Now that you have the background, lets talk about things that might be of actual use.
A large part of dealing with IBS when you have an eating disorder is that anxiety exacerbates the condition just as much as the way in which you eat food, so I have divided my tips into two sections to deal with them both separately.
What can I do about food?
- For me, the biggest part of calming my symptoms was establishing a regular eating pattern of four to six times a day. Three squares meals is fine for a lot of people but not for me. By having medium sized meals with smaller snacks in between, you avoid overloading your stomach, you keep your blood sugar levels pretty constant (which is important if you tend to have sugar drops or a tendency to faint like me) and its emotionally easier to handle the thought of a slightly smaller portioned meal (if you are compulsively restrictive) and to not be starving before every meal (if you have a tendency to binge eat.)
- Knowing the foods that don’t agree with you and avoiding them is not the same thing as restricting. These two concepts had become so intertwined in my head that I began to wonder would I ever be able to eat normal food again. For me, that means avoiding apples, white bread, honey and pasta and going easy on very starchy, heavy foods. But since I have stopped restricting and have a better control on binging, I can eat practically anything as long as I don’t eat a family-sized portion in a ten minute sitting.
- Enough sleep and enough water are essential to both balancing your behaviour around food and balancing your digestive system. The ideal for most people is 8 hours sleep and 8 glasses of water, but if you need more or less to feel at your peak, then do it.
What can I do about anxiety?
- Once a compulsion gets in your head, it is almost impossible to ignore and once you start a behaviour (such as binging, starving or purging), it is pretty much impossible to stop. For me, the stopping point was always getting physically sick, either from my IBS or from purging. The entire process would start a vicious cycle of guilt, anxiety, sickness ad nauseum. In a situation like this, the ideal option is to get out. Get out of the room, get out of the house, just get out of the situation. If this is not possible, treat the compulsion as you would a panic attack. It’s time to ground yourself. Sit down, feel your legs in the chair, try and relax your shoulders down your back. Tell yourself what you know is real e.g. “My name is Kate. I am sitting in a chair. My feet are on the ground.” Count down from 20, taking deep breaths on each number. If someone is around, put yourself in their company. If you feel comfortable, share your anxiety. If you don’t, don’t, but the simple act of having someone else around is more supporting than being alone. With someone else there, your mind will be slower to jump to a conclusion that engaging in your ED behaviour will help you cope with your IBS.
- At times when you feel calm and in control, try meditating. There are a million podcasts and Youtube videos of guided meditations, if this is your preference. If not, just sit in a quiet place and be aware. Be aware of the seat you are in. Expand that to the room you are in and notice all the space. You can extend this to your house or your street. Be aware of the sounds and smells around you. Don’t try and push any thoughts away. Just be aware of them. If you are the type who hates sitting still, yoga is a great option as it calms the mind and has positive effects on the whole body, including the digestive system.
- The sticky subject here is exercise. If you have an ED, particularly one where you compulsively exercise, pushing yourself to burn X amount of calories a day is not going to help you. However, 30 minutes of exercise a day was recommended to me by both my dietitian and my gastroenterologist and studies have shown that this amount of physical activity can significantly improve IBS symptoms. If, like me, you come from a background of compulsively exercising, begin with low-impact, supervised exercise. When missing a workout still had the potential to send me into a tailspin, but I was advised to cut back by my doctor, I would go for walks with my best friend or my mom. Eventually, I was allowed to run and cycle and kickbox all on my own again and as a non-obsessive activity, it is doing the world of good for my digestive symptoms.
So that’s the long and short of it. Both conditions suck. When they occur together, they suck even more. But you can handle IBS when you have an eating disorder and you can come out the other end fighting.