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Top tips for living with Irritable Bowel Syndrome...

Updated: Mar 5

A man experiencing stomach pain

Do you regularly suffer from digestive issues such as bloating, wind, stomach pain or frequent and urgent bowel movements? You may be suffering from irritable bowel syndrome (IBS).

IBS is a functional gut disorder

This means that there is no recognisable damage to the structures of the digestive system, but functionally it is not working optimally.

It is estimated to occur in up to 1 in 4 people, with females suffering more than men.

Symptoms can range from the mildly embarrassing or uncomfortable such as bloating or wind up to so severe that the sufferer will not go to public places without knowing where the next toilet is, or have abdominal bloating to the point of appearing pregnant. This can significantly affect a person’s quality of life and confidence.

The link between IBS and diet

Often people suffering IBS realise the link between diet and symptoms and attempt to remove trigger foods. Very often these include wheat based staples and dairy foods. In some cases this can improve symptoms but if often excludes foods that do not need to be excluded or it only works some of the time. At worst, it may put the person at risk of nutrient deficiencies. This can go on for months or even years before a deficiency syndrome presents itself and is subsequently diagnosed.

FODMAPs and how can they help

Fortunately, there is a dietary regime that can significantly improve or prevent IBS Symptoms called the low FODMAP diet. Controlled clinical trials have shown this to be effective in around 75% of sufferers.

FODMAPs are a group of carbohydrates that are poorly absorbed in the small intestine and undergo fermentation in the large intestine. Whilst this is a normal digestive process involving foods that are beneficial to health, sufferers of IBS are more sensitive to foods containing FODMAPs. The gut bacteria naturally present in large intestine ferment these carbohydrates, releasing gas in the process. This excess gas results in bloating and wind. Due to a process called osmosis, water is drawn into the bowel resulting in loose and urgent stools or in some sufferers, constipation may result.

How to implement a low FODMAP diet

Because the low FODMAP diet is complex and involves a broad range of foods, it may put someone at risk of nutrient deficiency if not well implemented. The goal is therefore not to permanently eliminate everything that potentially causes symptoms.

A strict low FODMAP diet is intended to be followed for a short period of time to determine if symptoms are improved. If they are, the next and arguably most important part of the process is called the “Rechallenge Phase”. This involves reintroducing foods in a systematic manner whilst monitoring digestive symptoms to determine what foods are “trigger foods” and which foods are tolerated and in what amounts. If the diet does not help relieve symptoms, it is important to go back to the normal diet and explore other options.

Who can help...

It is therefore important to undertake this diet under the guidance of an Accredited Practicing Dietitian with experience in this area. A dietitian will understand the process of elimination and reintroduction and offer alternative foods for those that are removed from the diet, thus ensuring that your nutrient requirements are being met.

Furthermore, it is important to rule out other possible causes for digestive symptoms such as coeliac disease or inflammatory bowel disease, for example. A dietitian will refer you to back to your doctor if something more sinister is suspected.

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