Irritable bowel syndrome, also known as IBS, is a functional gut disorder that has no obvious physical cause. Symptoms can include bloating, stomach cramps, constipation, diarrhoea or any combination of these. Most commonly it occurs in young females however, any age or gender can be affected. It can range in severity and for some people, if not managed correctly, can have a significant impact on daily life.
What are the causes of IBS?
IBS is a hypersensitivity disorder. This means that the body over-reacts to stimulus, usually certain foods and food groups. This over-reaction leads to inflammation, causing the common symptoms of pain and bloating. There is no exact cause for IBS however, there is a strong link to high levels of stress and other psychological conditions. There is a possibility that gut hypersensitivity can also be triggered by viral illnesses.
How do I know if I have IBS?
The diagnosis of IBS is usually on symptoms alone, although a medication or food elimination trial can be used to aid diagnosis. Many clinicians will also want to order blood tests to rule out any other conditions that could cause similar symptoms. Examples include coeliac disease, inflammatory bowel disease, or gynaecological conditions.
I’ve been told to follow a low FODMAP diet to help with my IBS. What is the low FODMAP diet?
FODMAP stands for ‘fermentable oligosaccharides, disaccharides, monosaccharides and polyols’. These are a type of natural sugars found in all food groups, especially grains, dairy products and fruit and vegetables. It can be difficult for people with IBS to digest one or more of these sugar groups, as they tend to sit in the gut and accumulate bacteria and acids. This is what leads to the pain, bloating, or change in bowel habit and gas!
The aim of the low FODMAP diet is to eliminate all of the foods in these groups for a maximum of 2-4 weeks (or until symptoms settle). The most important part of the diet is the reintroduction phase; this includes gradually introducing foods from the different sugar groups over a period of 12 weeks or so. Keeping a food diary is important as it can help to identify your personal trigger foods. Ideally, as many foods as possible are reintroduced, in order to keep your diet as varied as possible.
What are some examples of high and low FODMAP foods?
Triggers can be different for everyone but some of the most common culprits for causing symptoms include:
- Wheat and wheat-based products (cereal, bread, pasta, etc)
- Beans and legumes
- Dried fruits
Low-FODMAP foods on the other hand, are fairly universal and form an important part of the elimination and reintroduction phases of the diet. It is important to try and eat a balanced plate that includes protein, fats and carbohydrates. Some low FODMAP food options include:
- Peanut butter
- Gluten-Free Oats
- Most salad vegetables such as lettuce, tomato and cucumber.
When to talk to your doctor
With any change of bowel habit it’s worth contacting your GP or allied health professional. This is especially important if you notice any blood when going to the toilet, have any unintentional weight loss, or have pain that is not managed with typical painkillers.
Whilst it many be inconvenient, irritable bowel syndrome can be manageable with diet and lifestyle changes. Many people benefit from meditation and other stress-management techniques, as stress can be just as much of a trigger as foods. Probiotics may also be useful for people with IBS, to help build up a healthier gut microbiome.