Eating well for irritable bowel syndrome (IBS)

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that affects the large intestine. It is characterized by symptoms such as abdominal pain, bloating, diarrhoea, and constipation. While there is no single diet or medicine that works for everyone with IBS, there are several strategies and lifestyle changes that can help manage the symptoms effectively. In this article, we will explore various diet, lifestyle, and medication options to relieve IBS symptoms and improve overall quality of life.

Understanding Irritable Bowel Syndrome (IBS)

Before diving into the specifics of eating well for IBS, it is important to understand what IBS is and how it affects the body. Irritable Bowel Syndrome is a chronic condition that affects the large intestine, causing symptoms like abdominal pain, bloating, and changes in bowel habits. It is estimated that IBS affects around 10-15% of the global population, with women being more prone to developing the condition than men.

Symptoms of Irritable Bowel Syndrome (IBS)

The symptoms of IBS can vary from person to person, but common symptoms include:

• Abdominal pain or cramping
• Bloating and gas
• Diarrhea or constipation, or a combination of both
• Urgency to have a bowel movement
• Feeling of incomplete bowel movement
• Mucus in the stool

Causes of IBS

The exact cause of IBS is unknown, but several factors are believed to contribute to its development. These include abnormalities in the gut-brain axis, changes in gut motility, increased sensitivity of the gut, and alterations in the gut microbiota. Additionally, certain triggers such as stress, certain foods, and hormonal changes may exacerbate symptoms in individuals with IBS.

Getting diagnosed with Irritable Bowel Syndrome (IBS)

If you suspect you may have IBS, it is important to consult a healthcare professional for a proper diagnosis. The diagnosis of IBS is typically based on the presence of characteristic symptoms and the exclusion of other gastrointestinal disorders. Ruling out intolerance to lactose and gluten and celiac disease is important. Your healthcare provider may perform various tests, such as blood tests, stool tests, and imaging studies, to rule out other conditions and confirm the diagnosis of IBS.

Diet and lifestyle strategies for managing IBS

While there is no one-size-fits-all diet for IBS, there are certain general tips and strategies that can help relieve symptoms and improve overall well-being. It is important to keep in mind that what works for one person may not work for another, so it may take some trial and error to find the right approach for you. Here are some general tips to consider:

Keep a food diary

Keeping a food diary can help you identify trigger foods that worsen your IBS symptoms. Make a note of what you eat and drink, as well as any symptoms you experience. Over time, patterns may emerge, and you can make informed decisions about which foods to avoid or limit.

Cook homemade meals using fresh ingredients

Cooking homemade meals using fresh ingredients gives you better control over what goes into your food. Avoiding processed foods and opting for whole, unprocessed ingredients can help reduce the risk of triggering IBS symptoms.

Identify and avoid trigger foods

Different foods can trigger IBS symptoms in different individuals. Some common trigger foods include fatty foods, spicy foods, processed foods, caffeine, alcohol, and carbonated beverages. It is important to identify your trigger foods and avoid or limit their consumption.

Eat regularly and avoid skipping meals

Skipping meals or delaying meals can disrupt your digestive system and potentially trigger IBS symptoms. It is important to eat regular meals and snacks to keep your digestive system functioning smoothly.

Limiting fatty, spicy, and processed foods

Fatty, spicy, and processed foods are known to irritate the gastrointestinal tract and can trigger symptoms in individuals with IBS. These foods are often high in additives, preservatives, and unhealthy fats, which can worsen digestive symptoms.

Opt for lean sources of protein, such as skinless poultry, fish, and tofu, instead of fatty meats. Choose milder seasonings and herbs to add flavour to your meals, instead of relying on spicy ingredients. Minimize your intake of processed foods and opt for whole, unprocessed alternatives whenever possible.

Managing fresh fruit and caffeine intake

While fresh fruits are generally considered healthy, individuals with IBS may need to moderate their consumption. Some fruits, such as apples, pears, and plums, contain high amounts of fermentable sugars called FODMAPs, which can trigger symptoms in sensitive individuals. Choosing fruits such as bananas, strawberries, blueberries, raspberries, melons, kiwi, cantaloupe and grapefruit are better alternatives.

Caffeine, found in coffee, tea, and some soft drinks, can act as a stimulant and may worsen IBS symptoms in some individuals. It is advisable to limit caffeine intake and monitor how it affects your symptoms.

Minimising alcohol and fizzy drink consumption

Alcohol and fizzy drinks can irritate the digestive system and lead to symptom flare-ups in individuals with IBS. Alcohol can increase gut sensitivity and disrupt the natural balance of gut bacteria.

It is advisable to minimize alcohol consumption and opt for non-alcoholic alternatives or mocktails. Fizzy drinks, including carbonated water and sodas, can cause gas and bloating, so it is best to limit their intake as well.

Impact of sorbitol

Sorbitol is an artificial sweetener commonly found in sugar-free gum, sweets, and some fruits. It is known to have laxative effects and can worsen symptoms in individuals with IBS. Other common sugar alcohols are xylitol, maltitol and mannitol.

To ease bloating, cramps, and excess wind, it is advisable to minimise your intake of sorbitol-containing foods and beverages. Read food labels carefully to identify products that contain sorbitol and choose alternatives without this sweetener.

Eat slowly and mindfully

Eating too quickly can lead to swallowing excess air, which can contribute to bloating and gas. Take your time to chew your food thoroughly and savour each bite. Eating mindfully can also help you tune in to your body’s signals of hunger and fullness.

Experiment with a low-FODMAP diet

A low-FODMAP diet or IBS diet is a temporary elimination diet that can help identify specific types of carbohydrates that may trigger IBS symptoms. FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of poorly absorbed carbohydrates that can ferment in the gut, leading to symptoms like bloating and gas. These are a group of short-chain carbohydrates that are not very well absorbed in the gut (small intestine). Some gas-producing vegetables and legumes include broccoli, cauliflower, cabbage, brussels sprouts, chickpeas, lentils, and black beans.

Temporarily restricting or limiting your intake of high FODMAP foods for 2–6 weeks may help improve your IBS symptoms. Working with a registered dietitian can help guide you through the low-FODMAP diet and reintroduction phase.

Increase fibre intake

Soluble fibre is particularly beneficial for individuals with constipation-predominant IBS. It adds bulk to the stool and helps regulate bowel movements. Incorporate soluble fibre-rich foods into your diet, such as oats, pulses, carrots, and peeled potatoes. These foods can help soften the stool and alleviate constipation symptoms.

However, increasing fibre intake too quickly can worsen symptoms for some individuals with IBS. It is recommended to gradually increase fibre intake from sources like fruits, vegetables, whole grains, and legumes while monitoring how your body responds.

Stay hydrated

Drinking enough water is essential for maintaining good digestive health. Aim to drink at least 8 cups of water per day and more if you are physically active or in hot weather. Staying hydrated can help prevent constipation and promote regular bowel movements.

Manage stress

Stress can have a significant impact on digestive health and can worsen IBS symptoms. Finding effective stress management techniques, such as exercise, meditation, deep breathing exercises, or engaging in hobbies, can help reduce stress levels and improve overall well-being.

Consider Probiotics

Probiotics are beneficial bacteria that can help restore the balance of gut bacteria and potentially alleviate IBS symptoms. Some studies have shown that certain strains of probiotics, such as Bifidobacterium infantis and Lactobacillus plantarum, may be helpful for individuals with IBS. However, it is important to consult with your healthcare provider before starting any probiotic supplements.

Medications for managing IBS

In addition to diet and lifestyle strategies, medications may be prescribed to manage specific symptoms of IBS. It is important to consult with a healthcare professional before starting any medications. Here are some commonly prescribed medications for IBS:

Antispasmodics

Antispasmodics are medications that help relax the muscles of the intestines, reducing abdominal cramping and pain. They can be helpful for individuals with IBS who experience frequent abdominal pain or spasms.

Antidiarrheal medications

For individuals with IBS who experience frequent diarrhea, antidiarrheal medications such as loperamide (Imodium) can help reduce the frequency and urgency of bowel movements.

Laxatives

Laxatives may be recommended for individuals with IBS who experience constipation. There are different types of laxatives available, including bulk-forming laxatives, osmotic laxatives, and stimulant laxatives. It is important to use laxatives under the guidance of a healthcare professional.

Psychological therapies

Since stress and psychological factors can play a significant role in IBS symptoms, psychological therapies such as cognitive-behavioral therapy (CBT), hypnotherapy, and relaxation techniques may be recommended to help manage symptoms.

Further help and support for individuals with IBS

Living with IBS can be challenging, but there are resources and support available to help you manage the condition effectively. Here are some additional sources of help and support:

The IBS Network

The IBS Network is a charity organization that provides information, support, and resources for individuals with IBS. They offer a range of resources, including dietary advice, self-help materials, and a helpline.

Dietitians

Registered dietitians specialize in providing nutrition advice and support for individuals with various medical conditions, including IBS. Working with a dietitian can help you develop a personalized eating plan that suits your needs and preferences.

Self-management strategies

Self-management is an essential aspect of living well with IBS. This involves understanding your triggers, adopting healthy lifestyle habits, and finding strategies to cope with stress. Keeping a symptom diary can help identify patterns and triggers. It is also important to prioritize self-care, engage in regular physical activity, and practice stress management techniques such as deep breathing or mindfulness.

Support Groups

Joining a support group or online community for individuals with IBS can provide a sense of community and allow you to connect with others who understand what you’re going through. Sharing experiences and learning from others can help manage the condition.

In conclusion, while there is no one-size-fits-all approach to eating well for IBS, making certain dietary and lifestyle changes can help manage symptoms and improve overall well-being. It is important to work with healthcare professionals, such as doctors and dietitians, to develop a personalised plan that suits your individual needs. By implementing these strategies and seeking support when needed, individuals with IBS can lead a fulfilling and manageable life.

Sources

• Irritable bowel syndrome (IBS) – Diet, lifestyle and medicines – NHS
• Irritable Bowel Syndrome | Causes, Symptoms & Treatment | Guts UK