Understanding IBS (Irritable Bowel Syndrome)

Most of us feel some discomfort in our guts from time to time. It may be because we’re nervous about something, or perhaps we ate something that didn’t agree with us. But if you regularly feel aches in your abdomen, it might be a sign of a disorder called irritable bowel syndrome.

What is IBS (Irritable Bowel Syndrome)?

Irritable bowel syndrome (IBS) is a group of symptoms—including pain or discomfort in your abdomen and changes in your bowel movement patterns—that occur together. Irritable bowel syndrome doesn’t lead to cancer or other health problems. But its discomfort can be difficult to live with. The severe or frequent abdominal pain it can bring often leads people to visit a doctor.

Physicians and researchers don’t know for sure what causes irritable bowel syndrome. One possibility is that it comes from changes in the way that the brain and the gut communicate. Dr. Emeran Mayer at the University of California, Los Angeles, is an NIH-funded scientist who’s working to find treatments to correct altered brain-gut interactions. “Most people would agree that stress plays an important role in triggering symptom flares in irritable bowel syndrome,” says Mayer.

Irritable bowel syndrome affects about 1 in 5 Americans. It occurs more often in women than men, and begins before the age of 35 in about half the people who get it.

There’s no medical test to identify irritable bowel syndrome. Instead, doctors make a diagnosis based on the patient’s symptoms. The most common symptoms include bloating and pain in the abdomen, along with changes in bowel habits. People with irritable bowel syndrome may have constipation, diarrhea or both. Many patients first notice symptoms after a stressful event, like losing a loved one or changing jobs. People with irritable bowel syndrome often report higher levels of stress or anxiety. Stress reduction strategies and cognitive behavioral therapy, a type of talk therapy, can help relieve the symptoms of irritable bowel syndrome.

Some researchers suspect that irritable bowel syndrome can be caused by a change in gut bacteria. The gut is usually filled with helpful bacteria, which our bodies need to digest food. But sometimes the types of bacteria can change, like after taking certain medications. For people with this type of irritable bowel syndrome, a supplement of probiotics—a collection of live, healthful bacteria—might help. Probiotics are available as capsules, tablets and powders, and they’re found in some dairy foods, such as yogurts with live active cultures. The potential benefits of probiotics, however, are still under study.

How can my diet treat the symptoms of IBS?

Many people with irritable bowel syndrome find that certain foods can make them feel worse. “There is no specific irritable bowel syndrome diet,” says Mayer. “Irritable bowel syndrome patients are generally more sensitive to a variety of foods.” Every case of irritable bowel syndrome is unique, so if you have symptoms that disrupt your life, don’t suffer in silence. Your doctor can work with you to find the treatment that works best for you.

  1. Eating smaller meals more often, or eating smaller portions, may help your irritable bowel syndrome (IBS) symptoms. Large meals can cause cramping and diarrhea if you have IBS. Eating foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may help.
  2. Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 External Link Disclaimer that adults should get 22 to 34 grams of fiber a day.1
  3. While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in people with IBS. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating.
  4. If you have irritable bowel syndrome, try keeping a diary of the foods you eat and how they make you feel. Then, you and your doctor can decide together if you should try making changes to your diet.

What should I avoid eating to ease IBS symptoms?

Certain foods or drinks may make symptoms worse, such as

  • foods high in fat
  • some milk products
  • drinks with alcohol or caffeine
  • drinks with large amounts of artificial sweeteners
  • beans, cabbage, and other foods that may cause gas

To find out if certain foods trigger your symptoms, keep a diary and track

  • what you eat during the day
  • what symptoms you have
  • when symptoms occur

Take your notes to your doctor and talk about which foods seem to make your symptoms worse. You may need to avoid these foods or eat less of them. Your doctor may recommend that you try a special diet—called low FODMAP or FODMAP—to reduce or avoid certain foods containing carbohydrates that are hard to digest.
Examples of high FODMAP foods and products you may reduce or avoid include

  • Fruits such as apples, apricots, blackberries, cherries, mango, nectarines, pears, plums, and watermelon
  • Canned fruit in natural fruit juice, or large quantities of fruit juice or dried fruitVegetables such as artichokes, asparagus, beans, cabbage, cauliflower, garlic and garlic salts, lentils, mushrooms, onions, and sugar snap or snow peas
  • Dairy products such as milk, milk products, soft cheeses, yogurt, custard, and ice cream
    Wheat and rye products
  • Honey and foods with high-fructose corn syrup
    products with sweeteners ending in “–ol,” (including candy and gum), such as sorbitol, mannitol, xylitol and maltitol
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