Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal
pain or discomfort associated with altered bowel habit (diarrhea, constipation or both) symptoms in the
absence of structural, major inflammatory or biochemical abnormalities.
These symptoms can significantly impair quality of life, reduce work productivity and increase utilization
of health care resources. IBS include recurrent abdominal pain, on average, at least one day a week in the
past three months, associated with two or more additional criteria:
• Discomfort related to defecation
• A change in frequency of stool
• A change in form (appearance) of stool
Three distinct subtypes of IBS have been described:
• IBS with constipation (IBS-C) has a 28 percent prevalence.
• IBS with diarrhea (IBS-D) has a 26 percent prevalence.
• IBS with a mixed bowel pattern (IBS-M) has a 44 percent prevalence.
Some researchers hypothesize that disturbances in tryptophan metabolism may contribute to gastrointestinal symptoms and mood disturbances. Histamine, via histamine receptor 1, may potentiate visceral hypersensitivity.
Some researchers theorize that immune-mediated responses to food components may play a role in IBS.
Using confocal endomicroscopy, they have detected subtle structural changes in the duodenal mucosa in the small intestines after exposure to specific food antigens. The clinical significance, if any, of this finding is unclear. In addition to an exaggerated gastro-colonic motor response, some patients with IBS also have increased colonic perception of distention after a meal (Abdominal Bloat).
Emerging evidence supports the benefits of dietary management for IBS symptoms and generally focuses on modifying intake of the following foods:
Caffeine and fat
Because caffeine intake stimulates gut motility, reducing caffeine intake is recommended. As well as a
low-fat diet is recommended since fatty foods may cause painful contractions in patients with IBS.
Fiber
It is widely believed that IBS is also caused by a deficient intake of dietary fiber, and most physicians
recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms.
However, different types of dietary fiber exhibit differences in physical and chemical properties, and the associated health benefits are specific for each fiber type.
Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results
in rapid gas production that can cause abdominal pain, discomfort, abdominal bloating,
distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous,
soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS.
Gluten
Several studies have demonstrated that gluten may contribute to symptoms in IBS, even in patients without
celiac disease (non-celiac gluten sensitivity), and that at least a subset of IBS patients might benefit from
a diet containing no gluten, or a reduced amount. It’s important to rule out celiac disease before testing
a gluten-restricted diet.
FODMAPs
It’s also possible that FODMAPS, nonabsorbable carbohydrate components of wheat, may cause
IBS symptoms often attributed to gluten. Diets low in fermentable oligosaccharides, disaccharides,
monosaccharides and polyols (FODMAPs) may be appropriate for patients with IBS. Wheat, onions, some
fruits and vegetables, sorbitol, and some dairy products are some of the foods that contain FODMAPs.
What is FODMAP?
FODMAP foods are foods that the small intestine absorbs poorly.
To ease IBS and SIBO symptoms, it’s essential to avoid high FODMAP foods that aggravate the gut,
including:
• Dairy-based milk, yogurt and ice cream
• Wheat-based products such as cereal, bread, pasta and crackers
• Beans and lentils
• Some vegetables, such as artichokes, asparagus, onions and garlic
• Some fruits, such as apples, cherries, pears and peaches
Instead, base your meals around low FODMAP foods such as:
• Eggs and meat
• Certain lower fat cheeses such as feta and grana Padano
• Plant based milk products : Almond milk, oat milk, and coconut milk
• Grains like rice, quinoa and oats
• Vegetables like eggplant, potatoes, tomatoes, cucumbers and zucchini
• Fruits such as grapes, oranges, strawberries, blueberries and pineapple
IBS is a chronic condition. So, while it’s likely to be diagnosed before the age of 50, once you have IBS, it’s something you have to continue managing into your later life. IBS treatments focus on managing symptoms so they don’t interfere with your daily life. If you experience mild signs and symptoms of IBS, making minor changes to your daily living can help:
• Drinking the proper fluids - It’s helpful to drink lots of water to soothe your stomach. However, drinking too much caffeine or alcohol increases diarrhea. It would help if you also avoided carbonated drinks because they can cause gas.
• Manage your stress - Stress provokes IBS flare-ups. Work on ways to manage your stress, such as meditation, exercise, and deep breathing.
• Tweak your diet - What you eat plays a significant role in how your body feels. In general, foods known for causing gas, such as high FODMAP foods, should be avoided or eaten in moderation.
• Exercise regularly - Low to moderate-intensity workouts such as walking and yoga can help reduce symptoms by reducing stress and encouraging bowel movements. Light stretching can also help relieve the pain of the abdomen.
• Quality sleep - Many people with a gastrointestinal disorder experience trouble sleeping. To improve your sleep, try disconnecting from electronics, such as your phone and television, at least one hour before bed. Also, work on creating a bedtime routine with a regular bedtime each night. Eating dinner early also contributes to better quality sleep.
Contact me for a personalized IBS Friendly Nutrition plan #livingwithibs #ibs #healthyeating #fodmap
