What is Irritable Bowel Syndrome (IBS)?

April is IBS Awareness Month, so it is fitting that we discuss it today.

One of the most common problems I see in my integrative medicine office is Irritable Bowel Syndrome or IBS. It is a common disorder that affects the stomach and intestine, also called the gastrointestinal tract. It is estimated to affect 5-10% of people worldwide. It causes uncomfortable or painful abdominal symptoms like cramping, bloating, gas, abdominal pain, diarrhea, constipation, or both. The condition affects more women and young people. IBS does not damage your digestive tract or raise your risk for colon cancer. It is a chronic condition that you will need to manage over a lifetime. You can often manage symptoms through medications, diet, and lifestyle changes. Only a small number of people have severe symptoms.

There is no definitive test for IBS. It is often more of a condition that is diagnosed after other conditions are ruled out, like Celiac disease and Inflammatory Bowel Diseases (Crohn's or Ulcerative Colitis), or an infection.

The treatment is geared towards what type of IBS a patient has. There seem to be four types, based on symptoms: constipation-predominant, diarrhea-predominant, mixed or unclassified. Treatment focuses on relieving symptoms so that the patient can live life as symptom-free as possible.

Mild symptoms:

• Managing stress (mindfulness, getting outside, grounding, meditating)

• Avoiding foods that trigger your symptoms (eg. a certain member of my family cannot eat onions)

  • To find out which foods those are you may need to do an elimination diet or period of time to identify which foods are your triggers

• Drinking plenty of fluids (water, decaffeinated tea)

  • You might want to try avoiding carbonated water (Bubly, Spindrift, La Croix) to see if those could be contributing. Sometimes those bubbles may taste good but not best for our gut!

• Exercising regularly (you knew I was going to say that)

  • Whether that is walking after dinner or lifting weights in the morning, movement of your body can help regulate your gut motility

• Getting good quality and enough sleep

  • Turn that TV off 1-2 hours before bed, put away that phone, and prioritize shutting your mind down with a bedtime routine, bubble bath, or nighttime reading

• Eating enough and the right kinds of fiber

  • GRADUALLY increase your fiber. You don't want to increase it all at once or this could cause further problems. As women, we should be getting 25 grams per day while men need around 30 grams. Again, slowly taper up. Don't bomb your system all at once. If diarrhea is your problem, this will give your stools some bulk. If constipation is your problem, amping up your fiber with those easier to digest in the beginning (with plenty of water) can help keep things moving.

  • I included a list of higher-fiber foods at the bottom of this post. Just realize that crunchy, raw vegetables are going to be harder for your system to digest and can contribute to bloating and cramping. So, in the beginning, go for avocado, cooked vegetables, room-temperature fruits like berries & kiwi, and whole grains.

• Limiting caffeinated beverages as they seem to stimulate the intestine

• Probiotics

  • Building your gut microbiome is a great thing to focus on. While a probiotic will not be harmful, the best way to build your microbiome is to get it through whole foods - eating a diversity of plants. The millions and millions of bacteria in our gut all like different types of foods, therefore increasing the amount and diversity of plants in your diet is a good way to ensure everyone is happy!

  • Other ideas for food sources include yogurt with active bacteria, kefir, kimchi, sourdough bread, and so many others - see our post on fermented foods

For more severe symptoms, some patients have to try an elimination diet or eliminate things that are known to worsen IBS:

• High-gas foods: carbonated, alcoholic beverages and foods that lead to more gas (those harder-to-digest fiber sources like we talked about above)

• Gluten: some patients get better even if they do not have Celiac disease as gluten is known to be an inflammatory food

• FODMAPs: some patients are sensitive to certain carbohydrates such as fructose, oligosaccharides, disaccharides, monosaccharides, and polyols, hence the name FODMAPs. These are found in certain fruits, vegetables, grains, and dairy products.

A dietitian or provider who is well-versed in nutrition can help with these changes. Watch out for our next post about how to confront IBS from a functional nutritionist perspective.

Some nutriceuticals (food containing health-giving additives and having medicinal benefits) and other medicines can be prescribed by your provider to help as well.

You just want to make sure you have ruled out other causes for your symptoms. I do recommend everyone have a thorough evaluation before just assuming it is irritable bowel syndrome.

It is not a hopeless situation, and you can get better.

Complete list of fiber-rich foods:

https://www.healthline.com/nutrition/foods-high-in-soluble-fiber#nuts-and-seeds

All material was gathered and researched through my amazing fellowship program, The Arizona Center for Integrative Medicine.

https://integrativemedicine.arizona.edu/ 

and

https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016