Nutrition and IBS

By Jeannie Versagli, RD, LDN

What is IBS?

Irritable bowel syndrome (IBS) is a common disorder that affects the large bowel. Individuals that experience cramping, abdominal pain, bloating, gas, diarrhea or constipation, or both are likely suffering from IBS. Possible causes include an overly sensitive colon, brain-gut connection, or immune system. Post-infectious IBS is caused by a previous bacterial or viral infection as well as anything that disrupts gut flora.

What are some reasons and/or causes of IBS?

Muscle contractions lasting longer than the normal speed of the digestion process result in an increase in gas, bloating, and diarrhea
Weak intestinal contractions, on the other hand, slow the movement of food through the bowel resulting in slow-moving, hard, dry stools
Nervous system abnormalities between the gut-brain signaling occur, causing an overreactive digestion process resulting in abdominal pain, diarrhea, or constipation
Severe infection in the bowel results in an increase of bacteria in the intestinal tract called bacterial overgrowth
Food sensitivities
Change in the microbiome due to an increase or decrease of bacteria, fungus, and or virus in the intestinal tract
Inability to metabolize certain sugars

https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016

Who is more likely to succumb to IBS?

People of the age of 50 or younger are at greater risk of having IBS.
Females are at increased risk; estrogen therapy increases the risk of developing this disorder.
Having a family link to IBS increases the risk of developing IBS.
Anxiety and or depression are other factors that increase the risk factor for developing IBS.

There are diagnostic tools to help rule out IBS as the reason for the GI discomfort. These include the blood test, stool test, and or gastroscopy/colonoscopy. The Monash Institute does not recommend using the Breath test, IgG food intolerance tests, and or fecal microbiota testing to rule out IBS.

https://www.monashfodmap.com/ibs-central/what-is-ibs/

How do you improve and heal the gut through nutrition?

While not always the case, for many with IBS, certain foods can trigger or exacerbate symptoms. Everyone is different, so a food diary can help track which foods seem to trigger your symptoms. Foods that may set off a flair include caffeine, alcohol, dairy, fried foods, chocolate, sugar-free foods/sweeteners, etc. One of the most common triggers is seen in individuals who have difficulty metabolizing certain sugars in the intestinal tract.

These sugars are.

Sugars	Examples
Oligosaccharides (fructans and glacatans)	Baked beans Dates Nectarines Barley Garlic Onions Cashews Grapefruit Pistachios Chickpeas Lentils Red Kidney beans Shallots Rye Wheat
Disaccharides (lactose)	Cheese Milk Ice cream yogurt
Monosaccharides (fructose)	Agave Cherries Pears Apples Honey Sugar Snap peas Artichokes Mangoes Watermelon Asparagus High fructose corn syrup
Polyols	Apricots Blackberries Cauliflower Mushrooms Plums Snow peas Sweeteners sorbitol, mannitol, and xylitol

Dietitians recommend omitting these foods by following the FODMAP diet, through a three-step approach for improving IBS. These steps are…

Following a low FODMAP elimination diet for 2 to 6 weeks.
FODMAP food reintroduction for 8 to 12 weeks.
FODMAP Personalization. Allows one to personalize FODMAP foods in the diet per individual tolerance.

Monash University is a leader in this field and provides an excellent resource for professionals and individuals suffering from this disease.

https://www.monashfodmap.com/ibs-central/

Working through a FODMAP plan takes discipline, but the rewards that follow are worth the effort. Individuals will improve their symptoms and may even be able to reintroduce foods in limited quantities that once would set up a chain reaction in the gut. If you identify with these GI symptoms, consider investigating the possibility that you may be suffering from IBS. Through the proper nutritional approach, you will gain improved health and wellness.

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