Irritable Bowel Syndrome

Irritable Bowel Syndrome or IBS has numerous descriptions, but the best understood is the recent Rome III diagnostic criteria which simply states:

“A patient must have recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months associated with two or more of the following features: improvement with defecation, onset associated with a change in frequency of stool, or onset associated with a change in consistency of stool.”

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IBS is a very common condition affecting people in the UK. It is first noticed in people in their 20’s and 30’s but can sometimes affect teenagers as well. Although a troublesome condition if untreated it can last a lifetime with an unpredictable course; you may go for months without any symptoms and then have a sudden flare-up, but it will not increase your chances of developing bowel cancer or other bowel-related conditions. Symptoms affecting the digestive system include stomach cramps, gas, bloating, diarrhoea, constipation and undigested food and mucus in the stool.

The exact cause of IBS is unknown, however it could be caused by a bowel infection such as after having traveller’s diarrhoea, by psychological stress or in may cases from eating certain foods that act as a trigger causing symptoms. There are a number of foods that could cause problems including wheat and gluten. Some people suffer from a condition called Coeliac disease whereby the immune system attacks and destroys the gut when it encounters gluten. Signs of Coeliac disease beyond having IBS are anaemia and weight loss. Other trigger foods could be dairy, fruits and other grains.

Managing IBS

There is no cure for IBS, but the symptoms can be managed very well by making changes to what you eat. There are a number of diets with potential benefits to be able to effectively relieve the symptoms of IBS. These include:

  • The gluten free / casein free diet (GF/CF diet)
  • FODMAP diet
  • The specific carbohydrate diet (SCD)
  • The Gut and Psychology diet

The gluten free / casein free diet is quite self explanatory. It means removing all sources of gluten and dairy from the diet for a period of 2 to 4 weeks and evaluating how this changes your symptoms. Gluten is found in many foods such as bread, pasta, biscuits, cakes, soy source as well as sandwich means. It is important to read labels when you are on a GF/CF diet to avoid hidden sources of gluten. Also cut milk, cheese and yoghurt from your diet. It would be wise to work with a nutritionist to make sure you are getting adequate nutrition from the foods you do eat and to answer any questions about the GF/CF diet.

The FODMAP diet was developed by researchers in Australia and stand for Fermentable Oligo-, Di- and Mono-saccharides, and Polyols.  The foods high in FODMAPs include milk, soft cheese, bread, wheat, apples, pears, beans, broccoli and cauliflower. It is believed that when digested these foods cause the release of large amounts of liquid and gas into the bowels, causing symptoms such as abdominal pain, gas and bloating. Click here for a handout on FODMAP foods.

The Specific Carbohydrate Diet is outlined in the book Breaking the Vicious Cycle by Elaine Gottschall. It is a book that was written to help people with bowel health problems including Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis and chronic diarrhoea. The premise of the diet is to eat meat, fish, eggs, vegetables, nuts and low-sugar fruits and exclude starches, grains, pasta, legumes, and breads.

The Gut and Psychology (GAPs) diet by Dr. Natasha Campbell-McBride is very similar to and based upon the Specific Carbohydrate Diet. Dr Campbell-McBride has taken the SCD and evolved it further in to a full protocol for healing digestive disorders and includes foods such as eggs, fresh meats, fish, shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil. Fruit should be eaten on its own as a snack between meals.

The GAPs diet also encourages the consumption of fats such as butter, ghee, coconut oil and cold pressed olive oil; fermented foods such as sauerkraut, yogurt, and kefir and homemade stock. As with the other diets outlined in the management of IBS the GAPs diet recommends the avoidance of processed foods, grains, beans cheeses and soy products.

All of Specialised Diets for GI Healing have a very similar theme – eating non-processed meats, fish, vegetables, nuts and seeds, fruit in moderation and the avoidance of processed foods, grains and legumes. If you work with a nutritionist to introduce these dietary habits in to your life you too could resolve your IBS symptoms.

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