A guide to the IBS diet
Want to know if you may have irritable bowel syndrome? Registered nutritionist Kerry Torrens explains what it is, what dietary changes may help manage symptoms and suggests gut-friendly recipes to try
What is irritable bowel syndrome?
Irritable bowel syndrome (IBS) is a medical term used to describe a collection of digestive symptoms. These symptoms vary from person to person, but may include stomach cramps, bloating, diarrhoea and constipation. If you think you may have IBS, you're not alone – it affects around one in five of us.
What causes irritable bowel syndrome?
There is no known cause but common symptom triggers include stress as well as changes to the balance of beneficial bacteria in the gut. If you have IBS you may notice your symptoms coming and going, the symptoms may last for days, weeks and even months at a time. Some sufferers manage their symptoms with diet and lifestyle changes, these may include eating at regular times and cutting back on stimulants such as coffee, tea and alcohol.
How should I manage my irritable bowel syndrome?
Because symptoms vary from one person to another there is no one solution. However, you may find some relief from:
- Eating three regular meals per day
- Not skipping meals or eating late in the evening
- Having smaller portion sizes
- Adopting some stress management practices
- Keeping a food symptom diary to help identify trigger foods or situations
What foods and drinks should I avoid with irritable bowel syndrome?
Because the condition is so variable there are no hard and fast rules and what works for you, is likely to be unique to you. However, by limiting your alcohol intake, reducing caffeinated and carbonated drinks and minimising the refined, processed and fatty foods in your diet you may experience some relief.
Although fruit is a healthy option, for some people with IBS it may aggravate their symptoms and so it may be helpful to limit fruit to three portions per day (one portion is 80g).
What foods and drinks should I include in my diet if I have irritable bowel syndrome?
You may find replacing roughage like bran with gentler, soluble forms of fibre such as that in bananas, apples, pears, oats, rye and barley helpful. This may help alleviate bloating and regulate your bowel movements. Eating naturally fermented foods like yogurt and kefir, that contain 'live' cultures, may help restore healthy levels of gut bacteria. Some IBS sufferers find this helps relieve their symptoms, however, more studies are needed to identify the specific species and strains of bacteria which may lead to these benefits.
What dietary changes should I make to alleviate my irritable bowel syndrome?
Unfortunately, IBS is a condition where one dietary approach does not suit all people with the condition. This is because symptoms vary considerably and there is no definitive cause. The following are dietary modifications that some people find helpful:
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Try a low-fibre diet
Following a low-fibre diet for a short period of time (for example four weeks) may alleviate symptoms of bloating, flatulence and abdominal pain. Once your digestive system has settled down it may be possible to re-introduce some of the higher fibre foods you enjoy, whilst assessing your tolerance to them.
To find out more, read our guide to low-fibre diets.
Fibre-rich foods are generally good for us and help maintain a healthy digestive tract, many people with IBS eat inadequate amounts of fibre and find symptoms of constipation and bloating is helped by the addition of the right type of fibre.
If your symptoms include bloating and wind, you may need to focus on foods that provide a soluble form of fibre. This may be found in psyllium husks, oats and some fruit – this type of fibre has a lower rate of fermentation so may be more suitable.
This approach focuses on the avoidance of foods thought to be ‘triggers’. You will first need to thoroughly record and assess the effects of the foods in your diet and the severity of your symptoms – once this is done you may then eliminate one food at a time for a period of approximately four weeks, before carefully re-introducing it and assessing its effects. Once you complete this assessment you move on to the next food on your list.
An elimination diet is best done with the support and guidance of a registered dietician, this will ensure your nutritional requirements continue to be met.
Before you try this approach, read do you have a food intolerance?
The term ‘gluten’ refers to a group of proteins found in certain grains including wheat, rye and barley. Approximately one in 100 people have a condition called coeliac disease. For these people, gluten causes an immune reaction which results in damage to the small intestine. These people need to adopt a gluten-free diet to ease symptoms but also to prevent this damage from occurring.
Other people, although not diagnosed as coeliac, have a sensitivity to gluten. This means they experience some of the same symptoms.
IBS sufferers, most notably those with diarrhoea as a frequent symptom, may find removing gluten from their diet an effective means of calming the digestive tract.
Although we typically associate histamine with allergy, it plays many roles in the body including influencing the speed of the gut, determining how much stomach acid we produce and modifying the amount of mucus in the intestine. Studies suggest that the activation of the immune cells that produce histamine, called mast cells, may play a central role in IBS.
A low-histamine diet aims to limit histamine-containing foods as well as those referred to as ‘liberators’ because they trigger the body to release histamine.
Want to know more? Read our guide on a low-histamine diet.
FODMAPs are a broad range of carbohydrates found in the diet that for some people prove difficult to digest. This results in more water being drawn into the bowel increasing bloating, wind and potentially leading to diarrhoea.
The low-FODMAP diet is an interesting development and appears to be proving successful, but because these carbohydrates are found in so many different foods it can be confusing and is best conducted under professional supervision.
Get to grips with the low-FODMAP diet.
Remember if you choose to make dietary changes do so gradually so you don't aggravate an already sensitive system. It's also important to visit your GP to rule out any other health issues as soon as you experience a change to your normal bowel habits.
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Kerry Torrens is a qualified Nutritionist (MBANT) with a post graduate diploma in personalised nutrition and nutritional therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last two decades she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food. For more food and health tips follow Kerry on Instagram at @kerry_torrens_nutrition_
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