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Christopher Hertler was 23 when
the first symptoms appeared:

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severe gastro-intestinal complaints 
that kept coming back.

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My stomach and gastrointestinal tract
were producing a lot of air,

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and I was constantly having
to go to the bathroom.

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I realized that my stomach 
was working 24/7

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and I didn't know  
what the problem was.

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Nobody was able to
explain what the cause was.

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A gastroscopy and
colonoscopy were also normal.

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And since Christopher’s pain and
discomfort kept getting worse,

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he always had to make
sure there was a toilet nearby.

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It took a year until a doctor first
suspected irritable bowel syndrome,

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an intestinal disorder that
usually begins when people

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are in their thirties.

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It had a big impact
on my daily routine.

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I cut myself off from people
because of the embarrassment.

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I was staying in more at home
on my own, and didn’t want to go anywhere,

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because of these 
gastro-intestinal issues.

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I didn’t want to be out in public.

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One of the most common symptoms of
irritable bowel syndrome is diarrhea.

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But it can also lead to
constipation and in some cases

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to both, alternately.

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Non-specific tummy ache,
abdominal cramps and flatulence

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are also very typical.

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If these symptoms occur at least once
a week for at least three months,

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the reason might well be
irritable bowel syndrome.

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28-year-old Christopher is now being
treated at a specialist clinic

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for irritable bowel syndrome.

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Professor Andreas Stengel knows from
experience that while medication

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can help to alleviate symptoms,

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a change of diet can be 
particularly effective.

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Dietwise what often helps to start with
is trying to objectivize things.

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Which symptoms are
connected to which foods?

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You can do this in a consultation,
but it’s often advisable to also keep

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a food diary.

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A study by the University of Gothenburg 
investigated the effect

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of different diets on
irritable bowel syndrome.

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Patients were divided
into three groups.

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While the first was given
medication, another was given

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a low-carbohydrate 
fiber-optimized diet.

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The third group followed 
a diet that omitted foods including

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dairy products, onions and certain cereals
that contain FODMAPs.

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FODMAP stands for fermentable oligo-,
di- and mono-saccharides and polyols,

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carbohydrates and sugar alcohols.

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On reaching the colon they are
fermented by gut bacteria,

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leading to the production of
gases and an influx of water.

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This can cause flatulence, 
diarrhea and abdominal pain,

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symptoms that the low-FODMAP diet 
is designed to prevent.

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It works in three phases.

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The elimination phase involves
avoiding products containing FODMAPs

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for 4 to 6 weeks.

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The reintroduction phase features
foods with a variety of FODMAP groups,

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 to determine which ones 
are responsible for symptoms.

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Finally, that information is then
incorporated into the personalization phase

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with a long-term diet.

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58% of participants in the medicated
group reported an improvement

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in symptoms after four weeks, 
while the figure for the two diet groups

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was over 70%.

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Diet can be vital for
irritable bowel syndrome therapy.

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We can’t say whether this is 
the most important component,

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or indeed the only component, 
and I’d be skeptical there.

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In most cases, treatment
requires a multimodal approach,

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targeting different areas 
and with different methods.

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Christopher Hertler did change his diet, 
while also using psychotherapy

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to learn how to deal with stress.

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And he’s been
feeling much better for it.

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The most important factor for me
was that you're OK mentally,

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because that really affects
your gastrointestinal tract.

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And you need to clear
your mind of excess baggage.

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Christopher Hertler has
learned how to help himself.

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And with fewer symptoms, he no longer 
gets nervous  when going outside.