Thriving with IBS

Q&A with Kate Scarlata, MPH, RDN & Megan Riehl, PSYD

Authors Of 'Mind Your Gut,' The Science-based, Whole-body Guide to Living Well with IBS

Kate Scarlata, MPH, RDN & Megan Riehl, PSYD joined us for an in-depth interview to share on their partnership and why their new book, 'Mind Your Gut' is so important for readers managing digestive issues.

Over 45 million Americans are affected by irritable bowel syndrome (IBS) and diagnosis and management pose complex challenges. In their groundbreaking book 'Mind Your Gut,' Kate and Megan offer a comprehensive approach that bridges diet, stress management, and holistic interventions, providing essential tools and strategies for managing IBS effectively and limiting its impact on daily life.

Let’s get into our Q&A.

Congratulations on the book and thank you for joining us to share your expertise. To get started, how did you both meet and come up with this collaboration to write 'Mind Your Gut?'

Kate: I met Megan in Ann Arbor at Michigan Medicine’s annual nutrition conference, Food: The Main Course – and Megan asked if I might consider writing another book… with her! I was thrilled at this opportunity to incorporate key mind-gut directed therapies along with nutritional remedies into a comprehensive book for people living with IBS.

Dr. Riehl: I had the opportunity to meet Kate and hear her speak at several conferences years before the conception of our book. Her expertise was well known and I was inspired by her passion! We both recognized the need for not only highlighting the benefits of integrative care for those with GI conditions but most importantly increasing access to this information. We wanted our gastroenterology (GI) colleagues to have a science-based resource to provide to their patients and a trusted toolkit in book form for those with IBS!   

What makes 'Mind Your Gut' different from the other books on the market for IBS?

It’s the first in its kind – to incorporate the interdisciplinary approach to managing IBS – from science-backed medical treatments to nutrition as well as behavioral strategies. Working in the trenches with patients in clinical practice–this holistic comprehensive guide is something we both wish we had earlier as a resource working with our patients living with IBS.

“Science-backed medical treatments to nutrition as well as behavioral strategies”

What topics do you cover in the book from a behavioral point of view?

We provide science-based ways that psychological interventions have been adapted to target the brain-gut axis and aid in improving IBS symptoms. Readers will learn ways to effectively identify and manage GI-stress as well as how to optimize a healthy lifestyle, practice gut-directed relaxation, and apply principles of GI-targeted cognitive behavioral therapy.

What topics do you cover in the book about nutrition?

We review common GI triggers (highly fermentable carbohydrates, insoluble fiber and common indulges: too much fat, caffeine, alcohol and more) that can prompt digestive symptoms and ways to adapt the diet to calm the gut. We encourage the reader to engage in the most liberal diet approach possible to manage their symptoms.

“We encourage the reader to engage in the most liberal diet approach possible to manage their symptoms.”

We start with the “Gentle Diet Clean-up” which is loosely based in the United Kingdom IBS Nice Guidelines, review a more liberal way to reduce FODMAP carbohydrates via the FODMAP-flexible approach, and also provide detailed guidance through the 3-phase low FODMAP elimination diet.

Who is this book intended for? Patients or clinicians?

Mind Your Gut is written for individuals who want and need access to the gold standard of IBS care that includes a Dream Team approach. From this perspective, the person living with IBS learns more about this complex diagnosis and is led to behavioral and nutritional strategies that can assist in decreasing the severity, frequency and duration of their symptoms. The reader will feel empowered and validated as they move through the chapters. We also feel Mind Your Gut is a valuable resource for GI clinicians working with patients with IBS given it detailed and thorough review of IBS treatment modalities.

In chapter 7, ‘Making Sane Food Choices in a Food-Fear and Weight-Obsessed Culture,' what are some key topics in this well-needed chapter?

We want readers to know that making some adjustments in your nutrition based on identified foods that cause symptoms is appropriate in many cases. However, a long term overly restrictive diet is not the goal for most people living with IBS and sadly can contribute or lead to disordered eating. Also, pop culture and social media can add confusion regarding what can effectively help with gut symptoms and sometimes leads people down the road of unattainable or unsustainable goals for health that are not grounded in science.

“We provide tangible and science-based suggestions to facilitate a healthy relationship with food."

Gut health is all the rage now, tell me more about Chapter 8, 'Feeding Your Gut Microbiome.'

While this science is truly complex, individual and nuanced, we discuss some general guidance for improvement in diet quality that has been shown to benefit the gut microbial community. We focus on key features such as including adequate fiber, plant variety and the potential role of fermented foods with live and active cultures for IBS.

In chapter 9 you delve into symptom-specific interventions, how is this chapter outlined to help the individual with IBS or clinician?

This is a chapter that readers will go back to over and over. For individual symptom management (diarrhea, constipation, abdominal pain, bloating, anxiety, depression) we concisely describe common features, specific medical procedures and medications to discuss with a physician, as well as nutrition remedies and behavioral interventions to consider as you tackle that symptom.

What are some of the incredible tools you share in the resource section?

The resource section includes key reproducible handouts from a Mind Your Gut thought record, to a comprehensive food and lifestyle tracker. We also include the Bristol Stool Form Scale as this valuable tool helps the reader understand how to best describe their stool form and consistency to their GI provider which will inform how to treat their symptoms.

There is also a listing of low FODMAP brands we love, a QR-code that directs the reader to a diaphragmatic breathing demonstration by Dr. Riehl, supplements for consideration, how to find a GI-expert RD, GI-expert psychologists, pelvic floor physical therapists and even a graphic of the proper pooping position! But there's more… we also include digital apps we love, toilet accessories and novel treatments such as the emerging virtual reality technology for IBS!

In chapter 10 you discuss IBS mimickers. What are some common masqueraders of IBS?

We include celiac disease, inflammatory bowel disease (IBD), parasitic infections, bile acid diarrhea, sucrase isomaltase deficiency, small intestinal bacterial overgrowth (SIBO), exocrine pancreatic insufficiency and dyssynergic defecation as possible mimickers of IBS. Research in this area is expanding, and we provide up-to-date information in this chapter.

How can readers order your book and find you on the world wide web?

Mind Your Gut is available from Hachette Books in several formats: hardcover, ebook and audio. You can also look for it on Amazon, Barnes & Noble or your local bookstore!

We're active on Instagram @katescarlata & @drriehl and encourage you to follow and tune in for our new podcast, The Gut Health Podcast, available on all major podcast platforms. We share updates on new episodes on Instagram @theguthealthpodcast.

And that's a wrap!

Thank you, Kate & Megan, for sharing your expertise with our readers.