Dealing with irritable bowel syndrome (IBS) can be debilitating. Having to plan your daily routine around unpredictable bathroom habits can be challenging. While doctors often recommend a proper diet, sufficient sleep, and regular exercise to manage IBS symptoms, implementing these changes can be easier said than done for individuals struggling with the condition.
While medical intervention is crucial for treating IBS, making lifestyle and nutritional changes can also play a significant role in alleviating symptoms. In this article, we will explore nutritional changes that can help manage IBS symptoms. This will guide you through the steps to recovery and strategies for facing IBS challenges.
Prevalence
1. About 2 in 3 IBS sufferers are female. About 1 in 3 IBS sufferers are male. IBS affects people of all ages, even children.
2. Worldwide it’s estimated that 10-15% of the population has IBS.
3. Most persons with IBS are under the age of 50.
4. Approximately 20 to 40% of all visits to gastroenterologists are due to IBS symptoms.
5. Diagnosis of IBS was typically made 6.6 years after the symptoms began. (based on IFFGD survey)
Foods to limit:
Here’s a breakdown of the foods you should restrict:
Foods to incorporate:
IBS-related constipation – certain foods can exacerbate constipation associated with IBS. These include:
IBS-related diarrhea – certain foods can worsen IBS-related diarrhea. These include:
Medications that can trigger IBS – in many cases, the medications clients are taking may contribute to their IBS symptoms. Here are some examples:
It is important to consult your doctor before making any changes to your medication regimen. They can help you switch to a medication that won’t exacerbate your symptoms. When it comes to antidepressants, be cautious in your selection. Tricyclic antidepressants, the older class of medications, may cause constipation, while selective serotonin reuptake inhibitors (such as fluoxetine and sertraline) can lead to diarrhea. Collaborating with your doctor will help identify the most suitable antidepressant for your needs.
Understanding the Role of Dairy in IBS
IBS is a complex condition with multiple potential triggers, including food allergies, food sensitivities, small intestinal bacterial overgrowth (SIBO), and gut dysbiosis. One common irritant to the gut is lactose, a sugar found in milk. As infants, we produce an enzyme called lactase that helps break down and digest lactose. However, many adults lose this enzyme after the age of two, making digesting dairy difficult and potentially triggering IBS symptoms. Some individuals may be more affected than others.
Interestingly, many people have reported the disappearance of their IBS symptoms within weeks of eliminating dairy from their diets. This suggests that lactose intolerance may be a more common issue than IBS itself.
Therefore, it is worth eliminating dairy from your diet for a few weeks and monitoring your progress. This includes avoiding milk, curds, ghee, butter, paneer, and cheese. To make the transition easier, familiarize yourself with dairy alternatives and start substituting dairy products with options like soy milk chai instead of dairy chai and peanut and rice milk curds instead of dairy curds. These alternatives are widely available for purchase globally or can be easily made at home.
Implementing a Low-FODMAP Diet
Once you have successfully transitioned to dairy-free alternatives, the next step is to focus on rebuilding a healthy population of beneficial bacteria in your gut. Many physicians recommend a low-FODMAP diet for individuals with IBS. FODMAP stands for “Fermentable Oligo Di Monosaccharides And Polyols.”
High-FODMAP foods are more difficult to digest, and when the undigested portions reach the intestines, they are metabolized by gut bacteria, leading to excessive gas production, diarrhea, abdominal pain, and constipation.
A low-FODMAP approach can provide temporary relief, akin to putting a bandage on a wound. While it may alleviate symptoms, it does not address the underlying issue of a weak gut function. To truly heal the gut, it is crucial to gradually reintroduce high-FODMAP foods, as this promotes gut bacterial diversity and fosters healing. It is important to remember that a low FODMAP diet is not meant to be a long-term solution. Prolonged adherence to a strict low FODMAP diet can further weaken the gut. Instead, focus on strategically reintroducing new foods to your diet on a weekly basis, gradually expanding your range of choices.
Keeping a food diary and documenting the types and quantities of food consumed, along with any adverse effects experienced, can be invaluable in identifying intolerances. Mobile apps like Candor can greatly help in this effort.
The Candor app allows you to stay on track with low FODMAP diet. Candor’s food and drink catalog includes labels to easily identify High/Medium/Low FODMAP foods. Candor app users can also understand the most logged low FODMAP foods (see below).
The role of fiber in IBS
Fiber can be beneficial for some individuals with IBS, but it can also exacerbate symptoms such as gas and diarrhea. However, it’s important to note that the symptoms are not caused by fiber itself, but rather by a poorly functioning gut. Interestingly, fiber is nourishment for the beneficial gut bacteria! It is best to slowly incorporate soluble fiber first, followed by insoluble fiber. It is ideal to start with a daily intake of 25 grams of fiber (~1 oz) and gradually increase it to around 60 grams (~2 oz).
Recent studies have shown that embracing fiber can support a healthy gut microbiome. Fiber supplementation has also been linked to increased levels of Bifidobacterium, which are crucial gut bacteria that aid in gut motility, immune function, insulin resistance, and maintaining a healthy weight.
For individuals with severe SIBO symptoms, mild prebiotic supplements can be beneficial in conjunction with antimicrobial protocols. For example, a clinical study involving people with SIBO found that combining the antibiotic rifaximin with guar gum eliminated SIBO in 87.1% of cases, compared to 62.1% when using antibiotics alone.
Most people seem to benefit from starting with Psyllium Husk or Benafiber supplementation while simultaneously encouraging lifestyle changes. It is also advisable to begin with predominantly soluble fiber sources before incorporating insoluble fiber. Soluble fiber dissolves in water, unlike insoluble fiber, which adds bulk to the stool. Good sources of soluble fiber include citrus fruits, barley, peas, and apples.
The effectiveness of a gluten-free diet
Gluten is a protein commonly found in grain products like wheat, rye, and barley. It can cause issues for individuals with gluten intolerance, such as those with Celiac’s disease. In such cases, adopting a gluten-free diet can help reduce symptoms. However, it’s important to note that wheat, just like other grains, actually possesses anti-inflammatory properties. According to Harvard Medical School, avoiding gluten without a diagnosed sensitivity can do more harm than good, as it further reduces the diversity of plant-based foods in your diet. Plant diversity is a crucial factor in maintaining gut health.
The impact of a low-fat Diet
Consistently consuming high-fat foods contributes to various health problems, including obesity. Fats are broken down in the body by an enzyme called lipase. In some cases of IBS, there may be low lipase production, resulting in an inability to properly digest fats, thereby exacerbating symptoms.
Another issue is that high-fat foods tend to be low in fiber. Embracing a low-fat diet not only benefits heart health but also improves uncomfortable bowel symptoms.
What about healthy fats? Aim to consume no more than 30-40 grams (~1-1.5 oz) of nuts/seeds spread throughout the day. Whenever possible, incorporate olives and avocados into your diet. These sources of healthy fats are sufficient for your needs. In my work with clients, I also assist them in exploring oil-free cooking techniques.
Stress and anxiety triggers for IBS
Stress and anxiety can exacerbate symptoms of IBS. This is because stress stimulates the release of cortisol from the adrenal glands, which has inflammatory properties and can contribute to increased inflammation. Some common stress factors include:
Managing stress
Since everyone’s experience with IBS is unique, not all foods will be equally effective in managing symptoms. It’s important to assess your individual symptoms and consult your doctor before making any significant dietary changes. You may need to experiment with different foods and observe how your body responds to specific eating patterns. It is also recommended to stay hydrated, reduce caffeine intake, and engage in regular exercise to promote regularity and minimize IBS symptoms.
While medications can be used to treat IBS, a change in diet should be the first approach. Adopting a healthy lifestyle with a low-fat diet, regular exercise, and avoiding alcohol and smoking can make a significant difference. For those who still need further relief, diets like the low-FODMAP diet can be beneficial. Consider seeking guidance from a registered holistic nutritionist who can assist you in making optimal food choices. In some cases, your doctor may determine that medication is necessary to manage your IBS symptoms. These medications may include anticholinergic drugs or antidepressants to reduce stress and calm spasms.
Indian diet plan and lifestyle changes for managing IBS
Both diet and lifestyle changes play a crucial role in treating and controlling IBS. Before embarking on any changes, it’s important to understand your body. Keep a record of everything you eat and drink for 7 to 10 days, along with the timing, and note any symptoms you experience. Remember that food may not be the sole trigger. It is important to also explore some lifestyle changes that can be made alongside a sample meal plan.
By implementing these Indian diet plan and lifestyle changes, you can effectively manage your IBS symptoms and improve your overall well-being. However, it’s always recommended to consult with a healthcare professional or registered dietitian for personalized guidance and support.
Summary
Adopting a plant-centric, low FODMAP diet may require some effort and learning. It involves eliminating certain foods while incorporating others. Seeking guidance from healthcare professionals or nutritionists can ease the transition to the FODMAP diet. The time and effort invested in making these changes are worthwhile. Moreover, dietary modifications such as veganism or a low FODMAP diet offer healthy alternatives. Consulting a professional can assist in designing a well-balanced diet that meets your nutritional needs.
References:
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