April is IBS Awareness Month, so we thought we would focus this week’s blog on the basics of Irritable Bowel Syndrome. We’ll discuss what IBS is, diagnosis as well as diet and lifestyle management.
What is IBS?
IBS is a chronic functional bowel disorder characterized by abdominal pain, bloating and changes in bowel movements like diarrhoea, constipation or both. IBS is the most common functional gastrointestinal disorder, and it affects an estimated 1 in 5 people in Ireland. It affects more females than males and mostly affects those under the age of 40.
How do we Diagnose IBS?
- Firstly, always consult with the doctor before anything else. IBS can be diagnosed by your GP using symptom criteria. This includes symptom the patient is having and also the severity of those symptoms. Symptoms should include abdominal pain, bloating as well as changes in bowel movements like diarrhoea and/or constipation.
- Symptoms vary from person to person depending on how sensitive your gut is. If your gut is more sensitive this can cause increased abdominal pain and bloating.
- When diagnosing IBS, you will also be asked about your “poo” (nothing to be embarrassed about!). The Bristol stool chart is used to analyse form and how often you are going is also important.
- Other things to watch out for would be iron or folate anaemia, unexplained weight loss, watery diarrhoea and blood in the stool.
- Symptoms sometimes overlap with other gastrointestinal disorders such as non‑ulcer dyspepsia, inflammation or coeliac disease so it’s important to test for these first before diagnosing IBS.
First line management of IBS involves dietary advice. A lower overall diet quality, less varied diet and higher fat and sugar intake and lower fibre intake have been observed in patients with IBS so it’s really important to address these dietary behaviours first.
Dietary advice includes:
- Eat regular 3 meals a day.
- Introduce more diversity into the diet will increase the diversity of good bacteria in the gut.
- Practice a good eating routine including taking time over meals, chewing food thoroughly and not eating late at night. Eating too quickly/not chewing your food means that you are adding air into your gut which can cause bloating.
- Reduce intake of alcohol and caffeinated drinks as this may aggravate symptoms (no more than 3 cups a day).
- Reduce intake of fizzy drinks.
- Stay hydrated! Try to get the recommended 8 glasses/1.5-3 litres per day particularly.
- Limit fresh fruit to 3 portions per day.
- Cut down on rich/fatty foods including chips, fast foods, cheese, pizza and restrict intake of processed foods and cook from scratch where possible.
- Spicy foods can be related to IBS symptoms; however it is worth also looking at other components of spicy meals that may contribute to symptoms (e.g. garlic or onion)
- Milk and dairy restriction- there is no evidence for using low lactose or low dairy diets for treating IBS. However, if you are sensitive to lactose, lactose restriction may help with IBS symptoms.
- Dietary fibre- patients with IBS generally eat less dietary fibre due to the elimination of certain foods from the diet that triggers symptoms. Swapping insoluble fibres for a wide variety of high fibre starchy foods (e.g. oats, bran, brown rice, wholemeal/seeded bread, potatoes with skin, quinoa) is recommended for IBS patients.
Any strict elimination and reintroduction regime should only be considered as a secondary-line dietary treatment, after the first line dietary advice has been carried out and if symptoms still persist.
- A food and symptom diary can help to identify if a low FODMAP diet is likely to be effective.
- If it is determined that the low FODMAP diet is necessary, it’s important to work with a dietitian who will guide and support you with the elimination and reintroduction regime.
- The low Fodmap diet should not be followed for more than 4 weeks as long term it can result in changes to the gut microbiota due to the restriction of high fibre foods that actually feed your gut bacteria!
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Niamh is our Senior Nutritionist here at Gourmet Fuel. Niamh completed her BSc (Hons) in Nutritional Sciences at University College Cork and has recently completed a Master’s in Public Health Nutrition from University College Dublin. Before joining the team at Gourmet Fuel, she worked in the food and drinks industry both in Ireland and in San Francisco and gained valuable insight into the major role the industry can play in improving healthy eating and allowing us to make healthier food choices. Her areas of interest include health promotion, food sustainability, communication and nutrition research.
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