Irritable Bowel Syndrome is a condition which causes abdominal pain/discomfort with changes in bowel habits, i.e. constipation, diarrhoea.

Some methods to manage the symptoms include:

• Eat frequent small meals
• Avoid fatty foods
• High fibre diet

Increasing insoluble fibre through supplements or diet changes might exacerbate symptoms; soluble fibre on the other hand can improve symptoms (e.g. psyllium husks). If you are increasing fibre in your diet, increase it slowly, even in healthy individuals rapid changes in fibre intake can cause unpleasant side effects.

Possible methods of management include:

• The use of prebiotics & probiotics
• Pepperment oil (to relieve mild symptoms)
• Avoiding allergy foods/intolerances – Some patients (not all) with IBS may have food allergies or intolerances that trigger an IBS type reaction, if you suspect this is the case with you, see an allergy specialist or a dietician to undergo a supervised elimination diet.

Possible food triggers:

• Lactose malabsorption – Lactose is a sugar present in milk and other dairy products, the structure of Lactose requires the presence of an enzyme called lactase for absorption. If you do not produce enough of this the lactose will remain undigested and ferment in your bowel, causing pain and discomfort. This can be managed easily by purchasing low lactose/lactose free alternatives such as soy milk, lactose free milk, yoghurt, and avoiding products like cream.
• Fructose malabsorption – Fructose is a type of sugar present naturally in foods, it is also often added to foods such as breakfast cereals, baked goods, jam, and fruit juice. You can manage this by avoiding foods with added fructose (e.g. high fructose corn syrup), and by avoiding foods naturally high in fructose, such as:

-          Honey

-          Dates

-          Oranges

-          Cherries

-          Apples

-          Pears

Mixing this fruit with other foods will slow down the absorption of fructose. Some fruits lower in fructose include bananas and strawberries. Another added sugar is called inulin, this can be added to products such as yoghurt, and can be poorly absorbed.

• Reducing gas forming foods – some examples include:

-          Beans

-          Brussel sprouts

-          Onions

-          Celery

-          Carrots

-          Cabbage

• Wheat and gluten – Avoiding wheat and gluten can reduce symptoms if you are sensitive to the gluten protein. This could be due to a misdiagnosis, as you may not have IBS but might have celiac disease. If you suspect this, get tested before eliminating the food from your diet. Once tested if you would like to eliminate the food as a trial you will need to eliminate it for 3months to get an accurate result.
• Low fat diet – IBS patients have an increased sensitivity to fat, reducing the fat content of your diet might reduce symptoms.
• Coffee – Coffee stimulates the bowel with or without caffeine, eliminating coffee from the diet could reduce symptoms if diarrhoea is a problem.
• Caffeine – Other caffeinated products such as tea and chocolate might trigger symptoms in some individuals.
• Alcohol – Might trigger symptoms in some patients.

There will be a wide variety of differences between individuals as to what‘s a trigger food and what isn’t. Some trial and error will be necessary to determine problem foods.

Reference:

Heizer WD, Southern S, & McGovern S (2009). The Role of Diet in Symptoms of Irritable Bowel Syndrome in Adults: A Narrative Review. Journal of the American Dietetic Association. Volume 109, Issue 7, July 2009, Pages 1204-1214.