the causes and treat lost appetite with IBS.
• Applying this guide will help you regain the desire for food again.
• All in one place, you won’t need any other piece of information.

NOTE: this is not a substitute for professional help by your doctor or psychologist.

Step #1: Evaluate yourself for Anxiety, Mental wellbeing.

Regarding loss of appetite with IBS, the Mind-Gut axis is the NO. 1 mechanism causing anorexia. the most frequent cause of loss of appetite with IBS is due to psychological factors such as:

• Continous stress, and anxiety, including health anxiety
• Poor coping mechanisms with stressful situations.
• A low threshold to pain (including IBS-related Abdominal Pain).
• depression, Post-traumatic stress disorders.

How to evaluate your psychological well-being and the need for Help?

You, as an IBS sufferer, have a 40-50% chance to have anxiety or any other mental health problem.

So, Losing appetite may be just one of the manifestations of the abnormal “Gut-Brain connection”.

Anxiety is can be easily evaluated by a simple questionnaire called the GAD-7 score. but it is not only about anxiety. as many other psychological abnormalities can contribute.

So, to make it simple for you, this simple test provided by Online-Therapy.com screening for ANY Mental health issues is a better fit than taking an anxiety-only test.

Action step: take this 12-point test to evaluate for the role of your stress, anxiety in IBS, and anorexia.

if your results lie in the red or the yellow zone, your anorexia is likely related to psychological factors.

How to Fix your Mind-Gut Axis:

The next step after assessing your self for anxiety is to fix it.

Actually, there is too many treatments and actions you can take. But for me, the approach of mentioning every single option to cope with your anxiety is too overwhelming.

And the “Too-many” options can lead to you not taking any action.

So, I will narrow this to the two or 3 most effective approaches to deal with your mental health issues causing IBS and anorexia:

• The first approach (Easiest to implement): Gut-directed Hypnotherapy for anorexia.
• The second approach (the most effective): Cognitive Behavioral Therapy.
• Third approach: Anti-anxiety Medications (prescribed by your doctor).

How these strategies will help you with your IBS and loss of appetite:

• Stress, anxiety, and the lack of mental well-being may be the most impactful factor on your gut health. (FODMAPs are only part of the story)!
• Controlling and reversing your anxiety, stress, or depression will help you Beat both IBS and Anxiety.
• It is especially important if your IBS and anorexia are notably related to stress rather than food.
• It can help you completely reverse to normal life again, eat without pain.
• will make you more psychologically strong, able to cope with stress.
• It will bring your self-satisfaction back again.
• Becoming less vulnerable to the vague feeling of fear, worry, and sadness.
• And the net result is being able to eat food again and control your weight and physical health.

I Know..

I know that you are overwhelmed by the conflicting Advice about IBS, ranging from food-based advice, psychological treatments, medications, Yoga, supplements… etc.

But you have to try and figure out what works for YOU!

Being both a gastroenterologist and IBS sufferer, I found “Exploring and trying differen treatment approaches is the best way to control your IBS” and related issues such as loss of appetite.

Action steps:

• First, try an evidence-based Hypnotherapy audio program, give it 4 to 6 weeks try, if it doesn’t work for you, proceed to the next approach.
• Second, Try Cognitive Behavioral Therapy for IBS (One of the most effective and most underrated therapy for IBS). and the beauty of CBT is it can be performed completely online without wasting your time with local therapists.
• Third, if the above approaches fail, ask your doctor about anti-anxiety medications that can help you with your IBS and lost appetite.

Our recommended tools to start with:

1- Best Hypnotherapy for IBS and lost appetite: This affordable, industry-leading hypnosis company (hypnosis) has two great programs you can start with

• Beat Anorexia Hypnosis.
• Living with IBS Hypnosis.

And the good news is that they have 60 days money-back guarantee if it doesn’t work for you.

Another popular programs

2- Best CBT Online service:

My recommended online CBT service is online-therapy.com, I think it is the most reliable service with well-known faces behind this company.
Also, you will enjoy a full toolbox including worksheets, yoga classes, and more.

Step #2: Evaluate yourself for coexisting conditions causing anorexia.

As I discussed in part one of this series, loss of appetite with IBS may not be a result of IBS.

Lost appetite may be a result of co-existing diseases or conditions that commonly cause anorexia.

The associated condition may be:

A. Acute (for few days or few weeks): usually caused by infections

• Recent Gut infection, such as Viral gastroenteritis,  symptoms usually include recent diarrhea, vomiting, nausea, and maybe low-grade fever. infection can be viral, bacterial, parasitic, or protozoal. learn more HERE.
• Recent Infections elsewhere: any infection elsewhere outside your gut can also lead to anorexia, nausea, and maybe vomiting. symptoms vary according to the type of infection you have. common infections include flu, cold, urinary tract infection, sinusitis… etc.
• Any painful condition: pain can lead to lost appetite and nausea. common acute painful conditions include headache, migraine, ankle sprains, etc…

B. Chronic (usually more than 4 weeks):

• Co-existing Function gut disease (very common association), most commonly Functional dyspepsia (FD),  see part 1 of this series to learn more.
• Co-existing Gastritis, GERD, or Peptic ulcer disease: the major symptoms is epigastric pain or heartburn associated with meals.
• Co-existing chronic diseases: such as diabetes mellitus (commonly cause a condition called functional dyspepsia), Gallbladder diseases, chronic infections such as HIV, chronic liver, or kidney diseases.  LEARN MORE HERE.
• Co-existing malignant diseases (cancers).

Step #3: Review your list of medications that may cause anorexia.

Many medications (including some IBS medications) can cause loss of appetite with your IBS!

If you’re currently taking regular medications for IBS or any other conditions, please review the list with your doctor to figure out if one of them is the cause of anorexia.

Some IBS medications May cause loss of appetite, for example:

• Dicyclomine (Bentyl).
• Hyoscomine (Anaspaz, Hyosyne)
• Linaclotide(Linzess).
• Lubiprostone (Amitiza).
• Librax.
• And others.

Some other medications can cause anorexia (loss of appetite)

• Some antibiotics (such as Metronidazole).
• Certain sedatives and antidepressants such as Fluoxetine.
• Chemotherapy
• Some asthma medications such as Salbutamol and Theophylline.
• Some Heart medications such as Amiodarone, Acetazolamide.
• Some anti-epileptic medications such as Topiramate.

What to do if you’re taking one of the above-listed drugs?

Don’t stop any medication prescribed by your doctor whether it is for IBS or for other diseases. This is because:

• Taking one of the above-mentioned medications doesn’t necessarily mean it is the cause of your anorexia.
• Stopping IBS medications can worsen your IBS. Also, stopping prescribed medications for any condition or disease can cause harm.
• Always work with your care provider to identify and eliminate the offending medication if present.

Step #4: Check for any warning signs.

Before you continue to apply the below home remedies and strategies, you should make sure there is no worrisome feature with your anxiety:

If you experience any of the below symptoms or signs, consult your doctor immediately:

• Signs of an “Eating Disorder”: such as Anorexia Nervosa and “Avoidant/Restrictive Food Intake Disorder” or (ARFID). very restrictive food intake that can cause profound weight loss and impairment of physical and mental health. learn more HERE.
• Progress weight loss.
• Unexplained Fever.
• Unexplained anemia or manifestation of anemia such as palpitation, dizziness, and shortness of breath.
• Abnormal stool changes such as bloody stool or blackish stool.

Step #5: Control your IBS pain, colics, and diarrhea.

Our brain has a distinct system for Reward-seeking and avoidance behavior. your IBS pain can contribute to the loss of your appetite.

Simply, your brain associates food intake with IBS pain, this will result in anorexia. In severe forms, this behavior can progress to a real eating disorder (ARFID).

So…

The first step to regain your appetite is to control your IBS pain. Limiting your Painful IBS experience can help your brain to accept food again.

And the 3 main lines to work on are:

• Food: by avoiding food triggers, starting a low FODMAP diet plan Download our comprehensive FODMAP guide here.
• Mind: Anxiety and other psychological factors are major contributors to IBS (discussed above).
• Medications & supplements: such as antispasmodics, Anti-diarrheals, Probiotics, etc… 

Learn More on how to control IBS Pain HERE and HERE.

Step #6: Apply these food strategies to regain appetite.

Here the most effective food strategies that help with appetite:

1. Don’t snack between meals: this will help you to become hungry at the time of the next meal.
2. Add Flavors: adding spices, herbs, or other flavorings can encourage you to eat.
3. Socialize while you eat: relaxing and socializing with your beloved ones can greatly improve your appetite.
4. Try eating smaller meals instead of large ones.
5. Try taking your calories in a “liquid meal” such as “Ensure” instant breakfasts or any other meal replacement. it will keep balanced nutrition. BUT remember to ensure it is low in FODMAP. read this article to learn how.
6. Watch your favorite Movie, TV show, or music while eating.

Step #7: Restore your gut microbiome balance!

The living micro-organisms inside your intestine greatly affects your gut health, immunity, and even your appetite.

it is an entire world living inside your digestive system. Recent Research demonstrates its very important role in every aspect of your health. And its relation to your appetite is not an exception.
Wondering How a probiotic can improve your appetite?

This interesting review at oxford academic titled “Microbiota-Gut-Brain Axis: Modulator of Host Metabolism and Appetite” explains it all.

According to this study, Alternation of Mice gut microbiota resulted in abnormal appetite, food taste, and weight alternations.

Moreover, alternations in your gut microbiota are one of the strongest theories of IBS.
So, I recommend a Probiotic trial for one month to all My IBS patients.

Major Potential Benefits for your IBS and Appetite: (ref)

• Can ease Major IBS symptoms such as abdominal pain, diarrhea, bloating.
• Improve your appetite, food taste.
• Optimize your weight, prevent obesity and underweight.
• Improves mood, altered microbiota is strongly related to mental health problems such as anxiety, stress, depression. (Microbiota-Gut-Brain axis).

How to select a Probiotic that works?

The Ideal Probiotic should:

• Contain “Living” and “Active” bacterial cultures, so that you can obtain the benefits.
• Contain Multiple strains: Studies indicate that multiple-strain probiotics are more effective than single-strain probiotics.
• Contain important Gut-specific strains: Lactobacillus and Bifidobacterium.
• Contain at least 1 billion CFU (Colony Forming Unit).
• Allergen-free: the ideal probiotic should be free from lactose, Gluten, GMOs, and other perspectives that can trigger IBS symptoms.
• Take a prebiotic with your Probiotic: To Maximize the effect of Probiotics for loss of appetite and IBS, You should feed this good bacteria. the food for probiotic bacteria is called “prebiotics”.

Taking Prebiotic with your Probiotic boosts its effects and you will obtain better results.

What is the Best Probiotic for IBS and Lost Appetite?
NO ANSWER!
No scientific Probiotic strain/brand works for all IBS sufferers, the best strategy to choose a single probiotic, stick to it for one month, if no improvement, shift to the second. I recommend you experiment with at least 4 types of probiotic before you give up probiotics. Try our specific step-by-step guide approach and recommendations to start with.

If you’re already taking your probiotic, and is doing a good job controlling your IBS, don’t change it.

If you starting from zero, I recommend seed (a prebiotic and probiotic in one capsule, multi-strain, The highest quality I’ve seen)

Step #8: Ensure Normal zinc and thiamine.

Many vitamins and micro-nutrients play an important role appetite. the two most influential minerals and vitamins are zinc and Thiamine (Vit. B1).

This study shows that women who take thiamine supplements have better appetite. Also, Zinc is know to be appetite stimulator (ref).

It is better to take them combined in one capsule instead of taking endless amounts everyday. also, ensure that the capsule doesn’t include any allergen to trigger IBS.

A good option to start with for lost appetite and IBS is this allergen-free multivitamin (AMAZON.COM) which contain both Zinc and Thiamine.

Step #9: Exercise, Exercise, and Exercise.

Being sedentary is the biggest enemy of appetite. if you want to have a long-lasting good appetite, you have to regularly exercise.

Best Actionable exercises you can do:

1. Daily walking: 30-60 minutes.
2. Daily Biking: for at least 30 minutes.
3. swimming.

What exercises to avoid: (may trigger IBS symptoms

1. CrossFit.
2. Running.
3. HIIT (High-Intensity Interval Training)

Step #10: If no improvement, Ask your doctor about anorexia medications.

consult your doctor if:

1. No improvement in your appetite despite applying the above steps.
2. Extreme loss of appetite for longer periods (more than a week), suggesting an “eating disorder”.
3. Progressive and significant weight loss. (suggesting an eating disorder or hidden organic disease such as cancers)
4. The onset of anorexia is associated with the introduction of a new medication (or changing the dose of an old medication).
5. Associated Unexplained fever.
6. Any other associated symptoms that are not typical for your IBS such as blood in the stool, vomiting, irregular or very fast heartbeats, extreme dizziness, or vertigo.