Facts and Definition of Irritable Bowel Syndrome (IBS)
- Irritable bowel syndrome is a common disorder that affects individuals by causing signs and symptoms of
- Symptoms can vary from individual to individual but usually include bouts of diarrhea and constipation.
- The exact role of food intolerance in irritable bowel syndrome (IBS) is not clearly understood.
- It is known that many people have more severe symptoms depending on their dietary intake of certain foods.
- Discovering which foods to avoid and what diet is the best tolerated is one of the main treatments for patients suffering from IBS.
- An elimination diet (slowly eliminating foods from the diet, and noting any IBS symptom changes) may be helpful for some individuals with IBS to learn what foods trigger IBS symptoms, and what foods prevent triggers.
- Discuss any dietary changes with your health-care professional.
IBS (Irritable Bowel Syndrome) Diet Triggers and Constipation or Diarrhea
- Many people suffering from IBS are aware of very specific foods that trigger and worsen their symptoms. The person usually learns what trigger foods to avoid.
- Food diaries can be helpful in pinpointing the products causing symptoms to worsen.
- People with IBS usually suffer from both diarrhea and constipation, and different foods are often implicated as triggers.
- Treatment of IBS symptoms often is specific to the individual. There usually is no easy answer to relieve IBS symptoms, but rather a process that involves the patient and doctor working closely together.
IBS Diet Triggers and Diarrhea
- Gluten free diets have been linked in some research to improved diarrhea symptoms; however, this has not been clearly established.
- A subgroup of poorly absorbed carbohydrates referred to as FODMAPs (which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols) causes symptoms in some people with IBS. FODMAPs are found in many products such as some grains (what, rye), fruits (found in pears, honey, and apples), vegetables (artichokes, onions, garlic), artificial sweeteners, and dairy products (lactose intolerance). Some individuals tend to be sensitive to only some FODMAPs. For some individuals, a diet high in FODMAPs may result in bloating, gas, and diarrhea.
- Foods high in fat can worsen diarrhea symptoms
IBS Diet Triggers and Constipation
- In general foods that dehydrate can worsen the constipation symptoms of IBS.
- As with all food intake, some foods might be tolerated in moderation but cause symptoms if ingested in excess.
- One suggested approach is to remove a food or food category, watch and note symptoms, and slowly reintroduce the food back into the diet and track your symptoms (elimination diet).
- Fiber products can help (in case of constipation) or worsen IBS (diarrhea).
- Exercise helps prevent constipation and lack of exercise can worsen it.
IBS Triggers: Stress and Anxiety
- Most people who suffer from IBS notice increased stress and anxiety will worsen their symptoms. Avoiding activities that cause stress or anxiety may prevent IBS symptoms from occurring.
- IBS and its symptoms can be relieved or at least improved with non medical and none food related therapies. Relieving stress and anxiety will help improve IBS symptoms.
Exercise for IBS
- Moderate exercise seems to help with IBS. A moderate exercise program showed an improvement of IBS symptoms in one research study. During exercise it is important to stay hydrated and keep the exercise at a moderate level.
Yoga to reduce stress and anxiety
- Yoga has shown to improve IBS symptoms. Well-trained yoga practitioners will be able to take you through a yoga practice that not only relieves stress but also can specifically work on your digestive system.
Meditation and mindfulness to reduce stress and anxiety
- Meditation decreases stress and anxiety. It has also been linked with a decrease in IBS symptoms.
IBS Triggers: Menstruation
- IBS is twice as common in women as in men, leading some IBS experts to believe hormonal fluctuations and changes might play a role in IBS. In addition many women with IBS report an increase in symptoms during and around their menstrual period.
- Some cells in the digestive system are responsive to estrogen and progesterone. These hormones change during the menstrual cycle and could affect the digestive system.
Medication Triggers for IBS (Irritable Bowel Syndrome)
Some antidepressants can worsen symptoms.
Constipation may be worsened by tricyclic antidepressants, for example:
- amitriptyline (Elavil, Endep)
- amoxapine (Asendin)
- desipramine (Norpramin)
- doxepin (Adapin, Sinequan, Zonalon)
- imipramine (Tofranil)
- nortriptyline (Aventyl, Pamelor)
- protriptyline (Vivactil)
- trimipramine (Surmontil)
Diarrhea may be worsened by selective serotonin reuptake inhibitors (SSRIs) antidepressants, for example:
IBS Triggers: Others
- Eating while doing other activities because it can cause you to eat too quickly; not chew thoroughly; or to swallow excessive air, which can lead to worsening IBS symptoms.
- Exercise helps prevent constipation and lack of exercise can worsen constipation.
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Johannesson, E., et.al. "Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial." American Journal of Gastroenterology 2011 106:915-922.
Magge, S. et al. "Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome." Gastroenterol Hepatol (N Y). Nov 2012; 8(11): 739–745.
Muir, J. et al. "The Low FODMAP Diet for Treatment of Irritable Bowel Syndrome and Other Gastrointestinal Disorders." Gastroenterol Hepatol (N Y). Jul 2013; 9(7): 450–452.
Wald, A. MD. "Patient education: Irritable bowel syndrome (Beyond the Basics). UpToDate. Updated: Aug 12, 2015.