IBS – what is it? And how can it be treated?

ibs what causes it food

IBS stands for ‘irritable bowel syndrome’ and it’s thought to affect up to 20% of the UK population with women being twice as likely to be affected then men (1).

Although there’s no specific test to identify whether someone has IBS, diagnosis is often given to an individual who presents with a range of different symptoms such as:
• Changes from normal bowel movements like constipation, diarrhoea or a mix of both
• Bloating/ gas
• Stomach pains
• Feelings of fullness or loss of appetite

Evidence suggests that a gut microbiome with a diverse range of different bacteria can create an ideal foundation to wellbeing.

The range and intensity of IBS symptoms can often have a huge impact on a person’s quality of life and unfortunately there doesn’t seem to be a ‘one size fits all’ approach to overcoming it. In fact, with things such as genetic makeup, diet, inflammation and even stress potentially triggering its onset, it’s no wonder that it can often feel overwhelming to know where to start to get your gut feeling better.

How can IBS be treated?
Identifying any food triggers
As our bowel is quite obviously in contact with the foods we consume, it’s often a logical starting point to initially look closer at your diet to see whether any foods might be fuelling the IBS fire.

One way of identifying whether food is having an impact of IBS symptoms is by completing a food diary. This diary could simply record your food intake for a number of weeks alongside any IBS symptoms that occur to identify whether any patterns emerge. This will hopefully give you a great idea of what foods you may want to limit going forward.

Another ‘gold standard’ approach of identifying whether particular foods are triggering symptoms is by completing an elimination diet. This is a process where you remove foods known to cause sensitivities in some people for at least 3 weeks. Common foods that are eliminated in this are gluten, dairy, eggs and nuts. During the period of avoiding these foods the symptoms are monitored to see whether they improve before deciding whether it is appropriate to then re-introduce them.

Many people who suffer with IBS can also often have difficulties digesting certain fermentable carbohydrates in food called ‘FODMAPS’ (2). Although FODMAPS are generally great for gut health, as they help to feed our beneficial gut bacteria, some people find the hydrogen created in this process can lead to many symptoms seen within IBS (like bloating and gut pain).

Similarly to the elimination diet, another method of trying to identify the root cause of IBS can be going on a low-FODMAP diet where you eliminate (or reduce) FODMAP rich foods for several weeks before slowly introducing them to identify the potential culprit(s). This process should however be supported by a health professional where possible as long term elimination of high FODMAP foods could reduce the diversity of our gut bacteria which are essential for our overall wellbeing (3)

Balancing the gut microbiome
Our gut microbiome consists of trillions of different micro-organisms of bacteria, yeasts, viruses and parasites that live within our intestinal tract. Evidence suggests that a gut microbiome with a diverse range of different bacteria can create an ideal foundation to wellbeing. (4).

 

One way of identifying whether food is having an impact of IBS symptoms is by completing a food diary.

 

An imbalance within the gut is termed as ‘dysbiosis’ – when beneficial bacteria levels are reduced. Dysbiosis can occur as the result of antibiotic use, a poor quality diet or even stress. Quite often, dysbiosis can be found to be the root cause of IBS with overgrowths in opportunistic bacteria, yeasts (like candida) and parasites often causing the common symptoms that lead to the diagnosis. Imbalances within the gut can be identified through a comprehensive stool test.

In order to increase the beneficial bacteria within your gut your diet should be filled with a variety of different fruit and vegetables along with other high fibre foods like nuts and seeds. The high fibre foods act as ‘prebiotics’ which feed the beneficial bacteria in your gut. To further increase the numbers of these health promoting bacteria, ‘probiotics’ can also be used. This can either be through a probiotic supplement or through fermented foods like sauerkraut, kimchi and kefir.

Reducing stress
Reducing stress can make a huge impact on improving IBS symptoms. When we are stressed we enter into ‘fight or flight’ mode which means that we cannot ‘rest and digest’ as we should to fully digest our foods, repair our gut lining and create a beneficial environment for a healthy gut microbiome.

Practising regular stress relieving techniques like meditation, deep breathing and even yoga can be great habits to embrace whilst looking to overcome IBS.
As you can see, IBS can often be a complex condition to overcome but there is always hope. It might take a little bit of time to identify and overcome the issues seen in IBS but whether it’s doing it alone or with a health professional, the time spent to optimise gut health is always time well spent.

Article written for Thrive Magazine Autumn 2020 issue >>

Written by Laura Bryan. Laura is a registered Nutritional Therapist (mBANT, CNHC, Msc). Laura focuses on helping clients with the link between food and your mood. Her experience is also in dealing with gut health issues and creating 1-2-1 nutrition programmes. Connect with Laura >>

Refs:

1) NICE (2017). Introduction | Irritable Bowel Syndrome In Adults: Diagnosis And Management | Guidance | NICE. [online] Available at: <https://www.nice.org.uk/guidance/cg61/chapter/Introduction> [Accessed 13 August 2020].
2) Barrett, J. S., & Gibson, P. R. (2012). Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals? Therapeutic advances in gastroenterology, 5(4), 261–268. https://doi.org/10.1177/1756283X11436241
3) Sloan, T. J et al., (2018). A low FODMAP diet is associated with changes in the microbiota and reduction in breath hydrogen but not colonic volume in healthy subjects. PloS one, 13(7), e0201410. https://doi.org/10.1371/journal.pone.0201410
4) Sommer, F., et al., (2017). The resilience of the intestinal microbiota influences health and disease. Nature Reviews Microbiology, 15(10), pp.630-638.