Irritable bowel

Worried about your tummy and the funny things it does? You are not alone. While there can be many causes for different gut symptoms one of the conditions that causes a range of problems is Irritable Bowel Syndrome.

IBS is thought to affect about one in ten people, mostly women between the ages of 20 and 50 years. Symptoms can include heartburn, nausea, bloating, crampy abdominal pain, diarrhoea, constipation or even alternating diarrhoea and constipation.

Generally IBS is diagnosed when other health conditions have been eliminated as there is no specific diagnostic test for IBS. Management of IBS symptoms can include some or all of the following: medication, dietary changes and the management of stress and anxiety.

A number of people will self-diagnose their symptoms but it is always important to have these investigated by your doctor as other causes such as coeliac disease, thyroid disease, endometriosis, diverticulitis and cancer need to be excluded.

I see a number of people in my clinic with a range of gut problems. Unfortunately when it comes to IBS there is not one diet that fits all so some trial and error may be necessary to find the right approach.

I often see people who have tried so many different things that they are confused about what does or doesn’t aggravate their symptoms.

IBS Treatment

An initial starting point is to ensure that you are eating regularly. If you are skipping meals, especially breakfast, this can interfere with your bowel habits. A healthy balanced diet is important for people with IBS.

Assessing your fibre intake and knowing what sort of fibre to include is also important. Fibre is thought to be important in the management of IBS. There are two types of fibre in the plant foods we eat – soluble and insoluble. Soluble fibre found in food such as oats, fruits and dried beans will help to keep your bowel motions soft and is thought to be important in the management of IBS. Insoluble fibre, generally recommended for the treatment of constipation, may in fact aggravate symptoms for some people with IBS.

How much fat do you have in your diet? A high fat intake may make flatulence (wind) or bloating worse for the person with IBS. Decreasing your fat intake can be useful. Think of the hidden fats not just the obvious fats in the food you eat. Check your diet for its fat content. Fat will come from fried foods, pastries, fat found on meat and in mayonnaise, cakes, biscuits, cheese, full fat milk, cooking oils and spreads such as margarine or butter.

Other common diet triggers may include alcohol, caffeine, spicy foods, chocolate, or windy foods such as cabbage or onions.

For some people it will be necessary to go further and look for other food intolerances. A good starting place can often be to keep a food and symptom diary as this can help to identify less obvious food causes.

Recently research has identified that some of the naturally occurring sugars in food can affect some people. In most people the gut will breakdown and absorb the naturally occurring sugars in food. If the sugars do not get broken down and absorbed they can ferment in the gut causing the symptoms of bloating, abdominal pains and / or diarrhea.

The sugars that are suspected are the sugars found in some fruits (fructose); milk sugar (lactose); alcohol sugars found in some artificially sweetened products and some stone fruits; fructan the sugar found in wheat products and some vegetables as well as galactan the sugar found in dried beans.

It is unlikely that a person with IBS will react to all these sugars, so some detective work is necessary to identify which, if any, of these foods may be causing symptoms. It is also unlikely that complete exclusion of the sugar causing problems will be necessary as you may be able to tolerate a small amount in your diet.

If you need to exclude a range of foods from your diet it is important to get advice to ensure you are still getting a good range of the nutrients you need for good health.

If you suffer from IBS take a little consolation from the fact that you are not alone. While it may take some time to work out how to manage your symptoms it can be done. Food is only one aspect though. It is also important to address any stress in your life and ensure you are getting enough sleep.

Make sure you get your symptoms checked by your doctor. You need to make sure you have the correct diagnosis. Some people find removing gluten (a protein found in wheat, barley, rye and oats) resolves their symptoms; however it is important to have the diagnosis of coeliac disease eliminated. A person with coeliac disease needs to strictly avoid gluten for the rest of their life. A person with IBS may be able to tolerate small amounts of gluten without the risk of developing the same health issues that someone with coeliac disease would if they had traces of gluten in their diet.