Understanding what foods are suitable for individuals dealing with irritable bowel syndrome (IBS) presents a significant challenge. There isn't a universally applicable irritable bowel syndrome diet recommendation that fits everyone's unique needs.

 

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Irritable bowel syndrome (IBS) is classified into different subtypes based on the predominant bowel habits and symptoms that individuals experience. The Rome criteria, a set of guidelines used to diagnose functional gastrointestinal disorders, categorise IBS into four main subtypes:

• IBS with Constipation (IBS-C): Individuals with IBS-C primarily experience constipation as a predominant symptom. Common symptoms include infrequent bowel movements, difficulty passing stools, and the sensation of incomplete evacuation.
• IBS with Diarrhoea (IBS-D): This subtype is characterised by diarrhoea as the predominant symptom. People with IBS-D may have frequent bowel movements, loose or watery stools, and urgency.
• Mixed IBS (IBS-M): Also known as alternating IBS, this subtype involves a combination of both constipation and diarrhoea. Individuals with IBS-M experience a fluctuation between periods of constipation and diarrhoea.
• Unsubtyped IBS (IBS-U): This category is used when individuals do not clearly fit into any of the specific subtypes mentioned above. It may be due to variability in symptoms or a lack of consistency in the presentation of constipation or diarrhoea.

 

Distinguishing between IBS subtypes adds an additional layer of complexity. Triggers for those with irritable bowel syndrome -diarrhoea (IBS-D) may differ from those with IBS-constipation (IBS-C), and individuals with mixed-type IBS (IBS-M) may grapple with a combination of triggers. Even within these subtypes, the identification and avoidance of specific foods triggering IBS symptoms vary widely.

 

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Symptoms of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is diagnosed if there is abdominal pain or discomfort that is either alleviated by defecation or linked to a change in bowel habits. This should be accompanied by a minimum of two of the following four symptoms:

• Altered stool passage, including straining, urgency, or incomplete evacuation.
• Abdominal bloating (more prevalent in women than men), distension, tension, or hardness.
• Symptoms exacerbated by eating.
• Passage of mucus.
• Unintentional and unexplained weight loss.
• Rectal bleeding.
• Family history of bowel or ovarian cancer.
• Change in bowel habit to looser and/or more frequent stools persisting for more than six weeks in a person aged over 60 years.

 

Additional features like lethargy, nausea, backache, and bladder symptoms are common in individuals with irritable bowel syndrome and may support the diagnosis. 

 

It is crucial to have a confirmed diagnosis of IBS and rule out other conditions such as coeliac disease and inflammatory bowel disease. If you suspect you may have IBS but also experience any of the following symptoms, it is advisable to consult your doctor to discuss whether a referral to a specialist may be necessary.

 

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How can diet help treat symptoms of IBS? 

Individuals managing irritable bowel syndrome (IBS) can utilise lifestyle strategies to control and mitigate gut symptoms, enhance their quality of life, and optimise digestive health.  It's a common experience for people with IBS to encounter gut symptoms triggered by specific types of foods, and what causes discomfort for one person may not have the same effect on another. While there are general strategies beneficial for everyone with IBS, the most effective approach for you will likely require a personalised touch.

 

Food serves as a potent tool in constructing a long-term strategy and plan tailored to your unique needs and lifestyle. This involves cultivating a positive relationship with food, boosting confidence in making dietary choices both at home and when dining out, promoting nourishing foods that don't exacerbate gut symptoms, avoiding unnecessary food restrictions, and addressing potential food-related anxieties.

 

According to a 2022 study issued by the National Institute of Health, changing diet can help treat symptoms of irritable bowel syndrome (IBS). The study supports the decision of consuming more fibre, avoiding gluten-rich foods and following the low FODMAP diet.

 

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Diet For Irritable Bowel Syndrome

Nevertheless, there are several dietary approaches that seem promising in alleviating symptoms across IBS subtypes. While some may require customisation for sustained relief, a bit of patience and experimentation can lead to the discovery of an eating plan that effectively manages IBS symptoms. Individuals with IBS may find that different adjustments work for them. It might be necessary to modify the diet for IBS choices over several weeks to check whether symptoms improve.

• Opt for cooked vegetables over raw for easier digestion. Establish a routine for meals, ensuring regularity, thorough chewing, and a slow pace of eating to enhance digestion and tolerate smaller portions effectively. Space out fruit intake by 2-3 hours, limiting it to one portion per meal or snack. 
• Maintain hydration by consuming a minimum of 8 cups (2 L) of fluids daily, such as water, herbal tea, or broth. Restrict gas-producing vegetables and legumes if they provoke symptoms. Limit coffee and strong caffeinated teas to a maximum of 3 cups daily. Reduce intake of sugar alcohols and artificial sweeteners, especially if experiencing diarrhoea. 
• Experiment with a short-term low FODMAP diet to pinpoint specific food triggers. The acronym FODMAP stands for "fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. According to a 2022 report by National Institute of Diabetes and Digestive and Kidney Diseases, temporarily restricting or limiting the consumption of high FODMAP foods for 2–6 weeks may contribute to an improvement in IBS symptoms. High FODMAP foods include apples, onions, garlic, wheat, lactose, and sugar alcohols.
• Rule out gluten intolerance and celiac disease, as intolerance to wheat carbohydrates (FODMAP) rather than gluten protein may be the issue for some. Notably, some individuals may tolerate 100 per cent sourdough wheat bread (low FODMAP) but not regular wheat bread.
• Choose easily digestible proteins like eggs, chicken, turkey, fish, extra-firm tofu, and plain lactose-free Greek yoghurt. Employ lower-fat cooking methods like baking, roasting, steaming, boiling, or sautéing to minimise discomfort. Moderate spicy foods and fried or greasy items like French fries, pizza, and hamburgers.
• Eat fibre-rich foods to prevent constipation. Consider incorporating certain fibre types for constipation relief, such as flaxseeds, oats, inulin, or psyllium. Fibre contributes bulk to stool and promotes softer consistency, facilitating smoother bowel movements. According to a 2022 report by National Institute of Diabetes and Digestive and Kidney Diseases, for optimal health, the average adult, including individuals with IBS, is recommended to consume approximately 22–34 grams (g) of fibre daily, with specific amounts varying based on sex and age.  Avoid fermentable fibres like wheat bran and prunes, which can trigger gas and abdominal pain.
• Consider a short-term trial of a daily probiotic for at least one month, monitoring symptoms. According to a 2022 study issued in the National Institute of Health, probiotics are living microorganisms, primarily bacteria, that closely resemble the microorganisms naturally present in your digestive tract. The use of probiotics in the treatment of irritable bowel syndrome (IBS) is found to be potentially beneficial for individuals with IBS.
• Incorporate regular physical activity to reduce gas, bloating, stress, and anxiety, all potential triggers for gut symptoms. Consult with healthcare professionals to determine the appropriate level of activity.
• Effectively manage stress and anxiety, recognizing their strong connection with gut health. Employ various relaxation strategies such as nature walks, calming music, meditation, and therapeutic activities.

 

Seeking professional counselling or exploring psychological therapies like biofeedback, cognitive behavioural therapy (CBT), and gut-directed hypnotherapy may also be beneficial.

 

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