Are you or a relative suffering from irritable bowel syndrome? Maybe you are looking for more information about symptoms, or how to change your diet, or about the Low FODMAP diet. Read on to find out my 7 practical tips to help with irritable bowel syndrome, when to seek medical help, and about the FODMAP diet.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) affects up to 20% of adults, with a variety of symptoms that vary for person to person. The main symptoms are:
- Abdominal pain or discomfort which is relieved by going to the toilet, or a change in bowel habit
- Change in bowel habit
- Urgency to pass stool
Additionally, many people also report that they have other symptoms too such as:
- Bladder symptoms such as urgency needing the toilet
When To See Your Doctor
If you experience any of these symptoms, especially altered bowel habit, it is important to be checked out by your doctor to rule out other diagnoses such as Coeliac Disease. This is especially important if you have any of these additional symptoms:
- A family history of ovarian or bowel cancer
- Pass blood with stool
- Unexplained and unintentional weight loss
- Any change of bowel habit that persists for more than 6 weeks
What Causes Irritable Bowel Syndrome?
Why does IBS happen? Until recently we didn’t why or how the symptoms of IBS happened. This is now changing, and there are a number of possible mechanistic theories that might share similar pathways, explaining the spectrum of symptoms and often variability of the syndrome.
Gut infection, genetics, antibiotics, diet, chronic or a susceptible microbiome (friendly bacteria and organisms that live in the gut), are now thought to lead to a “leaky” gut. This in turn leads to inflammation and that could disturb the gut-brain axis, causing both gut and more generalised symptoms such as tiredness and anxiety.
7 Practical Tips to Help with Irritable Bowel Syndrome
At present any genetic risk of IBS can’t be changed, but there are number of other risk factors that can be modulated and practical tips you can do to help with symptoms of irritable bowel syndrome:
- Reduce your chronic stress, by taking time to relax. Exercise, mindfulness, massage, and sleep may help.
- Keep a food diary to see if any particular food items repeatedly worsen your symptoms.
- If you particularly suffer from wind and bloating, then limit the legumes, pulses, sprouts, and sugar-free chewing gum.
- If you suffer more from constipation, try to gradually increase your fibre intake from whole-grains, oats, vegetables, seeds and fruit.
- If diarrhoea is your main symptom then reduce your high-fibre intake, avoid sweeteners in hot drinks, sugar free mints and chewing gum, and reduce caffeine from tea and coffee.
- Probiotics and bacteria and yeasts that may help to restore the balance of friendly organisms within the gut (microbiota). There are lots of ways that you can help support these friendly micro-organisms that are so important for gut and general health. Firstly have a diet rich in fruit and vegetables that you can tolerate; the fibre in these are fermented by the organisms and used as nourishment for them. Secondly eat a range of naturally fermented foods/drinks such as kefir, low sugar kombucha, artisan cheese, and raw fermented slaw such as sauerkraut and kimchi. Thirdly, studies have shown that some probiotics can reduce the symptoms of IBS.
- Consider trying the FODMAP diet (see below).
What is the Low FODMAP Diet and Why Can it Help with Irritable Bowel Syndrome?
A diet developed in Australia termed the low FODMAP diet has had some success in managing irritable bowel syndrome symptoms, reducing symptoms by up to 70%. This diet involves restriction of fermentable carbohydrates, that are not absorbed in the bowel very well, but are altered by the microbiota. This restricts some naturally occurring prebiotics from the diet and it lowers the numbers of some key gut microbiota.
FODMAP stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. These fermentable short-chain carbohydrates are prevalent in the diet:
Oligosaccharides: fructans and galacto-oligosaccharides (GOS)
Polyols: sorbitol and mannitol
Fermentation of these carbohydrates in the bowel by the microbiota is associated with an increase of fluid and gas, that can lead to bloating, gas, pain and diarrhoea.
Eating less of these types of carbohydrates may decrease these symptoms.
- Dairy products
- Fruits such as pears, apples, pears, peaches, cherries, mangoes, pears and watermelon
- Sweeteners, such as honey and agave nectar
- Products containing high fructose corn syrup
- Vegetables such as artichokes, asparagus, Brussels sprouts, broccoli, beetroot, garlic and onions
- Grains such as wheat and rye
- Added fibre, such as inulin
- Chickpeas, lentils, kidney beans and soy products
- Vegetables, such as broccoli
- Fruits, such as apples, apricots, blackberries, cherries, nectarines, pears, peaches, plums and watermelon
- Vegetables, such as cauliflower, mushrooms and snow peas
- Sweeteners, such as sorbitol, mannitol, xylitol, maltitol and isomalt found in sugar-free gum and mints, and cough medicines and drops.
In the FODMAP diet, only the problematic foods in a category should be eliminated, not all of them. As some may be tolerated better than others, and trying to maintain gut diversity is still important.
There is concern that this diet is overly restrictive. Therefore, it is best to keep a diary, and notice any foods that persistently cause an increase in symptoms before cutting out any food groups from your diet. Exclusion diets can be managed by a qualified nutritionist or dietician, as it is important to make sure your eating plan is safe and healthy.
Further research is required on the effect of prebiotics in gastrointestinal disorders and, in particular, on their use in conjunction with the low FODMAP diet.
I hope that you have found these practical tips to help with irritable bowel syndrome helpful and know about the low FODMAP diet.