Irritable Bowel Syndrome (IBS) is a chronic condition that affects your digestive system. The exact reason for its existence is unknown, however, factors thought to be linked can include; the speed at which food passes through the digestive system, ultra-sensitive nerve endings in the gut, changes in gut bacteria, and stress. It has also been shown that a family history of IBS could increase your odds. 

How do you diagnose IBS?

It is very hard to diagnose IBS at the present time. There are no diagnostic tests available and diagnosis by a GP can only be made based on your symptom history.  
 
 However, it is important to note many IBS symptoms are similar to Inflammatory Bowel Disease (IBD). We recommend seeking medical advice from your GP if any of the below symptoms are affecting your quality of life. 

What are the symptoms of IBS?

The symptoms of IBS are widespread and can come and go throughout the course of a lifetime. The most common symptoms include:

  • Bloating
  • Flatulence
  • Abdominal distension
  • Constipation
  • Diarrhoea
  • Change in bowel habit
  • Mucous in stools
  • Fatigue
  • Nausea
  • Backache

Stress, illness, or specific foods and/or eating patterns may trigger any of the above symptoms.
 

How can I manage these symptoms?

Unfortunately, a cure for IBS is yet to be found. However, the following strategies may help you to improve your symptoms whilst ensuring you are meeting your nutritional requirements.

Bloating/flatulence/abdominal cramps

  • Spread your main meals evenly throughout each day. Aim for three main meals and 1-2 snacks, if necessary 
  • Use mindfulness strategies when eating (e.g the hunger scale or 20, 20, 20 rule ) to help avoid over-eating
  • Reduce the amount of air you swallow by chewing your food well. Also, avoid chewing gum and carbonated beverages 
  • Reduce or avoid gas producing foods such as onions, garlic, brussel sprouts, cabbage, red kidney beans, navy beans, chickpeas and lentils. These foods contain indigestible carbohydrates and can exacerbate flatulence and abdominal pain. If you do decide to include them in your diet, rinse with water first to reduce the starch content
  • Limit alcohol consumption as this can irritate the stomach and gastrointestinal tract
  • There is some evidence to suggest peppermint oil/capsules can reduce flatulence and abdominal pain for individuals who suffer from IBS

Diarrhoea

  • Reduce intake of insoluble fibre; remove skins from fruit and vegetableslimit consumption of nuts/seeds  replace wholegrain breads and cereals with wholemeal varieties 
  • Limit consumption of fruit (fresh, tinned, dried and juices)
  • Avoid consumption of spicy foods (e.g. curries, chilli) and very high fat foods (fast food, pastries, cakes, cream, ice cream, processed meats) 
  • Limit caffeine containing beverages as these can have a laxative effect
  • Avoid sorbitol; a sugar alcohol found in sugar free sweets, chewing gum and beverages which can act as a laxative 
  • Make sure to drink plenty of water and stay hydrated, particularly if the diarrhoea is severe 

Constipation

  • Aim for >2L water per day as this will help to soften the stool 
  • Increase intake of both soluble and insoluble fibre;Soluble fibre absorbs extra water in the colon and forms a thick gel that helps to soften stool (think oats, flax seed and psyllium) Insoluble fibre adds bulk to your stool, and is found in wholegrain carbohydrates (such as wholegrain bread, pasta and brown rice). However, it is important to increase intake of insoluble fibre slowly and with plenty of water to prevent exacerbation of symptoms
  • Engage in regular physical activity. This helps to stimulate your gut muscles and therefore keeps food moving along your digestive tract 

General tips

  • Prepare meals at home, using fresh ingredients 
  • You might like to make use of a food and symptom diary for 5-7 days. This can help you to identify whether your symptoms are food relatedIf it becomes obvious that certain foods are causing you symptoms, remove these from your diet to see if you notice any improvementIf symptoms don’t improve within several weeks of elimination, re-introduce the food back into your dietIf you’re eliminating a particular food group (e.g. dairy products), you might be lacking in essential nutrients. Talk to your mentor about alternative foods to choose so that you can get all the nutrients necessary for optimal health
  • There is some emerging research to suggest that fermented foods (kimchi, sauerkraut, kombucha or kefir, for example) can have a positive effect on gut bacteria and may help to improve symptoms of IBS. You could experiment by adding a range of these foods to your diet 
  • As stress is a major trigger for IBS flare ups, relaxation techniques such as meditation and breathing exercises can help calm the body and mind 
  • Cognitive behavioural therapy (CBT) is another valuable tool used by many to help improve thought processes and control low mood and anxiety  
  • Taking part in regular exercise will release endorphins which can help to reduce stress 

Are there any supplements I can take to help improve my symptoms?

  • Probiotic supplements may be beneficial for general ‘gut health’, however, there is not enough research yet to suggest these supplements will assist with symptom management of IBS 
  • It’s advisable to avoid prebiotic supplements, as it has been shown that many individuals who suffer from IBS are sensitive to these

What about the low FODMAP diet?

The low FODMAP diet is designed to help relieve symptoms associated with IBS. However, it is a specialised diet that should only be undertaken under the supervision of a Registered Dietitian who is an expert in this area. If this is of interest to you, we recommend discussing this with your GP who may request a specialist dietitian referral. 

For additional information on IBS, please visit the NHS website:
 https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/

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