Irritable Bowel Syndrome – IBS

Irritable Bowel Syndrome (IBS) is a common disorder of the gastrointestinal tract (the gut).  The cause is unknown although many patients with IBS suspect that their diet plays a key role in causing their symptoms. Not all IBS sufferers will have food related problems.

It is useful to consider the symptoms that you are getting, do you suffer from spasmodic tummy pain, alternating bouts of constipation and diarrhoea, and bloating or excessive wind?  Although this may indicate IBS, symptoms like these or any changes in bowel habits should be investigated by your GP, as there are other bowel conditions that should be ruled out first before you focus on a diagnosis of IBS.

The symptoms of IBS can often be eased with treatments such as anti-spasmodic medications, bulking agents, stool softeners or laxatives. If foods are the trigger, these can be easily investigated by studying your diet carefully. Keeping a detailed food and symptom diary can be used to identify dietary triggers. Because IBS is unlikely to be IgE mediated, there are no reliable tests that can be used to identify these foods, so this makes accurate diary-keeping an essential diagnostic tool. 

Lifestyle can also contribute to IBS so the following tips may help:

Do you go for a long time without eating and drinking?

A regular meal pattern could mean a regular bowel pattern. Skipping breakfast could mean that your bowels are missing the important reflex triggered by the first meal of the day. Fluids, especially water, mean that the contents of your bowel stay soft - passing hard stools is difficult and painful.  Aim for 8 - 10 glasses a day, more if are exercising or in a hot environment, or if you eat a high fibre diet.

Aim for five portions of fruit or vegetables every day.  The type of fibre in fruit, vegetables and peas/beans/pulses (lentils, chick peas, kidney beans etc) can help regulate the bowel and stool consistency.

Do you suffer from diarrhoea?

Look at your lifestyle. Are you the type of person who is always rushing around, missing meals and then fitting in a large dinner late at night?

Taking time out for food and drink away from the stresses of the day and eating regularly is very likely to help.

Excessive amounts of caffeine or acidic drinks may also be responsible.  Tea, coffee, cola drinks, fruit juice and alcohol may bring on bouts of diarrhoea.

Foods containing sorbitol such as diabetic products and some sweets can cause diarrhoea in a sensitive individual.

Diarrhoea symptoms with IBS may indicate food intolerance.  Symptoms can take from a few hours to 48 hours after eating to appear, making it very difficult to pinpoint the culprit.  The best thing to do is to keep a food and symptom diary for at least two weeks to see if a pattern emerges. Once the food has been identified, then you need to think whether it affects the balance of your diet.  If for example you find that chocolate triggers symptoms, then avoiding chocolate is not going to have a major impact on your diet.  If, however, you find that it  a major food group such as milk or wheat is not tolerated and needs to be excluded, then you may need to have your diet supervised by a dietitian. If you cannot identify the trigger foods from the food diary, the dietitian may suggest you follow an EXCLUSION DIET, which needs careful interpretation and monitoring. A suitable vitamin or mineral supplement may be required whilst these investigations are ongoing.

Bloating may be a main symptom on its own or it may occur alongside constipation and/ or diarrhoea.  Certain foods can cause excessive bloating and wind. 

Common foods include onions, artichokes, baked beans, lentils, cabbage, brussel sprouts, under-ripe bananas, and food that has been cooked, cooled and reheated, fizzy drinks may also make the problem worse for some people.

Eating too fast or talking whilst eating and so gulping down excessive air and drinking fizzy drinks with a meals can be a cause of bloating. 

Peppermints or peppermint tea can be helpful in alleviating some of the symptoms of IBS.

FODMAPS

Fructo oligosaccarhides, disaccharides, monosaccharides, and polyols (FODMAPS) are compounds found in certain foods and there is some good evidence to say that cutting down on these can help the symptoms of IBS.  For further information on FODMAPS and whether this could be a suitable dietary trial for you see www.fodmap.com

If you have IBS, helpful advice and information can be obtained from the IBS Network.

In summary, there are many dietary treatments for IBS and with expert advice it is possible to improve or resolve symptoms.