IBS – ‘facts and triggers’

First things first, this post is about IBS (irritable bowel syndrome), very different to IBD (inflammatory bowel disease). IBD involves chronic inflammation of sections of the intestines and can require hospitalisation during bad flareups. IBS has no known structural cause and, although it can be inhibiting, symptoms can be improved through making sensible lifestyle and dietary changes.

IBS is quite a common disorder; it is estimated that it could affect up to 25% of the UK population. IBS is thought to be caused through a mixture of psychological and physical factors including; infection, altered gut motility, ‘sensitivity’ to certain foods (I’ll explain this later) and stress.  Many patients who suffer from IBS report symptoms being worse during times of stress, and also recall initial onset to have occurred around the time of a stressful event.

There’s no diagnostic test for IBS, so the first step in diagnosis is excluding presence of more serious conditions, such as IBD. The doctor will then talk through your symptoms with you, and may suspect IBS if you match certain criteria.

Symptoms of IBS differ widely from person to person. Sufferers may experience diarrhoea, constipation (or a mixture of both), bloating, abdominal pain and swelling, wind, urgency to go to the toilet and the feeling of having not been properly. Consequently, the dietary advice varies depending on an individual’s symptoms.

IBS is not a life-threatening condition, but it can cause a significant social impact on those who suffer with it. The good news is that once you’ve learned what foods tend to ‘set it off’, you can work on avoiding these and often improve symptoms. A handy way of doing this is by keeping a food and symptom diary, so you’re able to identify trends in how foods affect your bowel.

As I mentioned earlier, some IBS sufferers can be ‘sensitive’ to certain foods, this is a kind of intolerance whereby specific foods can trigger IBS symptoms. It’s important to stress that these reactions are rarely indicative of food allergy.

Below, I have suggested some things that may help with IBS symptoms. However, because dietary advice will differ so much depending on symptoms, you should also consult a professional for personalised advice. It is important that you don’t cut out too many foods as this will impact the nutritional adequacy of your diet.

• Eating a healthy diet – This may sound obvious, but you should try to eat as close to the Eatwell Plate recommendations as possible. There’s no need for most IBS sufferers to follow any specific diet. It’s also important to drink plenty of fluids; water can help ease constipation and you’ll be needing to replace increased losses if you’re suffering from diarrhoea.
• Establishing a regular meal pattern – Having some sort of routine is important for preventing feelings of hunger, picking at less healthy foods and can help instill healthy habits. 
• Stress less! – Heightened emotions such as stress and anxiety can trigger hormonal changes that can affect digestive system mechanisms. Try taking up a new hobby or doing something active to take your mind off what is causing you stress.
• Prebiotics and Probiotics – Yes, they’re different! Probiotics are live microorganisms that get into the gut and help aid digestion. Prebiotics are non-living substances that encourage the growth of good bacteria in the gut. I think about it as prebiotics being the “food” for probiotics, both of these can be found in certain yoghurt drinks. Although it has not been categorically proven, many patients find that when taken regularly they can help ease IBS symptoms. Remember to always adhere to the manufacturers recommendations.
• Avoid food triggers – Triggers will be different for each person, but some typical ones include; caffeine, alcohol, fizzy drinks, spicy food, sorbitol (artificial sweetener) and fatty foods. Resistant starch found in processed foods can make bloating worse. Resistant starch is also formed when starchy foods (such as potatoes and rice) are reheated. 
• Fibre – It may be necessary to modify the amount and/or types of fibre in your diet. Recommendations about what to change will be based on your own diet and symptoms, so it’s best to talk fibre through with your own GP or a dietitian.

Please note that this post contains information for the general public, this advice should not replace that given to you by your own doctor or healthcare professional. If you think you may have IBS, make an appointment to go and see your doctor.

More information on IBS provided by NHS Choices is available here.