IBS and diet
Irritable bowel syndrome (IBS) affects about 10-20% of the population in the UK, with the majority being women. There is no single known cause. However, gut hypersensitivity, alerted gut motility, and the connection between the gut-brain axis, low-grade inflammation, immune system activation or intestinal permeability or changes in gut bacteria may play a role. Others may develop IBS following a bacterial, viral or parasitic infection.
There are three main types; IBS-C (constipation-predominant), IBS-D (diarrhoea predominant) and IBS-M (mixed hard and soft stools)
Common symptoms of IBS include a 6 month history of:
• Abdominal pain and a change in bowel habits (straining, urgency or incomplete evacuation)
• Excess wind, bloating and distension
• Mucus in stool
• Constipation, diarrhoea or a mix
• Some people also report feeling tired, sick, backache and bladder issues.
• You don’t need to have all these symptoms to have IBS.
There is no test to diagnose IBS, but a doctor should first arrange blood and stool tests to rule out other possible causes of the symptoms before diagnosing IBS. Red flags require further investigation. Tell your GP about unintentional weight loss, unexplained rectal bleeding, diarrhoea waking you up at night, a family history of bowel or ovarian cancer or a persistent change in bowel habits.
If you have been diagnosed with IBS, you may benefit from trying the following:
Avoid large meals or leave large gaps in between eating. Instead, have smaller balanced meals and snacks more frequently throughout the day.
Eat lunch away from your desk, in a relaxing environment and chew food well.
Avoid or reduce caffeine (tea, coffee, soda) and fizzy drinks. Instead, have more water, decaffeinated herbal teas or diluted squash.
Drink less alcohol. Aim to have no more than two units (175ml glass wine or 1 pint low-strength larger, beer or cider) per day and include at least two non-drink days a week.
If you have a lot of fruit in the day, aim to limit this to 3 pieces of fruit and eat this at different times in the day.
Foods which are high in fat can make symptoms worse. Try to have less often and smaller portions of takeaways, fried or battered foods, chips, cheese, cream, sauces and fatty meats, e.g. burgers, sausages, bacon, mince etc.
Find ways and make time to relax and de-stress. Practising regular deep breathing or taking up activities such as yoga or medication could help too. Stress management is often overlooked but can make a significant improvement in symptoms.
If bloating and wind are a concern, try to limit gas-producing foods such as beans, pulses, cabbage and foods with added sweeteners.
If you struggle most with constipation, gradually increase your fibre intake and drink plenty of water.
If your symptoms include diarrhoea, then try to reduce whole-wheat high-fibre foods, reduce your intake of alcohol and caffeinated drinks and avoid foods with added sweeteners.
Make time for movement you enjoy.
Some people may also benefit from following the low FODMAP diet for a period. To help identify which changes most benefit you, keep a food and symptom diary and make changes one at a time. If you’re looking for support with managing your diet and symptoms, seek advice from a dietitian.
