Why It's Not Just About Eliminating Foods: The Truth About IBS and Nutrition
If you have irritable bowel syndrome (IBS) and your doctor has handed you a list of foods to avoid, you might feel like overhauling your diet is the only step forward. You might blame yourself for not getting it right, despite the ways you are already maintaining a clean diet.
You might even already be avoiding trigger foods, but wondering why you’re still in pain.
The truth is, simply cutting out foods won’t magically fix IBS. While certain foods can trigger symptoms, IBS is a complex digestive disorder that requires more than just a restrictive diet. Unfortunately, what I often see is that many people with IBS are given oversimplified dietary advice because their condition isn't easily understood.
That's why working with dietitians who specialize in gut health is one of the best things you can do in your search for guidance with this condition. These practitioners welcome the complexity of your body and want to understand what's happening for you as an individual, not just hand you a generic elimination list with no follow-up instructions.
The Problem with Just Cutting Out Foods
When you search online for solutions to improving gut health, you'll be bombarded with lists of what NOT to eat. But here's what's really wild: proper IBS treatment often involves expanding your diet, not just restricting it.
In podcast episode 84, I talked with Samina Qureshi, a registered dietitian specializing in IBS management. She shared a fascinating point: people who try the low FODMAP diet alone usually fail. Not because they lack willpower, but because it's overwhelming and there's so much nuance beyond just avoiding certain carbohydrates.
“Your symptoms might be affected by erratic meal timing, stress while eating, not eating enough overall, or dozens of other factors that have nothing to do with specific food triggers.”
Here's something your doctor probably never told you: the elimination phase of low FODMAP should only last 2-4 weeks. If you're not seeing improvement by week two, you should stop.
Yet Samina shares that she’s met people who've been on these ultra-restrictive diets for years, literally starving their gut bacteria of the fiber-rich foods that actually support a healthy microbiome.
The Dangerous Cycle of Restriction
The wellness world loves telling us what to cut out, but offers almost nothing about how to add foods back. As a result, people end up afraid of most foods and limited to just a handful of "safe" options.
What's particularly concerning is how restriction actually makes gut issues worse. When you don't eat enough, your digestive motility slows down.
This leads to constipation, which then causes bloating, reflux, gas, and pain. Stay constipated long enough, and ironically, it can lead to bouts of diarrhea too.
Adding more restriction to an already stressed digestive system? That's like throwing gasoline on a fire.
A Completely Different Approach
Instead of jumping straight to cutting foods out, gut health actually starts with making sure you're eating enough, consistently.
Here's what that looks like:
Eating every 3-4 hours throughout the day.
Training your body to recognize that food is coming regularly so it can relax.
Only after establishing regular eating patterns, looking at specific symptom triggers.
Making targeted swaps rather than broad eliminations.
Gradually introducing foods that help form well-structured stools.
If this sounds totally different from what you've tried before, you're not alone. Most people are shocked to learn that the path to healing often involves adding more foods, not fewer.
The Truth About Trending Food Sensitivity Tests
We want to be really straightforward with you about these – the science doesn't back them up. Especially the IgG antibody tests which are so popular right now.
Research shows these tests often just identify foods you eat regularly, not foods you're actually sensitive to. I've seen people get results saying they're "sensitive" to 40+ foods, many of which they've eaten their whole lives without issues.
In fact, I (Destiny) eliminated vegetables for two years after getting my results from one of these tests. At the time, I had no idea that I was causing more damage than anything else by doing that.
The real question to ask yourself is: "Did I notice problems with this food before I took the test?" If you weren't having issues with avocados before a singular test told you to avoid them, there's likely no reason to cut them out now.
These tests have led so many people down a path of extreme restriction, creating food fear that leads to nutritional deficiencies that then – you guessed it – make gut symptoms even worse. Working with a professional who understands the nuances of your particular medical condition takes the guesswork completely out of your eating needs.
Little-Known Way to Support Your Nervous System: Eat Regularly
When you eat breakfast, even if it's just a protein bar, some milk, or smoothie, you're sending your body a powerful signal: "Food is coming regularly. You're safe."
This creates a profound sense of physical safety that impacts your entire digestive process.
This isn't complicated biohacking – it's meeting your basic human needs. Your body works better when it knows what to expect, especially around food.
And yes, this looks different for everyone. If you're on ADHD medication and struggle with morning appetite, maybe you start with just a few bites or a drink. If you have food fears from past experiences, you work with those gradually.
The point is to start where you are and build consistency.
Breaking Free from All Those Rules
We're surrounded by wellness culture telling us there's an ideal way to eat – whether it's intermittent fasting, carnivore diets, or some other protocol. But we've completely lost touch with figuring out what works for our unique bodies.
I see so many people following restrictive protocols that make them feel worse, while believing if they just push through, they'll eventually feel better. Meanwhile, they're not eating enough calories, not eating consistently, and getting less and less variety.
The truth?
Gut health has much more to do with eating enough food and focusing on variety than it does with eliminating potential triggers.
If you're struggling with IBS or any digestive issues, please know that you don’t have to doubt your experience—it’s real, and you deserve support.
The path forward probably isn't about more restriction. Instead, it's about finding a supportive approach that helps you expand your relationship with food while managing your symptoms.
Finding that balance takes time and often professional support, but it is absolutely possible to enjoy food again while improving your gut health.
Samina is currently accepting virtual clients in her 1:1 IBS Food Freedom Program. This program is right for you if you need to find balance with food and relief from your uncomfortable gut symptoms without a side of diet culture!
Schedule your free discovery call today to see if you’re a good fit to work with Samina.
Download your free guide on 5 Ways To Avoid IBS Flares!
Connect with Samina: Website | Facebook | Instagram | Tiktok
Want to listen to the podcast interview? Click here for Episode 84: The Truth About IBS and Nutrition: Why It's Not Just About Eliminating Foods.
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Episode transcribed with AI and will contain errors that are not representative of the actual word or meaning of the sentence.
Samina Qureshi RDN LD IBS dietitan
Destiny Davis LPC CRC: [00:00:00] The Chronic Illness Therapist podcast is meant to be a place where people with chronic illnesses can come to feel heard, seen, and safe. While listening to mental health therapists and other medical professionals talk about the realities of treating difficult conditions, this might be a new concept for you, one in which you never have to worry about someone inferring that it's all in your head.
We dive deep into the human side of treating complex medical conditions and help you find professionals that leave you feeling hopeful for the future. I hope you love what you learned here, and please consider leaving a review or sharing this podcast with someone you love. This podcast is meant for educational purposes only for specific questions related to your unique circumstances.
Please contact a licensed medical professional in your state of residence.
Samina Qureshi is the founder [00:01:00] and registered dietitian at Wholesome Start, a weight inclusive GI nutrition practice based in Houston, Texas. She specializes in helping people who struggle with irritable bowel syndrome find relief and nourish their bodies without rigid diets, stress, guilt, or shame.
Wonderful, right? Samina respects body diversity and encourages her clients to care for their health in a gentle way that best honors their lifestyle, unique needs, and cultural traditions. Through nutrition coaching, her clients are able to heal their relationship with food, find relief from really uncomfortable gut symptoms, and support long term gut health without the gimmicks.
As you all know, this podcast, I interview other licensed medical professionals because there's so much wild misinformation on the internet about how to be healthy, how to heal chronic illnesses, how to optimize your health, how to blah, blah, blah, blah, blah. There's so much and it gets really confusing.
And while I do think there's a lot to be said about the history of [00:02:00] scientists. licensed professionals, doctors, and the harm that has been done in these fields. We address those in our programs. I know in my program specifically, we talked about things like the Tuskegee experiments. We talked about things that therapists and psychologists and um, scientists have done that have been incredibly disgusting and harmful.
We talk about those things because talking about them is the only way to to make sure that they don't happen again. And so, you know, I've been approached by coaches who want to be interviewed on this podcast. And I even had one that was pretty upset with me and thought I was basically being exclusionary by not letting her on my podcast because she didn't have a licensed.
And the fact of the matter is there are so many podcasts out there that you are more than welcome to listen to that are filled with people talking about things that they don't really truly understand. Um, and so. We do go to school for a long [00:03:00] time and we stay up to date on research and we are Constantly not only the academic texts and the journals and we not only do we stay up to date with that But we are also chronically online just like the rest of you so we see the myths and the miss the misconceptions and the disinformation that's Spread and I feel really passionate about trying to dispel some of these myths because I was really harmed In the course of my own treatments trying to follow these rigid routines that were never going to work for me So I hope that you enjoy this episode with samina.
We are going to do a workshop together eventually a live workshop Um, you know one of the ones that I do monthly and it's going to be really great. And if you are participating in Ramadan this year, definitely check out Samina's profile. She is doing these tips on how to stay healthy and, uh, basically feed your gut the way that you should while fasting in Ramadan.
She [00:04:00] has a free download that you can go to her website and enter your email and it will come right to your inbox. So without further ado, here's our interview. Okay.
Samina Qureshi RDN LD: Hi, my name is Samina Qureshi. I'm a registered dietitian based in Houston, Texas, and I have a private practice called Wholesome Start Nutrition Counseling, where I work with individuals who struggle with GI disorders, specifically IBS.
Find relief without rigid diet, stress, guilt, or shame. So if you're someone who's struggled with a relationship with food from a history of eating disorders or currently struggling with your relationship with food and body image, and you also experience these uncomfortable digestive symptoms, I'm your dietitian.
Destiny Davis LPC CRC: What is the most, rewarding or fascinating part about working with this condition in particular?
Samina Qureshi RDN LD: Yeah, so I think, like, if you type in, like, gut health nutrition on Google, the first thing you're going to get is a bunch [00:05:00] of restrictions on what you cannot eat. And so what I love about working with this population is there are so many opportunities to truly expand your diet.
Be more inclusive with the foods that you're allowing yourself to eat to find relief. It, it really isn't about restriction and helping people get to that aha moment where it's not all about elimination of foods is my passion. That is what I love.
Destiny Davis LPC CRC: Do you? Do you employ elimination diets, but with that in mind, or are you anti elimination diet, or can you talk a little bit about your approach?
Right.
Samina Qureshi RDN LD: Yeah, so, you know, the medical nutrition therapy that is recommended for people with IBS, there's something called the low FODMAP diet. It works for about two out of three people who struggle with IBS. Predominantly, I would say IBS diarrhea subtype. It is an elimination style diet, right? You reduce total FODMAPs consumed to see if you can improve your symptoms, [00:06:00] and then there is a reintroduction phase to identify foods that you may, um, not tolerate.
And then you expand your diet and kind of, um, liberalize your diet as much as tolerated. And while this is a effective, um, nutrition protocol for some, for people who struggle with eating disorders and a history of eating disorders, it kind of, um, it's contraindicated, right? It's not warranted for someone who struggles with restriction or restrict Purge behaviors and and things like that.
And so how I approach managing IBS is something called the gentle FODMAP approach, which isn't a rigorous or restrictive, um, super restrictive way of managing FODMAPs. It's looking at your diet to see like, hey, do you even eat FODMAPs? FODMAPs or these highly fermentable carbohydrates regularly in your diet?
And if so, here are some swaps. So instead of saying [00:07:00] eliminate them forever, it's okay, I noticed that you're having coffee with regular cow's milk every morning and you're running to the bathroom having diarrhea immediately. Instead of avoiding all milk, it's why don't we opt for a lower lactose variety, and that may be cow's milk with the lactase enzyme added in, so it's lactose free, um, and seeing how that impacts your symptoms.
So it's taking it step by step, taking the overwhelmed milk. away from nourishing your body and finding solutions that are practical that work for you because when you struggle with your relationship with food, restriction can be triggering.
Destiny Davis LPC CRC: It is. Yeah. And I think we should talk a little bit more about that.
I am curious about a logistic though. Um, do people tend to see, like, they eat a food, you mentioned like the coffee, um, example, and you know, you're running to the bathroom right after. Is it also true that What you're eating can be, can impact you [00:08:00] hours or days later, or is it a pretty quick noticing?
Samina Qureshi RDN LD: Yeah, so in general, FODMAPS, which I guess we should do a little education, right?
FODMAPS is an acronym that stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are those sugar alcohols, right?
And for some people with IBS, they can be sensitive to them. And actually, you're right. It's not necessarily true that if you eat a FODMAP, you're immediately going to have a symptom minutes later, right? The symptoms can happen maybe three to four hours later because these FODMAPs are fermented in the small intestine and it does take time from entering our mouth to go through digestion and make it there.
Um, so you may not notice symptoms immediately. The thing with coffee Is that it can be a gastric irritant in itself and lactose specifically may have a shorter, um, time with [00:09:00] the symptoms that you experience, right? So if you are lactose intolerant, you may notice it 30 minutes to an hour later, um, after consuming.
Destiny Davis LPC CRC: Okay, okay, and what about days later? And this might not even be FODMAP related, but just in general with food, like, is it possible for people, this is what I've heard that makes it people, hard for people to figure out what their sensitivities are, because maybe days later something is showing up, but I've also heard that that's not true, and so I'm just trying to fact check here.
Samina Qureshi RDN LD: Yeah, yeah, that's a great point. So, I think it depends on each individual and how many co occurring conditions they're managing, right? So, if we're only talking about FODMAPs and IBS with those sensitivities or intolerances, um, I would say, yeah, you can experience symptoms days, a day later. Um, it just depends on the quantity of that food that you consume.
And also FODMAP stacking. So if you're having it multiple times throughout the day, then you're [00:10:00] experiencing symptoms and then the lingering symptoms can happen. And oftentimes, you know, when you trigger IBS symptoms and flares, what happens? Like our nervous system goes into this overdrive where it's scared.
You don't want to have these symptoms anymore. And it kind of ends up with this cycle of. Then fearing food, having the symptoms and it becomes this like self fulfilling prophecy almost of like, I'm fearful, I don't want to eat, I eat, I have symptoms, and then that just continues, and so is it truly the food that's causing you to have these symptoms or, um, the state of your nervous system?
In that moment. Which is such
Destiny Davis LPC CRC: a hard, I feel like it makes it so complicated. Do you have a way that you make this simpler for people to understand? Not from a logistic, like, like you just explained it very simply and very well, but from a place of how I track that in my body, [00:11:00] um, yeah. Or an orderly require some good amount of effort.
Samina Qureshi RDN LD: So most of the clients that I work with are working with me minimum for three months. They're getting high accountability and support with a program that I'm working them with them in. And so, and my, you know, IBS Food Freedom Program, they're getting this hand holding and coaching and support along the way as we identify their food triggers, reintroduce foods, assess their personal tolerance.
And so there is a component of food and symptom journaling, and that helps me better understand their symptoms in real time. That way, if I notice like, hey, after having XYZ meals, I'm noticing these are your symptoms. Why don't we offer this swap? And so Absolutely, it can be so overwhelming and impossible to do on your own.
That's why I offer this like high touch support because the low FODMAP diet, it, it's, [00:12:00] it does not produce results as effectively, um, as it would if you did alongside a trained FODMAP dietician.
Destiny Davis LPC CRC: That makes sense. Can you even name some of the things that differentiate someone trying to do a low FODMAP diet on their own versus working with someone like you?
Is it, is it really just, it's just the support of it all is what helps the success or are there just more nuances that you understand because of your training and education that you're just not going to find in the blogs?
Samina Qureshi RDN LD: Yeah, absolutely. I mean, I've had people who have tried the low FODMAP diet on their own and I will say 100 percent of my clients have failed, right?
Like that's why they're working with me to navigate it on their own. And the reason is, is because it's overwhelming. It's, there's a lot of nuanced things, right? It's not just FODMAPs that are causing you these symptoms. Like I said, there could be potentially other gastric irritants. There could also be [00:13:00] malnourishment going on in inconsistent, inconsistent meal patterns, um, stress during meal times, uh, And so many other lifestyle factors that could be contributing to their symptoms, so while understanding, um, you know, FODMAPs and whether or not they're a trigger for you, there's a lot of work that needs to be done before even approaching the FODMAP side of things with managing IBS, so laying that foundation of good, balanced nutrition.
Destiny Davis LPC CRC: Yeah.
Samina Qureshi RDN LD: In a way that, um, doesn't stress you out, to be honest.
Destiny Davis LPC CRC: What happens if this stuff just does stress you out over and over again? Do, what do we do about that?
Samina Qureshi RDN LD: Yeah, so that's why I partner and also collaborate very closely with their, um, mental health practitioners, whether it be a therapist or a counselor, um, to make sure that people are The people that I'm working with are getting supported where they [00:14:00] need right as a dietitian.
I offer nutrition counseling and support and coaching. Um, but that, you know, if you are noticing that This stuff is increasing your anxiety, you're very anxious about it. I also refer out to GI psychology because when it comes to, um, managing IBS, um, gut directed hypnotherapy and cognitive behavioral therapies for IBS or GI focused have been proven to be as effective as a low FODMAP diet.
So I'm seeing that, Hey, you know what? As we're working together, we've come through, we've gone through the minimum three months of working together, trying these approaches, you're still experiencing symptoms, we have to recognize that something else is going on.
Destiny Davis LPC CRC: It's good to hear that three months mark is kind of where, like, you should be seeing something after three months, and if not, then we're missing something.
Samina Qureshi RDN LD: Absolutely, and one thing I will say, so remember when I was talking to you about how, like, 100 percent of my patients have failed the low FODMAP diet? [00:15:00] Well, if you are not, if you want to go and try the low FODMAP diet on your own, go for it. Right. Of course, you need to assess and see how this is going to work with your lifestyle and needs.
But, this is something that GI doctors or physicians don't tell you, right? They just hand you the packet of the low FODMAP foods and they're like, avoid these foods and run with it. Yeah. They never say that there's a reintroduction phase. They never say that this is a short term diet. So the elimination phase of that low FODMAP diet should only be done for two to four weeks.
Destiny Davis LPC CRC: That's crazy.
Samina Qureshi RDN LD: If you are not experiencing symptom improvement by week two, stop the low FODMAP diet. That
Destiny Davis LPC CRC: is such,
Samina Qureshi RDN LD: like,
Destiny Davis LPC CRC: yeah, I think people try this for like three, four, five, six months. Like, this might be a pivot. Do you, what do you think of the GAPS diet?
Samina Qureshi RDN LD: I have heard of it.
I'm not as familiar, but I will say that there's no concrete evidence in [00:16:00] Showing results in large populations so that these studies haven't been done enough for me to speak about it, like with enough knowledge.
Destiny Davis LPC CRC: Okay. Okay. That's fair. That's good to know too. Like the FODMAP has been empirically studied and we do have a lot of data around it.
And so, um, with The gaps diet, like if somebody has had success with that, that's amazing. We just don't have the data to show and we do know that FODMAP diet works with support.
Samina Qureshi RDN LD: Yeah, absolutely. And one thing I will say is like, um, we're talking about food sensitivities and intolerances, right? And a lot of people come to me.
Going on a low FODMAP diet for years. So they are starving their gut bacteria of these amazing fiber rich foods that actually support their microbiome and their gut health for years and They are limited to such small small amount Even small list of foods like three foods that they're comfortable eating.[00:17:00]
Destiny Davis LPC CRC: Yeah,
Samina Qureshi RDN LD: right And so what I wanted to say was There's a lot of information out there on what to restrict and nothing on how to add back to. their diets, right? What foods can you safely introduce? What foods can you add to just baseline, offer yourself that consistent and adequate nourishment so that your GI system can function optimally, right?
What I see is with this, um, overlap of eating disorders and GI disorders is that, and in research you'll see this, is that GI function suffers immediately when there is any form of restriction.
Destiny Davis LPC CRC: Yeah,
Samina Qureshi RDN LD: right. Your GI motility slows down. That means that you're constipated. That means the constipation is going to cause you that extra acid reflux and bloating and gas and stomach pain.
And once that constipation has been sitting there for a long time, there's that backflow of diarrhea. So there it's just. Um, [00:18:00] really hard and so adding more restriction to that is not the solution.
Destiny Davis LPC CRC: I love
Samina Qureshi RDN LD: that. Yes,
Destiny Davis LPC CRC: it's very validating to hear that, like, and, um, I think people really need to hear that more.
Because a lot of the wellness content is about, like, online is really about. Restricting, um, even from some medical professionals. So absolutely. Yeah. I'm trying to think of another I still want to expand on this concept of like adding foods back in and basically what a healthy wholesome diet looks like.
Because, yeah, I think that whole concept of, well, fiber hurts my stomach and, you know, um, all of that is so real. So, with going low FODMAP for two to four weeks with support, um, is it that we want to, that then we, the goal is to start adding fiber back in and [00:19:00] like we should see improvement or how does that, how does that look?
Samina Qureshi RDN LD: Yeah, so the goal is not to just like bombard your system with fiber. Anytime that you introduce a plant based food, obviously a source of fiber, you are going to experience some type of GI. Symptom whether it be excess gas or bloating, hopefully not stomach pain and hopefully not diarrhea or constipation, right?
That's what we're trying to avoid. And so when I'm working with my patients again, I don't jump straight to the FODMAP diet Because we have to lay this foundation of adequate nourishment. And so what does a balanced diet look like then? It is eating consistently every three to four hours. And that could look like breakfast, morning snack, lunch, afternoon snack, and dinner.
The reason that I do this is to recalibrate the GI system. And your nervous system [00:20:00] to know that I am going to be fed regularly and consistently throughout the day. So I do not need to slow down my GI system. I don't need to hold on to foods because I know when I'm going to be fed next. So my GI system can naturally have that GM motility, have that migrating motor complex move so that it can push the food through your GI system, create a stool, and evacuate.
Destiny Davis LPC CRC: Yeah,
Samina Qureshi RDN LD: right. And so once I feel like you have gotten the routine of nourishing your body down, then we go to, Hey, I'm noticing with this consistency of nourishment, you're still experiencing X, Y, Z symptoms. And this is the trend that I'm seeing. Here are some swaps that we can offer. Let's try this out. And let's also with these swaps, I'm including options that are, um, Iron soluble fiber.
Soluble fiber is something that is going to form like a [00:21:00] gel like liquid in your body as it goes through the digestive system and make a nice lubricated but formed stool. To help it pass easily. And so, um, yes, step by step, and it's not about throwing fiber at the wall and seeing what sticks literally.
It is about having that baseline nutrition and then adding foods in to support the symptoms that you're experiencing.
Destiny Davis LPC CRC: I love that. I, so many of my clients, or just even people I work, like, hear from, uh, with any kind of chronic, this is not just IBS related, but it's so hard to get breakfast in, um, and especially if they're on any kind of ADHD medication, uh, very, very difficult, and so You know, there's some of that that's like, if you know how important it is, and it really, internally, you are intrinsically motivated to start eating three meals a day.
I went through this a few years ago, and I was like, I don't [00:22:00] care what happens, I don't care how uncomfortable I am, I don't care how much, like, cause I would just have this, like, feeling of aversion whenever I would try to eat in the morning. Yeah. And I was like, I don't care, I need to eat something. So I think I started with, like, a protein bar, or like, I don't even know, just something that wasn't like a whole meal.
Eventually it was like, oh, what if I just ate foods I liked, like eggs and bacon and toast? And that was really what helped me start, like, eating breakfast. And then, like you said, I was able to add in more foods and yogurts and things I wasn't able to before. Is that really, is that kind of what you're helping people get to?
Or is there
Samina Qureshi RDN LD: Absolutely. Yes. And I love that you brought up, you know, ADHD and neurodivergence. People who are on these types of medications to manage ADHD, absolutely it has an impact on your appetite. Right? And even if you're not on medication, it can be really hard to complete a task to [00:23:00] change and shift to now I need to eat and break away from that thing.
So, yes, I work with many people who experience, you know, who have, who are neurodivergent, who have ADHD, and I love that you tried something and saw how it made you feel. And that you were not aiming for perfection. I think that's where a lot of people struggle is that like, oh, I need to have breakfast. I need to start my day.
Okay. I'm going to get something. I'm going to have this. Yes. I'm going to do oatmeal. And I'm going to add all these things and the cheese seeds. And, and, you know, it's great. I did go through that
Destiny Davis LPC CRC: by the way.
Samina Qureshi RDN LD: And then I was like, wait. Yeah, for sure. But I love that you opted for something that was convenient.
And so that is something that I really, really talk a lot about with my clients is. Anytime you are making a change to your day, lifestyle, health, taking care of yourself, it has to be easy. [00:24:00] So what can we set ourselves, how can we set ourselves up for success? And while bars are great, liquid nutrition can be awesome too.
Destiny Davis LPC CRC: Yeah, my functional doctor always tried to get me to do smoothies and to put my supplement I just cannot do smoothies, but I'm so glad that a lot of people can because it is an easy
Samina Qureshi RDN LD: thing. Yeah, and even if it's not smoothies, it could be a like a drink that you get from the store. Okay, right or a powder or just for something just to have that first step of what does it feel like to put something in my system?
Within an hour of waking up, right? And, and then we assess how you feel. And then we take the next little step. And a lot of what I do is that accountability and coaching support as well, because we are making a lot of these changes. How do we strategically do this in a way that is accessible and doable?
And you don't feel overwhelmed.
Destiny Davis LPC CRC: Yeah. [00:25:00] It's such individualized work because we all have our different hangups about whether we have different food rules that are hanging us up or different food aversions or, yeah.
Samina Qureshi RDN LD: Yeah, absolutely. Yeah, and the food rules. I mean, we live in a wellness culture that loves to put restrictions and rules and real rigid thoughts about how we should do things.
And I think, like, we've lost this, um, idea of, like, what works for us individually.
Destiny Davis LPC CRC: Yeah.
Samina Qureshi RDN LD: Yeah. It's all about like, Oh, well, I saw someone did this and it worked for them, but like, you're not them.
Destiny Davis LPC CRC: Yeah. Yeah. And of course, like the things that people, a lot of people are selling online don't help because that's the marketing that we're constantly hearing.
This worked for me. It's even taught like in like business coaches teach it. It's all about like your audience. Let them know this worked for you, and this worked for your ten other clients, and [00:26:00] therefore it can work for anyone. And it's like, that's, that's not a double blind controlled study, but.
Samina Qureshi RDN LD: Yeah, absolutely.
And I love that you brought that up because I, um, so there's this one condition called dyssynergic defecation. It's a subtype of like constipation, which means that, um, really your GI system is having a hard time pushing the muscles are having a hard time moving the stool down. And so you may get like some backed up.
I'm not a GI doctor, so I don't know the physiology as well. But The treatment for that, a lot of it is helpful with, um, pelvic floor physical therapy. So I partner a lot and I collaborate with a lot of pelvic floor physical therapists, but as this person was working with me, you know, they didn't gain the relief that they were looking for to the extent that they wanted and had hoped for, right?
Like yes, they added more variety to their diet, they were eating more consistently, they did notice more frequent bowel [00:27:00] movements, but upon MRI, they saw that they were still like. Stools stuck in their system.
Destiny Davis LPC CRC: Wow.
Samina Qureshi RDN LD: Right? And from there, I am not going to push them and be like, Okay, well you just need to work with me more.
You didn't do X, Y, and Z. And that's why this is not working for you. Like, blaming the person. Right? Yeah. I said, okay, let me call my friend. I'm gonna call Dr. So and so, pelvic floor physical therapist, and we are going to come up with a solution for you, because I think this is where we need to pivot now, to see how connecting the muscles and your mind with, you know, relaxing that pelvic floor can help with moving some of that stool down the system.
Destiny Davis LPC CRC: Yeah, absolutely. Um,
Samina Qureshi RDN LD: yeah, I'm not a magic fix. Okay.
Destiny Davis LPC CRC: Right, we, and this stuff takes such an interdisciplinary team. It takes sometimes P. T. and nutritionist and counseling and the specialists like GI doctors and yeah, because [00:28:00] yeah, we don't all have the answers for everything, so it takes multiple eyes to get to it.
Um, you know, you said something earlier that has stuck with me, um, The, because we talk a lot, the, right now, like, nervous system regulation is really hot and I try to be really careful with, like, how we talk about that because it also becomes one of those things that's, like, well, you just need to reset your nervous system and then, like, everything else will go away.
So, you said, though, like, Just eating breakfast, just getting something in, even if it's just a drink from the store, like it lets your body know that food is coming, which creates safety in the body. And that in and of itself is nervous system work. And I think people really need to know that because again, they think it has to be this like really convoluted nervous system, bootcamp retraining thing.
And it doesn't at all.
Samina Qureshi RDN LD: Oh my god, I love that. You picked that out. I mean, obviously you would, of all people,
Destiny Davis LPC CRC: right? This is like [00:29:00] my biggest no fun. This is your specialty, yeah.
Samina Qureshi RDN LD: But yeah, I mean, caring for your body, meeting your basic human needs, is going to help with regulating your nervous system. And nourishing your body is one of them.
And so how can we make that a priority in our busy, busy, busy lives? That's the biggest hurdle. It's like, I know what I need to do. I know that this is going to help me, but what is the step that I need to take to just dip my toe in and see how that makes my body feel?
Destiny Davis LPC CRC: Exactly. Yes. Yeah. Um, it really is such a journey.
I think about my own journey a lot in this because I didn't really have any of like the words around this now. I feel like all this stuff is online and people like. Kind of, they see so much, like, language around this, but when I was going through it, I didn't have a diagnosis, I didn't have [00:30:00] a, like, anything.
I kind of just kept trying to follow my intuition and kept trying to follow the, those basic rules, like, just get breakfast in, or, but it took a long time. To get there, and I also want to ask you about food sensitivity tests, um, because that wrecked me. So I would love to hear your take on that. Okay,
Samina Qureshi RDN LD: I'm gonna give you my honest truth.
They are bogus.
Okay. Yeah, food sensitivity testing and I even have like one of my really good good friends is an allergist at our like medical center here in Houston and she's like, we don't use those in practice. I don't know why people keep coming in with IgG antibody testing to determine food sensitivities when that's not a thing.
Um, in research IgG antibody testing, um, has been shown to, um, um, Indicate foods that you commonly eat, [00:31:00] not foods that you're sensitive to. And it's so funny because I have clients come to me with their, you know, you know what brand tests. And they're like, these are all the foods that I can't eat because this company said so.
And then they sell you a diet plan that is how to eat yada yada yada. Like, anyways, it's more money making scheme.
Destiny Davis LPC CRC: And
Samina Qureshi RDN LD: what we find is that my number one question that I ask people because it's like, I also believe you, right? Like, while I, these testings, these food sensitivity tests are not validated.
They're not evidence based. I believe you when you tell me that if you eat something, you feel this way, okay? Like, I just want to put that out there. So, with this information that I get from these food sensitivity tests, I ask my patients, Did you notice symptoms before this [00:32:00] test, when eating this food?
Right. Right? Like,
Destiny Davis LPC CRC: Yeah. Yeah.
Samina Qureshi RDN LD: If you weren't avoiding strawberries before this, There's no need to avoid strawberries now. Yeah,
Destiny Davis LPC CRC: you would have noticed before. Well, I guess that goes back to that question of how long does it take before we notice, like, something happening? I think that might be what contributes to why these tests feel so hopeful for people, because if they feel confused about what's flaring them up, which was where I was at, I was like, I have no food that makes me run to the bathroom.
Like, that isn't what I'm struggling with. And so taking the test was like, I mean, it was terrifying because it was all of the foods. It was every vegetable that I put into my body. And I was like, I, I learned, I taught myself how to eat vegetables. And now you're telling me I can't eat any of these. Um, and for two, I think for two [00:33:00] years, I like avoided vegetables.
It was. Really horrible until I started hearing like, wait, these tests like are not that great. Um, and so, uh, yeah, I think it can be hopeful when you're hearing, oh, well, this is the source of your problem, um, when you aren't attuned, when you don't know what was causing the problem to begin with.
Samina Qureshi RDN LD: Absolutely. If they're selling that hope. And what I have seen from that, unfortunately, is people coming to me with a very restricted. Like, list of foods that they are able to eat, and unknowingly, um, causing themselves to have an eating disorder. And then that layering worsened GI symptoms because of that malnourishment.
Destiny Davis LPC CRC: Yeah, I can attest to that.
Samina Qureshi RDN LD: So, it's a vicious cycle. Yeah,
Destiny Davis LPC CRC: um, tell me then, what is [00:34:00] like your, when people come to you with this test, like, what is your response? Like, um, you educate in the way you just did, but then it's like, so here's what we're gonna do next.
Samina Qureshi RDN LD: Yes, so this is, and I love this, because this is where I get to help people identify foods that they actually have symptoms with, um, or they're, they're triggered by, um, and then also expand their diet.
So we do reintroduction challenges. I say, okay, we're going to continue with your normal diet, whatever you think that, um, you know, makes you feel good. We'll continue with that and we're going to add in strawberries on day one. We're going to add in strawberries in a bigger portion on day three. Two, we're going to add in strawberries on a bigger portion on day three.
Day four, five, and six are going to be washout period. Let's see if you have any lingering symptoms. Right? We're going to assess how you feel to [00:35:00] truly and confidently nourish your body and hopefully expand your diet as well. We notice that, okay, you're eating nothing out of the ordinary and we're just changing one single ingredient food, like strawberries, and you don't have a reaction.
I think we're safe to say that you can tolerate them in a normal portion for you.
Destiny Davis LPC CRC: That's great. Really reducing the fear around food. Um, what are some other food rules that you hear or food ideas or philosophies?
Samina Qureshi RDN LD: Oh my god, so many. Here's one, okay? So, intermittent fasting last year was like the thing everybody wanted to not eat forever.
When, you guys, listen to this. We all fast. We all should be fasting during our sleeping period. We should. Right? If we are nighttime sleepers, that means we're sleeping [00:36:00] in the night and our body is having that rest and digest moment. And when we wake up, it is important to break our fast so that we can stimulate that GI motility to get going and working and offer it that safety and comfort.
Destiny Davis LPC CRC: Absolutely. Yeah. I remember even, yeah, my functional medicine doctor was like, yeah, for, for women, um, like if you're going to fast, it should be at night. So like you start at like, The six or seven. And that was when it hit me. I was like, you mean like normal, like that's the normal, that's like what we've been told forever to do.
Samina Qureshi RDN LD: Yeah, like you mean go to sleep? Like I eat dinner and then I like end my night and I sleep and I wake up and I eat again? Yeah.
Destiny Davis LPC CRC: I know, we make things so complicated. Humans just make things so complicated.
Samina Qureshi RDN LD: We're great. No, it's actually, you know what? We love to be trendy and buzzy and Exciting and this is where the marketing world gets us.[00:37:00]
Yes.
Destiny Davis LPC CRC: Yeah,
Samina Qureshi RDN LD: like yeah
Destiny Davis LPC CRC: And really that's been like since forever I mean if you look back into like even like into ancient Greek times and anywhere where we have like Old, uh, especially food philosophies and thinking like, uh, who said like, heal thyself or food is your medicine. It's like some old, old, ancient kind of philosopher.
But like, if you look back into those histories, there's always some kind of like thing being peddled, like some kind of new, uh, medicine thing. So this is something, this is like always existed for humans. It's just on a different level now, cause we have so much technology and. We are a global economy. So we just see it so much now, but it's really nothing new, which I don't know what that says about us, but.
Samina Qureshi RDN LD: Yeah, yeah, or I have the people that do intermittent fasting and then come to me and they're like, I haven't had a bowel movement in weeks, and I'm like, duh. [00:38:00] Oh, man. Makes sense. You're not putting anything in. How could anything come out?
Destiny Davis LPC CRC: Or I know, and we just get so wrapped up. We get so wrapped up in the hope of these things.
Do you find yourself like doing? That that's what a lot of your, your coaching and education is on is like kind of just dispelling myths and like, can, do you also find you have to convince people a lot of this kind of stuff too before they'll follow it? Or
Samina Qureshi RDN LD: are they just Wonderful.
Destiny Davis LPC CRC: Yeah. Ready by the time Wonderful
Samina Qureshi RDN LD: question.
Okay. Yeah. So a lot of my nutrition education in session is myth busting. A lot of, especially the first few sessions that we have, it's like really breaking down the barriers, understanding your previous food rules and rigidity around food, your relationship with food. You grew up with a mom who was like, you know, the almond mom type where, okay, you can only have single ingredient foods.
You don't need to eat a muffin. I have like, you know, almonds and blueberries. You can eat that. [00:39:00] So we break down these barriers. We. Dispel myths in these sessions, but also if someone has been wanting to work with me, they are following me on all the medias, social medias and learning that I am a very, I would say anti diet culture dietitian, right?
Where I help people really Get back in tune with their body and learn how to nourish themselves without that stress, guilt and shame that comes from society and wellness culture. Um, and so, yeah, a lot of dispelling myths and then a lot of people do come to me and they're like, I'm ready to find food freedom.
I'm ready to stop holding on to these rigid food rules and I want to know, like, how am I going to nourish my body and be balanced and include foods? Like, I'm done restricting.
Destiny Davis LPC CRC: Yeah, yeah, which is really nice. Um, [00:40:00] yeah, that they're already kind of there. Uh, and then when you do dispel the myths that, that, you know, are still in their brain, even if they're ready to move on, they still have these.
Thoughts floating around, they're more open to hearing it and believing it. And then that sets the stage for doing the work.
Samina Qureshi RDN LD: Yeah, absolutely. And as they continue to work with me, they, they see their, like, their symptoms improving. They're like, oh, it wasn't that I needed to restrict more. I, I, you know, adding in things and finding balance with food is helpful.
Yeah. And I'm gonna continue doing this. And you had mentioned, you know, are there certain people that you're like, you have to convince, um, you know, everyone's allowed to think what they want to think. Right. If, and, and I also am a fan of placebo effect, to be honest, because if something is helping you, who am I to say if it's not hurting or harming in any way or legal, yada, yada, you know, um, it's not harming me.
It's not harming you. And you find that smelling lemon balm in the morning cures your nausea. [00:41:00] Why would I? Yes. Get in the way of that.
Destiny Davis LPC CRC: Yeah. If it is getting you to eat breakfast, then please do that. .
Samina Qureshi RDN LD: It's like Exactly. Yeah. Yeah. Absolutely. So there's, there's nuance to it, right? I am not here to fight with any of my clients.
If, and even I do have clients who are like, no, intermittent fasting is. working for me, then I encourage them, like your functional doctor said, to do it during the nighttime hours and find a time for you to, um, nourish your body adequately during the daytime within the hours that you are allowed to eat them.
Yeah. Yeah. Right? Because, um, it's hard then, then it makes that time period so much shorter depending on if you're working or not, like, where are you going to find the time to fit all of the fiber and all of the meals and all of the nutrients in?
Destiny Davis LPC CRC: Yeah. Yeah. I think, um, I'm working [00:42:00] with clients kind of before they get to you, because I'm working with them when they're way, way, like, not open yet to, like, Changing some of the, the, the diet things that, you know, you mentioned, like, if it's working for you, it feels great, then go for it.
But I think a lot of people are doing some things that they've convinced themselves is going to make them feel great, but they're not feeling great yet. But they have a strong belief that this will work if they can just be consistent with it.
Samina Qureshi RDN LD: And what are those things that you're seeing? I'd love to hear.
Destiny Davis LPC CRC: Yeah, it might be, um, well, eliminating vegetables, um, going more, Carnivore, and I'm, I'm careful to say that because I do know, like, I do know people who, like, very, very strongly have seen success on the other side of that. Now, I think there's long term consequences with that. I'm, I always tell them, I'm not a dietician, so I can't tell you, like, is or isn't gonna work, but yeah, it will be something like that, or it would be Fasting or even honestly, and this is something that it's [00:43:00] almost never said.
I have to prompt my clients by specifically saying are you eating enough calories? Because most of the time they're not and they're like and and you know calorie counting is a thing. Yep. Trying to go down the calorie counting path to lose weight. But I actually, and this would be counterintuitive for someone with an eating disorder, but if that's not a concern, then I will say, count your calories for two days.
Like I w you should be count. You should be eating around 2000 degrees a day. Yeah,
Samina Qureshi RDN LD: absolutely. Yeah, yeah, absolutely. So really, yeah, making sure that people are eating enough is my number one concern because like I said, your GI system will not work without it.
Destiny Davis LPC CRC: And then, like you, like I was saying with my own experience, it was like, I needed to make sure that I was just eating, like you were saying too, just eating these three meals plus snacks a day, then I can focus on like, whether I want [00:44:00] to, Increase my protein or decrease my fat or and I am playing around with some with fat content now because I am noticing like, oh, when I do have a lot of fat, like it actually does change the way I go to the bathroom and things like that.
So, but it's from such a grounded place and it doesn't mean I'm fearful of fat and I've cut it out again. It just means I'm going to pay attention to this. Like,
Samina Qureshi RDN LD: yeah, you're applying gentle nutrition. I love it. Yeah. Uh, just inquisitively curiosity, you know, versus I should, and this is the way, and I must do X, Y, and Z.
Destiny Davis LPC CRC: Yeah.
Samina Qureshi RDN LD: It's, you're making an informed decision, informed decision around caring for your health.
Destiny Davis LPC CRC: Yeah, I love this. Is there anything else, um, any kind of big topic that you love talking about that we haven't addressed yet, um, in this area?
Samina Qureshi RDN LD: Oh, so much. Um, I feel like we could go on and on. Um, we covered some really great points and I think when it comes to [00:45:00] caring for your gut health, it has more to do with eating enough and then focusing on variety versus eliminating potential triggers.
Destiny Davis LPC CRC: I love that. Eating
Samina Qureshi RDN LD: enough
Destiny Davis LPC CRC: and adding variety. That's really, that's,
Samina Qureshi RDN LD: that's why I'm the inclusive IVS dietician because we want to include, include things into your diet. I love it. Where can people find you? Oh yeah. So on Instagram, and I think all the things I'm at inclusive dot IBS. dot dietitian. My name is Samina Qureshi, so I'm sure if you type in Samina IBS dietitian, I'll be there as well.
You can click on my profile. And yeah, I'm accepting people now in my 12 week IBS food freedom program where I help you find relief from these uncomfortable digestive symptoms, confidently nourish your body and feel your best. [00:46:00]
Destiny Davis LPC CRC: I love that. Is there anything if people aren't sure if they haven't been following you, is there anything maybe, uh, like a free download that you have or somewhere where they can find, like they can kind of learn?
What the prerequisite is to this, uh, to your,
Samina Qureshi RDN LD: yeah, yeah, absolutely. I have, um, a free download. It is an IBS guide on five ways to avoid IBS flares, and it really breaks it down to some, again, Things that you can do to care for your basic human needs that will help you reduce that stress and anxiety, which in turn will help your digestive system function optimally.
And so, yeah, check it out. There's some simple tips for you to apply into your daily routine day to help you get on, um, and see, and see how that impacts your symptoms.
Destiny Davis LPC CRC: Awesome. Well, thank you so much, Samina. This was really wonderful.
Samina Qureshi RDN LD: Thanks for having me. I had so much fun.
[00:47:00] Thanks for listening. If you learned something new today, consider writing it down in your phone notes or journal and make that new neural pathway light up. Better yet, I'd love to hear from you. Send me a DM on Instagram, email me, or leave a voice memo for us to play on the next show. The way you summarize your takeaways can be the perfect little soundbite that someone else might need.
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Listen to Samina’s interview with me, Destiny, on Episode 84: The Truth About IBS and Nutrition: Why It's Not Just About Eliminating Foods.
Samina Qureshi is the Registered Dietitian (RD) and founder of Wholesome Start, a virtual nutrition practice specializing in digestive health. She received her B.S. in Nutritional Sciences and Dietetics from the University of Texas at Austin where she also completed her dietetic internship to become a dietitian. Her wellness philosophy is derived from the Intuitive Eating principles and Health At Every Size® (HAES®) framework. She encourages her clients to care for their health in a holistic way that best honors their lifestyle and cultural traditions and respects body diversity.
Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.
Destiny Davis, LPC CRC, is solely responsible for the content of this document. The views expressed herein may or may not necessarily reflect the opinions of Samina Qureshi, RD.