Irritable bowel syndrome (IBS) is believed to affect as much as 20% of the American population. The exact cause is still unknown but it appears to be due to an abnormality is the speed and contractility of the muscles in the intestinal wall. Abdominal pain is common and the changes in bowel habit can range from diarrhea to constipation and sometimes even an alternation of these two symptoms. Excessive gas with abdominal bloating are other common symptoms. Although there is no cure for IBS, it can be effectively managed with drugs, diet and lifestyle.
It is important to understand the facts about irritable bowel syndrome (IBS) as it can help you identify ways to control your condition beyond the general advice most health care professionals. One one end of the spectrum there is diarrhea-predominant IBS. Here the bowel movements are more frequent with acute episodes of diarrhea where loose and watery stool is passed. On the other end is constipation-predominant IBS where a person passes stool too infrequently, strain to defecate and the stool may be hard. In between lies the mixed type of IBS where there are episodes of diarrhea and constipation alternating.
People with IBS do not usually have intense or debilitating symptoms all of the time. Symptoms can be triggered by certain foods and situations but usually the symptoms arise and persists in episodes. A person may then experience an almost complete resolution of these symptoms for weeks, months and years until the next episode arises. Understanding what may elicit these episodes and how to prevent it is an integral part of IBS management.
Keep A Food Diary
This is the starting point of dietary management in irritable bowel syndrome. A food diary will allow you to identify problem foods that may trigger episodes of abdominal pain and changes in bowel habit. However, it is important to understand how to correlate the information. You should also record the intensity of your abdominal pain (if any) on a scale of 1 to 10, bloating and abnormalities in bowel habit before you ate a specific meal. In this way you can clearly identify if the change in symptoms occurred after eating specific foods or had started prior to consuming what seems like a problem food.
Try Food Elimination
Sometime the trigger foods may not always be easy to identify through the records in a food diary. An elimination diet may be the better choice. You can either remove all suspected problem foods from your diet and gradually include each one back into your diet. Alternatively, you can remove suspected problems foods from your diet one at a time. Over the years there has been much attention on FODMAP carbohydrates and its role in IBS. FODMAP stands for fermentable oligo-, di-, and monosaccharides and polyols. Although the FODMAP elimination diet is still sometimes looked at with skepticism by the medical community, it may be worth trying to see if it could help your IBS.
Avoid Spicy And Processed Foods
Most IBS sufferers are well aware that spicy foods can trigger an episode, or exacerbate the symptoms that are currently present. Spicy foods are not a problem for every person with IBS but it tends to be one of the common irritants. This includes foods that are laden with spices such as chili, pepper, paprika and other pungent aromatics. Preservatives, coloring agents and flavorants can also be a problem and therefore processed foods should be consumed with caution. Many IBS sufferers have problems with common additives like monosodium glutmate (MSG), sulfur dioxide, tartrazine and others. Once again a food diary and elimination diet may help to isolate the problem food(s) or ingredients(s).
Consider Increasing Fiber Intake
Increasing your dietary fiber is one of the recommendations for managing IBS. However, it does not help every person and can sometimes exacerbate symptoms like excessive gas and bloating. Fiber tends to be more useful for patients with constipation-predominant IBS and when constipation is present in the mixed variety rather than in diarrhea-predominant IBS. You should slowly increase your daily fiber intake with food and see if it does help your individual case. Opt for preferred foods from a list of high fiber foods and eventually consider fiber supplements if fiber does not seem to be a problem for you.
Breathing Exercises for Stress
The stress component of irritable bowel syndrome cannot be ignored in any management program. Both psychological and physical stress are exacerbating factors but do not actually cause the condition. Psychological stress is a major contributor. Intense nervousness, sadness and strong emotions like anger can very rapidly bring about an attack. Ideally the stress should be removed from your life where possible. However, learning good coping skills to handle different situations should be part of IBS management. Deep breathing exercises can be helpful, especially to minimize the impact of a stressful situation as it occurs. Other relaxation techniques like yoga, tai chi and meditation are also useful.
Stay Away From The Stimulants
Nicotine use is another major lifestyle factor in IBS management. Patients with diarrhea-predominant IBS often report that the frequency and unpredictability of bowel movements subside when they quit nicotine use. This does not only refer to cigarette smoking but also nicotine replacement products like nicotine gum. Nicotine tends to exacerbate the rapid bowel motility seen in diarrhea-predominant IBS and can possibly intensify the spasm of the bowel muscles thereby worsening abdominal cramps. The same effect may be seen with other stimulants like caffeine and you should take note in your food diary if beverages like coffee are a problem for you.
Drink Alcohol In Moderation
There is no need to stop drinking alcohol entirely if you do consume it. However, moderation is important. Heavy bouts of drinking can aggravate your irritable bowel syndrome and some alcoholic beverages may be more of a problem than others. Once again your notes in your food diary can provide better insight. The daily recommended intake of alcoholic drinks is a maximum of 2 units for men and 1 unit for women. Try to keep your alcohol intake within these limits. The odd extra drink or two may not be harmful if it is infrequent but try not to exceed the recommended daily intake on a regular basis.
Exercise More Often
Exercise has a host of health benefits and it can also be an effective way to relieve stress. It also appears to have some effect on normalizing contractions within the intestinal wall. Therefore exercise should be included as a part of an IBS management program. It is important that IBS sufferers who are sedentary first consult with a doctor before starting on any exercise program. Start slowly and gradually increase the duration and frequency of workouts. Ideally a person should exercise about 150 minutes a week, which should be divided into 5 sessions of 30 minutes each.
Use A Reputable Probiotic
There is no conclusive evidence that probiotics are beneficial in the treatment and management of irritable bowel syndromes. Some reviews have noted that there could be some benefit. Other studies did not find any noticeable benefit. However, these reviews suggested that larger trials focused on probiotic use should be conducted before any definitive conclusions are drawn. What can be agreed upon though is that probiotics are not harmful. If you choose to use a probiotic supplement, ensure that it is a reputable brand that contains microorganisms like Lactobacilli and Saccharomyces boulardii. Live culture yogurt may also be an option but only if dairy does not worsen your symptoms.