IBS Awareness Month

What is IBS?

Irritable Bowel Syndrome, commonly known as IBS, is a chronic, reoccurring and often lifelong disorder of the lower gastrointestinal tract (1). The cause of IBS is not yet understood but what we know is that there is miscommunication between the gut and brain resulting in motility issues, increased pain and a change in central nervous system processing. Other potential risk factors may include genetics, a change in gut microbiota or immune and mucosal function issues (2).

IBS can cause more discomfort than harm, symptoms can range from mild to severe and whilst there is no cure, lifestyle changes and treatments can help to alleviate symptoms (3).

Symptoms & Prevalence

The most common symptoms of IBS may include: 

-Abdominal pain

-Change in bowel habits

-Bloating

-Excessive wind

-Urgency to go to the toilet and sensation of incomplete bowel movements

Other symptoms include:

-Headaches

-Joint pain

-Indigestion

-Anxiety

-Nausea and tiredness

If you have long-term bowel problems with pain and bloating, go to your doctor as they may diagnose you with IBS or something else (4). IBS affects 1 in 20 people in the UK. Treatments vary from person-to-person depending on your symptoms and may include diet, medications and lifestyle factors (5).

Diet & IBS

Whilst there is no specific diet that can cure IBS, diet and nutrition should be assessed for those with IBS and general advice may include:

-Eating meals slowly

-Consuming 8 cups of fluids per day

-Reducing alcohol, caffeine and fizzy drinks intake

-Reducing fibre-rich foods and limiting fresh fruit to 3 portions per day (6).

A staged approach may be useful with IBS; it may be as simple as lifestyle and diet changes. Keeping a food and symptom diary for a week is recommended before carrying out any dietary changes, along with making a note of IBS symptoms. Fibre can be confusing when it comes to IBS as it can sometimes improve or make symptoms worse. Reducing insoluble fibre may be beneficial with symptoms of diarrhoea. These foods include skin and pips of fruit and vegetables, wheat and bran, nuts and whole-grains. If increased fibre is required, include soluble fibre which may help to improve constipation. These foods include oats, barley, beans and pulses, fruit and vegetables. Increasing fibre can also cause gas and bloating, but introducing high fibre foods gradually can allow the gut to get used to extra fibre (7). 

There is growing evidence that the low fermentable oligo di and monosaccharides polyols (FODMAP) diet may help with symptoms of IBS. The British dietetic association suggests this as a first and second line of treatment. With a low FODMAP diet you are reducing short chain carbohydrates which are not greatly absorbed and some of these foods are fruit and vegetables, legumes and pulses, lactose, wheat, rye and honey. The low FODMAP diet has been a successful intervention by researchers at King's College London and under the supervision of a dietitian, a low FODMAP diet will be tailored to the individual (8,9).

Lifestyle Changes

Hypnotherapy, relaxation and cognitive behaviour therapy have been shown to be useful for some people with IBS. Self-management can be a useful tool in terms of what symptoms are experienced and observing if there are any trigger foods (10). Stress can play a role on our digestive system and some research shows that yoga breathing and meditation can improve symptoms of IBS along with adequate physical activity and relaxation techniques to be suitable non-medical approaches for alleviating symptoms of IBS (11).

First line of management should incorporate simple lifestyle and dietary changes, and suggestion of probiotics and the importance of movement and relaxation. If these are not successful, a dietitian referral would be considered (12). Over the counter medication can be purchased by speaking to your pharmacist if you experience diarrhoea, constipation, bloating or pain (13).

Support & Resources

See your GP who may refer you to a dietitian who can support dietary modifications. 

- The IBS network is a charity for those who suffer from IBS Support Groups | The IBS Network

- Guts UK is a charity for digestive conditions Guts UK - committed to fighting all digestive diseases (gutscharity.org.uk)

- Follow these Specialised Gut Health Dietitians:

@sophiedietitian

@the.ibsdietitian

@themissiondietitian

@caffdietitian

Written by: Gopika Chandratheva RNutr

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