Irritable Bowel Syndrome (IBS)

IBS is a bowel disorder characterized by abdominal pain with constipation and/or diarrhea.

It is slightly common in women than men and the symptoms range from abdominal pains/cramps, constipation alternating with diarrhea and bloating. Some people may even experience blood in the stools and the symptoms come and go.

The Mechanism Of How IBS Occurs

After food is ingested, it moves to the stomach all the way to the small intestine, then to the large intestine until it gets to the rectum where it is now stools ready to be passed. The movement of food particles in the intestines occur by intestinal walls pressing against each other.

When the movement is:

Fast = D – digestive system contracts quickly resulting in diarrhoea

Slow = C – digestive system contracts slowly resulting in constipation

Mixed = M – stools alternate between constipation and diarrhoea

The cause remains UNKNOWN but there are triggers:

  1. Stress (physical and emotional)
  2. Infections e.g. viral or bacterial
  3. Medications (certain antibiotics, antidepressants (amitriptyline), cough syrups containing sorbitol
  4. Certain foods especially gas producing foods such as Vegetables (cabbage, broccoli, cauliflower, brussel sprouts, onions); Fruits (pears, apples, peaches); Beans; Milk and Milk products; Whole grains (whole wheat, rye and bran); sugar-free gums (containing sugar alcohols such as sorbitol, mannitol and xylitol)
  5. Alcohol and smoking

(Each persons triggers are individual and not everyone reacts to the same food)

The Management Of IBS

It important to know that there is no common or umbrella treatment for IBS. One will have to consult with their doctor and dietician to rule out some of the triggers and work out an individualized meal plan to relieve the symptoms.

Keep a symptom diary as this will assist your dietician in identifying the triggers to better plan her meal plan.

For more serve cases of IBS special diets like a LOW and HIGH FODMAP diet needs to be implemented, but this should only be done with the assistant of a dietician as the elimination of various foods can become really tricky and various nutrient deficiencies can occur.

FODMAP = Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

Low FODMAP diet includes limiting foods that contain lactose, fructose, fructo-oligosaccharides, galacto-oligosaccharides, polyols (low calorie sugar substitutes) and sugars alcohols.

These carbohydrates are poorly absorbed in the small intestines,  and rapidly fermented by bacteria in the large intestine, resulting in gas, pain and diarrhoea. Some people are bale to tolerate small amounts of these foods and only develop symptoms if large amounts of the food is eaten.

A low FODMAP diet may result in some deficiencies such as folate, Vit B6, Thiamine, Calcium and Vitamin D. Thus, the importance of working with w dietician who can assist in preventing these deficiencies.

If a person has severe IBS, a high FODMAP diet will be recommended, but I urge again to work with a registered dietician to assist with this scientific nutritional intervention. As even more foods will be eliminated from the diet including certain vegetables, fruits, cereal, legumes, sweeteners and milk.

  1. Vegetables: artichokes, asparagus, garlic, onions and peppers.
  2. Fruits: apples, pears, peaches, watermelon, cherries, nectarines, plums, prunes.
  3. Cereals: wheat, rye-based products, barley (in large amounts).
  4. Legumes: beans, chickpeas, lentils.
  5. Sweeteners and condiments: sorbitol, mannitol, xylitol, maltitol, honey, juice concentrates.
  6. Milk

knowing how to read a food label becomes very important in implementing this type of diet.

other ways to help relieve the symptoms is to include medications to relieve bowel spasm, diarrhea and constipation (You have to consult with your general practitioner for the best product). Studies have shown that supplements such as probiotics and prebiotics can assist in the management of IBS.

How To Manage Uncomfortable Flatulence

  • Take 20 minutes to eat your meals.
  • Drinks to be consumed slowly.
  • Avoid eating while anxious or upset or on the run. Sit down to have your meal.
  • Chew thoroughly before swallowing.
  • Eat small meals throughout the day.
  • Avoid chewing gums and hard candy.
  • Don’t smoke.
  • Cut back on fried foods.
  • Avoid carbonated drinks.
  • Exercise regularly.

For more guidance on managing IBS, please consult with your nearest dietician.

Written By TAD Dietician – Member of TYHN Dieticians, RD(SA)

About the author:

Tanya has been providing dietary guidance since 2009 as a registered dietician licensed in South Africa. Her goal is to help patients understand the connection between diet and diagnosis for improved nutritional well being.