Dante Carrillo
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects around 1 in 10 people in the United States each year. It causes uncomfortable abdominal symptoms, including constipation, diarrhoea, gas and bloating. While there is no single diet that works for everyone with IBS, symptoms can often be managed through dietary and lifestyle changes. Doctors may recommend a low FODMAP diet, which involves reducing the amount of hard-to-digest carbohydrates in your diet, or avoiding gluten. Staying hydrated by drinking enough water or herbal tea is also recommended, while caffeine and alcohol may make symptoms worse and should be limited or avoided.
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Avoid gluten
While there is no single diet that works for everyone with IBS, some dietary changes may improve symptoms. One option is to avoid gluten, a protein found in wheat, barley, and rye. This includes most cereals, grains, pasta, and processed foods.
Some people with IBS report an improvement in symptoms when following a gluten-free diet, even if they do not have celiac disease. Gluten-containing grains are high in fructans, which are fermentable sugars that can trigger IBS symptoms. Fructans are a type of FODMAP, which stands for Fermentable Oligo-Di-Monosaccharides and Polyols. These are short-chain carbohydrates that are poorly digested and absorbed in the small intestine, even in healthy individuals.
A low FODMAP diet is considered one of the best and most effective IBS treatments. This diet involves eliminating FODMAP-containing foods for a few weeks and then slowly reintroducing them to determine individual triggers. A recent study found that 100% of participants with both gluten sensitivity and IBS experienced better symptom relief on a low FODMAP diet compared to a gluten-free diet. However, it is important to note that only a small percentage of participants experienced symptoms when gluten was added back into their diet.
While a gluten-free diet may not be necessary for everyone with IBS, it may be worth trying under the guidance of a healthcare professional. This could involve working with a specialized dietitian to ensure the diet is least restrictive and provides long-term symptom relief and nutritional variety.
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Try the low FODMAP diet
The low FODMAP diet is an approach to identifying and reducing foods that may be irritating your gut and causing gastrointestinal distress. It is a temporary eating plan that is very restrictive, so it is not meant to be followed long-term. It is important to work with a doctor or dietitian to ensure you are following the diet correctly.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are short-chain carbohydrates (sugars) that the small intestine absorbs poorly. FODMAPs draw more fluid into the intestine and create more gas, slowing digestion and resulting in gas, bloating, pain, or diarrhoea.
The low-FODMAP diet restricts these carbohydrates in order to relieve uncomfortable symptoms and give your digestive system a rest. Removing irritants gives your gut lining a chance to repair itself and can help restore a healthy balance of gut flora. It is often prescribed as an elimination diet to identify food triggers for people with IBS.
The diet has three phases: an elimination phase, a reintroduction phase, and a maintenance phase that’s customised to you. During the elimination phase, you'll avoid all of the high-FODMAP foods, including specific fruits, vegetables, grains, and proteins. After two to four weeks, you’ll begin the reintroduction phase, in which you systematically add foods back in, one at a time, to see if they cause any symptoms. The third phase keeps the foods that work for you and leaves out the ones that don’t.
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Drink more water
While there is no one-size-fits-all solution for managing IBS, staying hydrated by drinking enough water is generally recommended. Water is the best form of hydration for people with IBS because it effectively flushes out your system and soothes stomach distress. Aim for at least 6 to 8 eight-ounce glasses of water daily, which equates to around 1.5 litres. This is especially important if you experience diarrhoea, as staying hydrated will help to prevent dehydration.
In addition to water, you can also drink other fluids such as non-caffeinated herbal tea. However, it is important to note that not all fluids have the same effect on your stomach. Caffeinated drinks, carbonated beverages, and alcohol can cause stomach distress and negatively impact your IBS symptoms. Caffeine and alcohol can overstimulate your intestines and lead to diarrhoea, while carbonated drinks can cause gas. Therefore, it is advisable to minimise or avoid these types of drinks and opt for water instead.
If you find plain water boring, you can try adding fresh peppermint leaves to add a hint of flavour. This has the added benefit of potentially helping with IBS symptoms, as peppermint oil is often recommended by pharmacists to help with IBS.
Overall, staying properly hydrated by drinking adequate water is an important part of managing IBS symptoms and maintaining overall health.
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Limit caffeine
While there is no one-size-fits-all solution for managing IBS, dietary and lifestyle changes can help improve symptoms. One such change is limiting caffeine intake.
Caffeine, typically in the form of coffee, is commonly associated with triggering IBS symptoms. However, it is important to note that not all individuals with IBS will experience the same triggers, and some may be able to tolerate small amounts of coffee without issue. Nonetheless, due to its potential to aggravate symptoms, it is generally recommended to limit or avoid caffeine if you have IBS.
The stimulating effects of caffeine can be harnessed to promote laxation in those with constipation-dominant IBS. This can be done in conjunction with other diet and lifestyle changes, such as eating breakfast, increasing fluid intake, and incorporating more soluble fibre into your diet. Additionally, regular exercise is recommended alongside these dietary adjustments.
It is worth noting that there is limited evidence to suggest that altering caffeine intake significantly improves IBS symptom control. Nevertheless, if caffeine is suspected to be a trigger for your IBS symptoms, it is advisable to restrict your intake.
If you are seeking further guidance on managing your IBS through diet, consider consulting a registered dietitian or gastroenterologist. They can provide specialised advice and help you determine which foods may be triggering your symptoms.
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Exercise
A 2018 study found that low- to moderate-intensity activity can help relieve IBS symptoms. There is also evidence that vigorous exercise may aggravate symptoms, with some sources suggesting that intense or prolonged activities, such as running a marathon, may trigger diarrhoea or draw blood away from the gut, causing cramps, bloating and pain.
It is recommended that individuals with IBS aim for 150 minutes of moderate exercise weekly, which equates to approximately 30 minutes a day, five days a week. "Moderate" exercise means you are raising your heart rate. Walking is a great option for beginners, as it is free, low impact, and can be done outdoors, which is beneficial for your circadian rhythm.
Yoga and tai chi are also recommended for IBS sufferers. These practices involve connecting the brain, body, and breath through a series of poses and slow, graceful movements, coupled with deep breathing. Yoga and tai chi can help to reduce stress, which is a common trigger for IBS flare-ups.
Other exercises that may be beneficial include light jogging, swimming, and cycling. These activities can help regulate blood sugar levels, improve cardiovascular health, and provide a good workout for the legs and heart.
It is important to note that everyone's experience with IBS is unique, and it may take time to find an exercise routine that works for you. Always consult your doctor before beginning a new exercise program, especially if you have been inactive for a while or are experiencing abdominal pain or GI distress.
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Frequently asked questions
IBS stands for irritable bowel syndrome. It is a common gastrointestinal disorder that affects the intestines and causes uncomfortable abdominal symptoms, including constipation, diarrhoea, gas and bloating.
There is no single diet that works for everyone with IBS, but some common recommendations include:
- Reducing caffeine and alcohol intake
- Avoiding foods that are hard to digest, such as cabbage, broccoli, cauliflower, brussels sprouts, beans and onions
- Cutting down on high-fibre foods like whole grains, nuts and seeds
- Limiting gluten, a protein found in wheat, barley and rye
- Following a low FODMAP diet, which involves reducing certain carbohydrates that are hard to digest
It is important to stay hydrated, so aim to drink at least 1.5 to 2 litres of fluid per day, preferably water or herbal tea. Probiotics, found in some foods or supplements, may also help restore the natural balance of gut bacteria.
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