What Do We Know About IBS?

What Do We Know About IBS?
When it comes to talking about our digestive health, it is a common subject which people tend to avoid. However, this should not be the case. We're not saying disclose your personal health concerns to everyone, but if we can speak more openly about digestive discomfort or abnormalities to the people who are close to us, then we may be inclined to seek medical support quicker. Irritable Bowel Syndrome, otherwise known as IBS, is a common disorder that affects the large colon. The main symptoms include bloating, pain, discomfort, gas and cramping. Some sufferers can also suffer from diarrhoea or constipation, or a combination of them all. Sorry ladies, it's more common for women than it is in men and you are more likely to feel the symptoms from your teens that may persist on and off throughout your life. The severity of symptoms will also vary from person to person. There is, unfortunately, no specific cause of IBS, but the most common risk factors include a traumatic or upsetting event, an attack of gastroenteritis or by a course of antibiotics. If you have a particularly sensitive gut, you may also find a change in diet, stress levels or a lifestyle change can also have an effect.

Diet

People with IBS are usually very sensitive to certain types of foods. Food can not only modify the way our gut behaves, but it can also be quite an emotional topic. So if the thought of food, or spending time with friends and family sharing a meal brings on heightened emotions, both positive and negative, this can go on to cause the gut to be more sensitive and for intolerances to occur. Intolerance to certain food types can trigger spasms in the stomach and distend it with either gas or fluid. So what are the foods which may upset the stomach in this way? The most common offenders include:
  • Wheat
  • milk
  • Fruits including plums, apricots, peaches, mangoes, apples and pears
  • Onions and garlic
  • Fried foods
  • Chocolate, butter & cream.
banner_25Dec16_2 There is another aspect of dietary requirements in which people who suffer from IBS have to watch out for, and these are called 'FODMAPS'. FODMAPS stands for 'Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols' - quite a mouthful! FODMAPS are a collection of poorly absorbed complex sugars which are a part of foods we consume almost every day. Most commonly they are found in fruits, vegetables and wheat, but there is a very extensive list of foods which may cause IBS sufferers a problem. After digestion, FODMAPS travel through our stomachs and into the small intestines without any change. They are then either fermented by colonic bacteria, releasing gas or expelled together with foods. People who suffer from a sensitive gut will then experience bloating, abdominal pain and loose bowels when this happens. Make things a little easier for your stomach by searching for a FODMAP list which tells you which foods to avoid or reduce and those that are right for you. It is advisable to eliminate or minimise the following from your diet:
  • Vegetables & legumes - asparagus, beetroot, cauliflower, falafel, kidney beans, savoy cabbage, shallots, split peas, butter beans, black beans.
  • Fruits - apples, avocado, blackberries, cherries, dates, figs, grapefruit, mango, dried pineapple, prunes, raisins, watermelon.
  • Meats - chorizo, sausages, processed meats.
  • Cereals & Grains - biscuits, croissants, more than one slice of bread containing wheat, wheat-based flours, crumpets, muffins.
  • Drinks - beer (if more than one), coconut water, juices made from apple, pear or mango, sodas containing high fructose levels, sports drinks, fennel tea, oolong tea, black tea with soy milk.
  • Dairy foods - buttermilk, cream, custard, ice cream, cows milk, goats milk, sour cream and yoghurt.
banner_25Dec16_4 That does look like quite a daunting list (and sorry to say that's not everything). However, it does not mean you're destined for culinary blandness for the rest of your life! The 'acceptable food' list is exciting, with many foods which shouldn't cause your IBS to flare up. Here are a few flavourful options:
  • Vegetables - bok choi, butternut squash, carrots, chives, green beans, kale, lentils, olives, pumpkin, spinach, sun dried tomatoes, sweet potato and tomato.
  • Fruits - bananas, blueberries, cranberry, guava, kiwi fruit, lemons and limes, orange, passion fruit, strawberry and raspberry.
  • Meats - beef, chicken, turkey, lamb.
  • Cereals & Grains - wheat free bread, gluten free bread, almonds, brown rice, crisp bread, corn cakes, mixed nuts, oatmeal, peanuts, popcorn, polenta, rice cakes, rice bran, chia, pumpkin, sesame and sunflower seeds.
  • Drinks - limited alcohol, coffee including espresso, instant coffee with lactose-free milk, protein supplements, black tea, chai tea, green tea, soy milk make from soy protein, peppermint tea, water.
  • Dairy - butter, cheeses including Brie, Camembert, Cheddar, feta and goats cheese, eggs, almond milk, tofu, lactose-free yoghurt.
  • Plus a range of herbs and spices including - basil, curry leaves, lemon grass, mint, black pepper, chilli powder, cloves, cumin, paprika, saffron, turmeric.
It's important to remember that everyone is different, and as with any diet, it's down to what works best for the person and what symptoms you carry. Aside from making changes to your diet to control IBS, there are other guidelines and avenues in which you can explore to manage your symptoms which do not immediately include taking medication.

Managing Stress Levels

Reducing your stress levels may also reduce the frequency and severity of IBS. Try relaxation techniques, such as breathing exercises and meditation. Relaxing will work towards reducing any stress which may be building up and triggering off IBS symptoms. If you're feeling up to a little activity try yoga, pilates, walking or swimming, which are gentle enough to reduce stress levels without exacerbating any uncomfortable feelings.

Probiotics

Some people may find that taking a regular dose of probiotics can help restore the balance in their gut. Probiotics are 'healthy bacteria' which can be found in foods such as yoghurt, as well as in supplements. There is currently little evidence to scientifically support the fact probiotics can help directly with IBS. However, there is proof that probiotics offer sufficient support to your gut when it is not in a healthy condition. You can read more about how probiotics can help our health here: The no1 supplement you should be taking.

Psychological Treatment

If you have not been able to manage your symptoms after 12 months, then your doctor may suggest some different forms of management, such as therapy. One type of treatment is known as 'psychological intervention'. The psychological intervention involves talking to a trained CBT (cognitive behavioural therapy) therapist who examines how your thoughts and beliefs link to your behaviour with food and assists you with coping mechanisms you can practise on your own. banner_25Dec16_1

A Real Life Example

We recently spoke with someone who suffers from IBS, to talk about her symptoms, the struggles of being diagnosed and how she has learnt to manage it in daily life. Here is her story: "It took the hospital over a year to diagnose me with IBS. My symptoms were atrocious after I had my appendix out, the doctors believed the trauma of this (collapsed at work and was rushed into A&E) brought the symptoms on and made them more noticeable to me. It took many appointments over that year for them to narrow it down to IBS. A month after my appendix operation, I was admitted back into the hospital where they ran some more tests to make sure it wasn't post-op complications; they soon ruled that out. I spoke to a doctor from the gastro dept who referred me to his clinic. Over the next year, I was tested for IBD (inflammatory bowel disease), celiac (which was pointless as I had already cut out gluten at this point), smaller gut issues and a few gynaecology problems. Once they ruled these out, I was transferred completely to gynaecology to rule out endometriosis. Once that was confirmed, they narrowed it down to IBS. It was a long process. When the doctors first started going down the IBD and IBS route, I read up about both to see what aggravated the condition more, everything I read lead me to the FODMAP diet. The main ones I read said to take out gluten and dairy, so that was my first decision, then I removed caffeine (this gave me headaches). I tried to stick to the diet but found it hard to do living with my parents. However, now I moved out of my parents home, I stick to it as much as possible as I find it eases my symptoms. It is tough as there are so many foods I love to eat that they suggest you can't. I find exercise is fantastic to manage my symptoms away from what I eat. With exercise, I don't have to be so strict with my diet, and my symptoms aren't as regular. However sometimes keeping fit just doesn't work, it is still a learning curve for me! The doctors always prescribe me Buscopan which I find doesn't help that much. And I hate taking it; I don't want to rely on something like that, I would rather treat it with diet, exercise and herbal remedies. Which leads me to my next thing, peppermint tea, or any tea that has peppermint tea (the best tea I've found is the Pukka Three Mint Tea). I've tried capsules of peppermint too, but I don't find it works as well as the tea! If you feel you may be suffering from IBS, the first important step is to get a diagnosis from the doctor. In the meantime keep an eye on what you are eating and note any patterns, try and stay relaxed and ensure you keep your gut as healthy and happy as possible.

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