Those who deal with irritable bowel syndrome (IBS) suffer from pretty uncomfortable issues. With common symptoms like abdominal pain, bloating, diarrhea and gas, many people struggle to maintain an optimistic, open and happy outlook when trying to manage the effects of this digestive issue. It’s no wonder then that up to 25% of the UK population who have it find it hard to broach the subject (1).
Here’s an overview to help you understand what it’s all about, answer some lingering questions you may have and help you manage the symptoms of IBS.
What is irritable bowel syndrome (IBS) and who gets it?
Irritable bowel syndrome (IBS) is the most common long-term condition affecting the digestive system. In fact, women are twice as likely to get the condition than men (1).
For some people, symptoms are mild and come and go, while for others, the condition affects them more severely impacting their ability to work and sleep. Because the severity of the condition varies from person to person, there is no one cure or treatment. Every body is different and therefore requires different solutions whether they be dietary or pharmaceutical.
However, one thing’s for sure, the right combination of nutritional guidelines and lifestyle choices are said to help you learn to manage symptoms as best as possible and help you overcome your personal frustration with the condition.
What are the causes and symptoms of IBS?
You are more likely to experience IBS if other people in your family have it, if you are female under the age of 50, or if you suffer from stress, anxiety or depression. IBS can be very frustrating to live with and can have a big impact on everyday life, especially as some people can suddenly develop it. It’s a complex condition with many factors and many potential causes (1).
The main symptom is a digestive disturbance – pain or cramping as well as changes in the frequency and consistency of stools. There is no single test for IBS and your Doctor or GP will likely diagnose it by ruling out other potential issues with similar symptoms.
IBS is a digestive condition, therefore common physical symptoms include cramping, constipation or diarrhea, bloating, gas and flatulence, feeling the urge to urinate urgently, mucus in the stool and painful bowel movements. There are also emotional effects to watch out for such as anxiety, depression, and overwhelming feelings of stress.
As IBS affects each individual differently, there is no one root cause. Rather, it is a multi-factorial disorder that can have multiple root causes, for example, food sensitivities, intolerances and stress.
Foods to avoid with IBS: What not to eat
The gut plays an important role when it comes to dealing with IBS flare-ups and the painful symptoms. Here are a few things to bear in mind when it comes to the link between nutrition and IBS:
1. Avoid sugar and alcohol
People with an imbalance of bacteria are more prone to the symptoms of IBS (2). This imbalance of altered gut flora called Dysbiosis happens when the bad bugs in your gut take over. Some of the most common food and drink culprits that cause IBS flare-ups are sugar and alcohol.
It’s important to manage your intake as a healthy gut flora contributes to the production of amino acids, certain vitamins, as well as neurotransmitters, like your happy hormone serotonin.
2. Avoid gluten and lactose
IBS sufferers often report sensitivity to foods containing gluten and lactose (3,4). This is not to say that you are in fact allergic or actually have an intolerance, however if you notice sensitivity or get an upset stomach, make sure that you get yourself tested as soon as possible as they are both commonly linked to IBS.
3. Avoid caffeine
Some people find this to be a difficult ritual to give up when dealing with IBS, but unfortunately caffeinated drinks like coffee have a stimulating effect on the intestines that can cause diarrhea. Coffee, sodas, and energy drinks that contain caffeine and sugar can be a disastrous trigger for flare-ups. Try to switch to natural, uncaffeinated herbal teas instead if you still need the ritual of sipping a hot drink.
What lifestyle changes and everyday tips can help with IBS relief?
Our gut is often referred to as our ‘second brain’ and many IBS sufferers miss the importance of the link between their emotions and the severity of symptoms. Working with your GP and/or Nutritional Therapist can help you understand this connection between lifestyle choices and flare-ups.
For example, those under a lot of stress, as well as people suffering from anxiety and depression, are more prone to experience IBS symptoms (5). If you are struggling to find relief from flare-ups, try to make a conscious effort to manage your everyday stressors. Notice your triggers and learn to deal with them in a mindful way in order to avoid crippling issues like constipation and nausea.
On another note, exercise is crucial for the functioning of your digestive system – if you are inactive, so will be your digestion. If you rarely work out, try to gradually incorporate some form of light exercise to help you manage IBS.
What else can cause IBS flare-ups?
• Small Intestinal Bacterial Overgrowth (SIBO)
SIBO is a condition characterised by abnormal overgrowth of bacteria in the small intestine. It is estimated that up to 84% of IBS sufferers have SIBO (6). Most of the gut bacteria are meant to be located in the large intestine, where they help to break down food, synthesize vitamins, and eliminate waste. However in SIBO sufferers, these healthy bacteria colonise the small intestine. People with SIBO will have excess levels of hydrogen, methane or both, and it can be diagnosed by hydrogen and methane breath test (7).
• Leaky gut syndrome
Studies have also shown an association between IBS and increased intestinal permeability, or leaky gut (8). The gut lining is like a net with extremely small holes to allow certain substances to pass through. In a leaky gut, those holes become bigger allowing undigested food particles, proteins, toxins and bad bacteria to pass through. Unhealthy gut lining makes it harder for digestion to work at its best.
When it comes to irritable bowel syndrome, make sure that you give yourself the best chances of coping with the symptoms by being aware of your nutritional and lifestyle choices and seek the support of your GP and/or Nutritional Therapist in order to help you live as happy and healthy as possible.
1. Agrawal, Whorwell. Irritable bowel syndrome: diagnosis and management. BMJ. 2006; 332: 280-83.
2. Kassinen A, Krogius-Kurikka L, Mäkivuokko H, et al. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology. 2007;133(1):24.
3. Simrén M, Månsson A, Langkilde AM, et al. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001;63(2):108.
4. Pasquale Mansueto, Alberto D’Alcamo, Aurelio Seidita, et al. Food allergy in irritable bowel syndrome: The case of non-celiac wheat sensitivity. World J Gastroenterol. 2015 Jun 21; 21(23): 7089–7109.
5. Nicholl BI, Halder SL, Macfarlane GJ, et al. Psychosocial risk markers for new onset irritable bowel syndrome--results of a large prospective population-based study. Pain. 2008;137(1):147.
6. Pimentel M1, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol. 2000 Dec;95(12):3503-6.
7. Jan Bures, Jiri Cyrany, Darina Kohoutova et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010 Jun 28; 16(24): 2978–2990.
8. Camilleri M1, Madsen K, Spiller R, Greenwood-Van Meerveld B et. al., Intestinal barrier function in health and gastrointestinal disease. Neurogastroenterol Motil. 2012 Jun;24(6):503-12. doi: 10.1111/j.1365-2982.2012.01921.x.