Irritable bowel Syndrome (IBS) is a common chronic disorder affecting the digestive system. It can cause complications such as bloating, stomach pain and it alters toilet habits, alongside taking a significant toll on an individual’s quality of life.
There are various foods, drinks and emotional states that have been reported as triggers for IBS symptom flare ups. Increasing our understanding of these triggers can help individuals to manage their condition.
What can you do to reduce symptoms?
IBS Individuals can be super sensitive to some foods and drinks that normally would not have any negative consequences after consumption. There is no specific cure for IBS, however there are simple dietary and lifestyle modifications that can be implemented to reduce symptoms.
The “Low FODMAP” diet is often recommended, but is not meant to be a first line therapy for IBS. It can be very restrictive and it does not come without risks, so should not be attempted without the help of a trained Dietitian.
However, restrictive diets are not always the most appropriate form of treatment and there are plenty of other things that may actually also play a part in triggering IBS symptoms which would be far simpler to address first.
Here are some simple changes to try first which could be effective at reducing symptoms.
- Keep a food diary for a whole week to see if you can spot some of these common triggers in your diet and how often you have them.
- Choose one thing at a time, cut this out for 2 weeks and see if that made a difference. If it did, then gradually include it again to see if your symptoms return. It may be that you are able to eat it in small amounts now and again.
- Download my free Symptom & Trigger Tracker to help you in this process.
Common Triggers
1. Spicy foods
There is a link between spicy foods and an increased frequency of passing stool. It accelerates the activity in the digestive system which can lead to diarrhoea, this is particularly problematic for diarrhoea predominant IBS sufferers (IBS-D) (1).
2. Fatty foods
People with IBS typically have an exaggerated digestive response to eating a meal and eating certain types of foods. There is evidence that demonstrate fat causes bloating and stomach pain and discomfort (2, 3)
Fatty foods and large meals can speed up the movement in the gut to make room for more food and this leads to increased frequency and urgency of bowel habits, which is particularly unfortunate for those suffering with IBS-D.
Eating a diet high in fatty foods can also affect your gut microbiome. The microbiome refers to all the beneficial organisms that live in the large bowel. Typically a high fat diet tends to be low in fibre and lower in plant foods which will starve the microbiome. This can cause an imbalance in the gut and lead to symptoms such as bloating, diarrhoea or constipation.
3. Dairy products
Milk and dairy products contain the common sugar ‘lactose’. This exists under the umbrella term of ‘FODMAPS’, which means people with IBS may struggle to digest it and instead, our gut bacteria ferments it and produces gas. This leads to the unpleasant sensations of feeling bloated and having stomach pain. (1)
If you suspect dairy may be a problem, keep a food diary to see how much you are consuming. Then reduce it or cut it out for 2-4 weeks to see if that made a difference.
Please be careful when cutting out a whole food group.
There are plenty of lactose free varieties of milk available and you could just switch to lactose free dairy milk for a start. If choosing a plant-based milk, ensure that it is unsweetened and fortified with calcium. Some plant milks will contain FODMAPs, for example milk made of soya bean will be higher in FODMAPs and could cause a problem. Only make one change at a time. If you suspect a Lactose intolerance, speak to a Registered Dietitian who can help you find suitable alternatives and ensure you diet remains high in calcium.
4. Fibre
Fibre encourages healthy digestion and can prevent constipation through softening stools and promoting regular bowel movements. (1)
The current recommendations for fibre consumption is 30g per day. Despite this, much of the population do not meet this target, and this is particularly problematic for those with IBS.
Here are some tips to increase your fibre intake:
- Eat a high fibre breakfast, such as porridge
- Add nuts and seeds to meals. Low FODMAP ones include: walnuts, almonds, peanuts, pecans, pine nuts, macadamia nuts, and sesame seeds
- Add canned pulses such as chickpeas and lentils to meals like spaghetti bolognese, lasagne, soups. Although these are pulses high in FODMAPS, low quantities can be tolerated. Start by including a small amount and gradually increase to determine your tolerance level
- Eat the skins of fruit and vegetables. Oranges, satsumas, kiwi, unripe bananas, passionfruit, blueberries and strawberries are all good examples
- Add grains to salads, such as quinoa
- Eat legume-based dips – e.g. hummus, lentil dip
- Fibre supplementation – can lead to improvements in overall symptoms of IBS. A Registered Dietitian can help with this. If you would like to discuss how I can help, book a free introductory call here
When checking your food diary, check your fibre intake. If it is low in fibre, then gradually and slowly increase your fibre intake. Breakfast is usually a great place to start by switching your low fibre option for high fibre option such as porridge.
If you think you are eating a lot of fibre and you struggle with lots of wind, pain and bloating, try to reduce your fibre intake slightly to see if that makes a difference. Please speak to a Registered Dietitian before making too many changes to your diet.
5. Alcohol
Alcohol can have a direct effect on our gut and is known as a gut irritant. Although the evidence is inconsistent, it has been reported to alter bowel habits. Alcohol can speed up the rate food moves through our digestive system, leading to diarrhoea. Additionally, alcohol reduces nutrient absorption meaning our gut bacteria digest more undigested food in our large intestine to produce gas, which leads to stomach pain and bloating. (4)
Alcohol can still be consumed by people with IBS, but it is important to be aware that the type of alcohol consumed, the way it’s consumed and the amount can have different effects in terms of symptom presentation. To initially reduce symptoms, eliminating alcohol may be beneficial. Read more about alcohol and IBS in this blog.
6. Dehydration
Make sure you are hydrated throughout the day. Try to avoid gulping a large glass of water at a time and rather continuously sip water throughout the day. This ensures you stay hydrated and does not overload the stomach with a large volume of water. Aiming for 1.5-2 litres is beneficial for encouraging regular bowel movements and preventing constipation, but this may be dependent on your size and activities. (1)
7. Stress
Stress can influence our gut and is strongly linked with symptoms of IBS. This is supported by the connection between the gut and the brain, called the gut brain axis. You can learn more about the influence of stress in IBS in my blog post on stress (read here).
In short, when we are stressed our body goes into a ‘fight or flight’ state and digestion slows down to save energy. When we are relaxed, our body goes into its ‘rest and digest’ state, which allows for more energy and blood flow in the gut to move food along.
There are many very helpful practices that can help reduce stress, such as:
- Meditation
- Yoga
- Walking
- Cognitive Behaviour Therapy (CBT)
- Practise mindful eating habits. This involves chewing your food slowly and eating without distraction or stressful conversations.
8. Movement
A simple way to reduce symptoms is to make sure you move regularly throughout the day. The standard sedentary lifestyle promotes a ‘sluggish’ gut. This can lead to stomach discomfort, bloating and reduces bowel movements.
Gentle exercise is best for people with IBS. Aim for at least 150 minutes of gentle exercise each week. This includes activities like yoga, swimming, walking, jogging and cycling. Even taking 5 minutes every hour to stand up and walk around can be effective in reducing IBS symptoms.
In particular, yoga can be very effective as certain postures can be performed targeted at reducing stomach pain. Another great benefit of yoga is that evidence suggests yoga is useful at promoting calmness and reducing stress.
Second-line treatment options
If symptoms persist after these primary intervention strategies, a more restrictive diet known as the LOW FODMAP diet may be trialled.
The low FODMAP diet is a 4–6-week restrictive diet that eliminates specific foods that contain high levels of fermentable carbohydrates, found to cause the symptoms associated with IBS. However, it can be a very challenging diet to follow, and it often eliminates certain fruits and vegetables, which are otherwise generally recommended for health.
The challenging nature of this diet means that it is better to first try the primary treatment options as mentioned and then work with a trained Dietitian to see if the low FODMAP diet may be appropriate. Research has found that the low FODMAP diet is most effective when done with the support of a trained Dietitian. If you are thinking of going on a low FODMAP diet, then I can help. Please do get in touch to discuss if this would be a good option for you.
Irritable Bowel Syndrome is complex. Every IBS sufferer has different triggers and symptoms and responds differently to treatment. Knowing what your triggers are and what specifically works for you through trial and error is essential to figure out how to best manage your IBS.
I am passionate about helping IBS sufferers feel confident in their bodies again, by taking control of their digestive issues.
I work with you for a period of 3 months to fully understand the root cause of your symptoms and guide you through a personalised diet plan to get your gut back on track. This could be through the low FODMAP diet, if appropriate, to identify any food intolerances. I make sure that you are not alone and am available for you throughout the 3 months. At the end of the 3 months you will understand your IBS and be able to manage any flare-ups confidently, giving you back control.
Take the first step today by booking a free 20 minute introductory call to find out how I can help.
References
1. Cozma-Petruţ, A., Loghin, F., Miere, D. and Dumitraşcu, D.L. 2017. Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients! World Journal of Gastroenterology. 23(21), p.3771.
2. Passos, M.C. 2005. Impaired reflex control of intestinal gas transit in patients with abdominal bloating. Gut. 54(3), pp.344–348.
3. Simrén, agerforz, björnsson and abrahamsson 2007. Nutrient-dependent enhancement of rectal sensitivity in irritable bowel syndrome (IBS). Neurogastroenterology & Motility. 19(1), pp.20–29.
4. Reding, K.W., Cain, K.C., Jarrett, M.E., Eugenio, M.D. and Heitkemper, M.M. 2013. Relationship Between Patterns of Alcohol Consumption and Gastrointestinal Symptoms Among Patients With Irritable Bowel Syndrome. American Journal of Gastroenterology. 108(2), pp.270–276.
