Irritable Bowel Syndrome
(IBS) is a disease that consists of diarrhea, constipation, bloating, abdominal pain, gas (flatulence), mucous in the stool, or a combination of these that lasts at least three months. It is one of the most common disorders of the gastrointestinal tract (GI tract) seen in clinical practice and represents a major burden of suffering for those affected. Although the condition is not life-threatening, IBS usually induces multiple doctors’ visits and can compromise the quality of life.
Factors that Contribute to IBS
While a single specific cause is unknown, it is associated with genetic, environmental and hormonal factors as well as allergy, infection, bacterial overgrowth, GI motility disorders, and even stress. For patients with diarrheic IBS there is strong evidence that the problem may be immunologic in nature and associated with food intolerance.
The British Dietetic Association, after reviewing studies on several databases from 1985 to 2009, released some evidence based guidelines for dietary management of IBS in adults. 1
These are some of the dietary suggestions:
Remove Dairy Products
This intervention is especially in groups with high levels of lactase deficiency. While lactose may be a source of bloating and poor digestion in many people, the casein can lead to constipation in others.
Avoid Wheat Bran
Supplement with ground linseed (flax).
Eat High Fiber, Whole Plant-Based Diet
Avoid problem foods if they are an issue, such as beans, cauliflower, cabbage, and broccoli. These can lead to bloating and abdominal discomfort. Slow cooking beans in a crock pot or soaking them in water and throwing away the water three times before using them can help.
Soluble fiber can help relieve constipation, and peppermint oil can relieve the abdominal pain of bloating. Fiber may not always benefit for symptoms relief in all cases of IBS. Fiber, however, does confer multiple other health benefits and should be not abandoned.
Avoid Fructose and Sorbitol Sweetened Beverages
Studies indicate that foods with non-fermentable carbohydrates, such as fructose (found in refined sugar), sorbitol (sugar free sweeteners), and galactosoligosaccharides (found in beans) can worsen bloating for up to 24 hours.
Avoid Trigger Foods
Chocolate, carbonated beverages and alcohol can cause bloating.
Probiotics May Help
Probiotics can be helpful to adjust the bowel flora, although no specific product is recommended. Foods found in a whole plant-food based diet can achieve the same results.
More Lifestyle Suggestions
Don’t swallow air by chewing gum, drinking from a drinking fountain, or through a straw, as these can lead to bloating.
Be aware that symptoms in women can worsen around the menses.
Stay active. A regular walking program can help decrease bloating, constipation, and a feeling of fullness. Move!
Get stress relief! Stress can be a trigger. A recent abstract suggested that gastrointestinal symptoms increased during college examination days in college students.2 A recent intervention that involved 90-minute sessions of education, reassurance, dietary intervention, and exercise instruction, decreased the number of GI related visits and symptoms improved significantly.3 In some cases cognitive behavioral therapy was helpful as well.4 Prayer and meditation provide stress relief for many, and may be the most important action one can take.
- Mckenzie YA., et al. British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults. J Hum Nutr Diet 2012: 25 (3): 260-274↩
- Singh G, Singh B. et al. Gastrointestinal Symptoms During Examination Days in College Students. Am J Gastro Supplement 2012: 107 (S):S708-09↩
- Kalami A. Griem A, et al. A Simple Intervention Program Markedly Decreases Resource Utilization for Adolescents with Irritable Bowel Syndrome. 2012: 107(S):S700-01↩
- Shen YH, Nahas R. Complementary and alternative medicine for treatment of irritable bowel syndrome. Can Fam Physician 2009 Feb; 55(2):143-48↩