Things We Don’t Talk About at the Table

by | Apr 12, 2017

Ah, poop. If there’s one thing I’ve learned in the last four-plus years of studying nutrition, it’s that Registered Dietitians loooooove to talk about poop.

And why shouldn’t we? It’s the one way to determine how healthy our clients’ foods are, whether they’re getting enough fiber in their diets, if they’re drinking enough water, and how healthy they are in general1. The color and consistency of someone’s bowel movements could help diagnose everything from stomach ulcers to celiac disease to colon cancer.

If you didn’t already know, there is a ginormous amount of evidence that the gut and mind are very much connected, so it makes sense that April is not only Stress Awareness Month, but it’s also IBS Awareness Month. (I could write about and discuss mental health and all facets of gut physiology every day for an entire year and wouldn’t make a dent in the amount of topics that can be covered under these categories.)

Irritable bowel syndrome (IBS) is one of those elusive gastrointestinal conditions that seems to get diagnosed only after other conditions can be ruled out, which can be frustrating for the person with IBS because there are sometimes no physical signs and no specific cause for it. People with IBS usually experience abdominal pain, constipation or diarrhea (IBS can be considered IBS-C with constipation, IBS-D with diarrhea, or IBS-A when alternating with both), and/or bloating, among other things, and may also have some sort of sensitivity to stress and diet. None of these triggers may seem consistent during each flare-up, so it’s important for anyone suffering from the condition to jot down the what, when, where, and how an episode occurs to help recognize if there’s a pattern they can relay to their doctor.

Thankfully, once diagnosed, people with IBS can manage their diet, lifestyle habits, and stress to keep their pain and discomfort under control. Working with a Registered Dietitian Nutritionist (RDN) also helps as we understand how to incorporate a healthy, balanced diet and other treatment guidelines, based on scientific evidence, to manage the condition2. An issue with looking online for self-treatment of IBS is that it can be quite confusing and, because the human body is so magnificent, there is no general rule that applies to anyone suffering with IBS. Instead, it will most likely be a trial-and-error approach in adjusting one’s intake of fiber, carbohydrates, and fat to determine what alleviates or exacerbates the symptoms. The good news is that researchers continue to study nutrition therapy for IBS, so expect to see even more information on this issue in the very near future3.

If you think you might have IBS, please meet with your doctor first and request a referral to a gastroenterologist and a Registered Dietitian Nutritionist. It’s no fun being in pain, but it’s less fun having your condition worsen because you don’t understand what role your diet and lifestyle might play in it.


  1. Greenfield, P. (2014). 7 Things Your Poop Says About You. Prevention website.
  2. Palmer, S. (2009). Soothing the Symptoms of IBS With Diet Therapy, Today’s Dietitian, 11(6), 34.
  3. Gibson, P.R. (2017). The evidence base for efficacy of the low FODMAP diet in irritable bowel syndrome: is it ready for prime time as a first-line therapy? Journal of Gastroenterology and Hepatology. 32(S1), 32-35.


I’m Dina R. D’Alessandro, MS, RDN, CDN. I am a Registered Dietitian Nutritionist based in New York City, and I provide nutrition counseling to women.

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