How to manage irritable bowel syndrome and other digestive issues during the festive season

Harrison Kefford is finally looking forward to the holidays again. After having his colon removed in Feb, he can’t wait to eat his grandmother’s fudge and pile his plate high with something other than plain turkey. Maybe he’ll even enjoy some gravy with his meal.

Kefford, a 28-year-old pizza delivery driver and TikTok creator who lives in Melbourne, Australia, has Crohn’s disease, a condition that often caused him sharp gut pain, nausea and loss of appetite for days on end. He is one of more than 6 million people worldwide diagnosed with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. About 11 per cent of the global population deals with a more broadly defined gastrointestinal condition known as irritable bowel syndrome (IBS), which has a wide range of causes and includes symptoms like gas, bloating, constipation and diarrhoea.

IBS and IBD are distinct illnesses with separate treatments, but the daily challenges can be similar. Foods that are processed or high in fat – and, among other things, the nuts, dairy products and alcoholic beverages often found on holiday tables – are common triggers for people with both conditions.

Before Kefford had an ileostomy, the holidays were full of land mines. One year, he recalled taking steroids to help quell symptoms in anticipation of eating Christmas dinner with his family. He thought the medication worked until he woke up at 3am. with stomach pain. He ended up in the hospital for seven days.

Sneha Dave, a 24-year-old, was diagnosed with ulcerative colitis when she was six and lives with an internal pouch that allows stool to pass through the small bowel. Dave, who founded an organization dedicated to young people with chronic illnesses called Generation Patient, is aware of her culinary triggers, but when she celebrates Deepavali with her family each Oct, she’s still tempted by some of her favourite Indian fare: samosas and mithaas flavoured with spices that aggravate her condition.

When basking in the joy of being with family, an indulgence “doesn’t feel as serious,” she said. “Until you’re by yourself and suffering the consequences of those decisions.”

Whether someone has been managing symptoms for years or is newly diagnosed, gastrointestinal conditions can require constant attention. And while holiday plans are disruptive for most – with late nights, indulgent food, extensive travel and intensive social time – the consequences are often higher for people with IBD and IBS.  Below, experts shared strategies to help navigate the season. Here's how to handle IBS and IBD during the holiday season.

PREPARE FOR A LITTLE DISRUPTION

Many chronically ill patients experience worsening symptoms during the holidays because there has been a change in routine, said Dr Fola May, a gastroenterologist and assistant professor of medicine at the University of California Los Angeles. “November and December are the times we tend to deviate from our habits, like healthy food and exercise,” she said. Even traveling can be associated with an increase in symptoms.

To start, Dr May recommended that patients make sure they travel with enough medication and know how to reach their providers if necessary.

DEVELOP A PLAN TO MANAGE STRESS

There’s evidence that stress can aggravate both IBD and IBS symptoms, Dr May said. And the holidays are full of stressors.

Scheduling downtime before and after holiday parties or travel may help stave off potential symptoms. Dr May recommended mindfulness activities like meditation, yoga, and massage aromatherapy.

RECRUIT HELPERS

Shay Habestroh, a 25-year-old content creator, said she has experienced holiday IBD flare-ups when trying to participate in every family activity. To combat this, she tells her husband when she doesn’t feel well, and he relays the message to their larger family. “It’s nice because the family hears it from another healthy person, so they kind of listen a little bit more,” she said.

Enlisting help is an important part of feeling prepared for the holidays, said Catalina Lawsin, a Los Angeles-based therapist who has run support groups for people with IBD and IBS. “You don’t have to tell them everything. It just has to be someone who you can go to when you need space or when you need backup. It’s identifying someone you can really trust.”

BE MINDFUL OF FOOD TRIGGERS (AND BRING YOUR OWN TREATS)

Habestroh has learned to avoid anything with corn and milk, which can rule out many holiday dishes. Her safe Thanksgiving foods are plain turkey, mashed potatoes and squash.

Beth Morton, a 43-year-old, manages her IBS by bringing her own dishes to holiday gatherings. Through working with dietitians, she discovered that garlic and onions are her biggest triggers, and she has learned to cook without them. “I’ve found substitutes that I think taste the same,” she said.

Being aware of your triggers, however, doesn’t mean you’ll always be able, or willing, to avoid them. Sometimes getting into the holiday spirit includes eating something that will cause discomfort. Dr May suggested that anyone deviating from their normal diet “do it in moderation,” adding that even moderation might result in a few tough days.

CREATE A DINNER PARTY SCRIPT

Habestroh said that avoiding certain foods can leave her open to unsolicited comments – especially during Thanksgiving, a holiday that often revolves around eating. “The attention is hard,” she said. “Everyone wants to know everything, and you’re almost too embarrassed to talk about it.” Creating a response that you practice ahead of time can ease discomfort, Dr Lawsin said.

Morton, who has IBS and sometimes brings her own meals to social gatherings, fields questions by saying, “I have to avoid certain foods to control symptom flares, so I’ve prepared something different.” Her immediate family is used to her substitutions, she said, but sometimes she gets questions from extended family.

BE KIND TO YOURSELF THROUGHOUT THE SEASON

Even if you adhere to your diet and routine, you may still experience holiday flare-ups. This is the nature of chronic illness. To combat any shame or disappointment, Dr. Lawsin suggested practicing empathy and kindness. “Acknowledge your body where it’s at,” she said. “Giving yourself compassion before, during, and after is the best thing you can do.”

By Fortesa Latifi © The New York Times

This article first appeared in The New York Times.