Irritable bowel syndrome: The right diet can help
Irritable Bowel Syndrome is a functional bowel disease that affects 10-15 percent of the population, but many people with IBS never seek medical advice. IBS can cause symptoms such as urgent diarrhea that leave individuals anxious to even leave the house for fear they will not be near a bathroom when needed. IBS is the second leading cause (after colds) for sick days. Many of these sick days could be prevented with the help of dietary changes and, in some cases, medications to alleviate the symptoms of IBS.
IBS can be diagnosed when a person has recurrent abdominal pain, on average once a week for three or more months, plus two of the following: association of pain with timing of defecation (pain before having a bowel movement and improvement afterwards), association with a change in stool frequency, and association with a change in stool form/appearance (anything from diarrhea to hard stools). People with IBS may have many other symptoms such as bloating, gas and a sense of urgency to defecate after meals.
There are many other gastrointestinal problems that can present similarly to IBS. It is important to rule out other possible causes of symptoms if there are “red flags” such as progressive worsening of pain, blood in stool, abnormal weight loss, loss of appetite, waking up in the night with pain or diarrhea, or a family history of inflammatory bowel disease or colon cancer. Also, the onset of symptoms in someone who is older than 40, may warrant ruling out other causes of symptoms.
IBS varies greatly from person to person in regards to severity and frequency of symptoms. Symptoms may be triggered during times of emotional stress. Diet also has a significant impact on symptoms. There are many different dietary options for individuals with IBS. Lactose free diets, gluten free diets, and elimination of gas producing foods (beans, bananas, onions, broccoli, celery, etc.) may be beneficial.
For many patients with IBS, I recommend a low FODMAPs diet, which is an abbreviation for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. High FODMAP foods are carbohydrates that do not get absorbed well and tend to ferment in the intestines leading to gas, bloating and pain. Foods high in FODMAPs that should be avoided include wheat, onions, legumes, milk, apples, cashews, cherries, cauliflower and artificial sweeteners. More foods on the list can be found at IBSdiets.org. It is a challenging diet to follow, but many people with IBS benefit from this diet. After six to eight weeks, a trial of slowly adding foods back to the diet will help identify which foods are tolerated or not tolerated.
While dietary changes have the potential to improve symptoms for many individuals, there are various other helpful interventions. Regular physical activity helps reduce symptoms of IBS, in part, due to stress reduction. Fiber supplements may help some people. Acupuncture, digestive enzymes, probiotics and herbal supplements have also been proposed as aiding IBS (but not necessarily supported by medical studies). There are various OTC and prescription medications that can be used to alleviate symptoms of diarrhea, constipation or abdominal cramping. The bottom line is that there are many options to improve the quality of life for individuals with IBS that can be discussed with a gastroenterologist.
Colleen Farnum is the physician assistant at Roaring Fork Gastroenterology. Reach her at firstname.lastname@example.org or 970-230-9623.
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