Irritable Bowel Syndrome (IBS) covers a huge range of symptoms from bloating, wind, constipation, diarrhoea, nausea, cramps and reflux. The symptoms vary hugely in both frequency and severity. It can be a very debilitating condition that is miserable to live with. It is more common in women than men.
If you regularly suffer from all or some of the above symptoms, you need to see your GP before you self-diagnose with IBS and start eliminating food groups. It is important to eliminate any serious underlying conditions like the inflammatory bowel diseases Crohn’s disease and colitis, or conditions like bowel or ovarian cancer. Your GP will also need to rule out coeliac disease, but you cannot be given an accurate test for this if you have already eliminated gluten from your diet.
Firstly, get on top of stress and how you deal with it.
Make sure that you are getting enough sleep and schedule regular exercise into your day.
Create a routine around your meal times so they are not rushed.
Sit upright at a table when you eat, not slouched in front of your computer or TV.
Once you have been diagnosed with IBS, here’s what to do before you make changes to your diet.
Take time to chew your food slowly and properly.
Do not let yourself get so hungry that you end up overeating.
Eat small meals throughout the day so that you don’t overload your stomach.
Don’t drink too much liquid with your meals.
Start keeping a food diary and note your symptoms as they occur. As you can see from the list below, many of the problem foods are actually good for you. But for IBS sufferers, a combination of too many of these foods, even over a week, can cause problems. The best idea is to work with a registered dietitian or nutritionist to work out a plan. Initially you will eliminate FODMAPS, before gradually reintroducing them to see where your tolerance levels lie. I have clients who are fine with one slice of toast a day but if they add more wheat, as in a sandwich at lunchtime or pasta at dinner, they are in trouble. The same goes for things like dried fruit – a raisin or two in your muesli is unlikely to cause a problem but dried fruit as a daily snack may be too much. One of my clients fixed all her symptoms simply by switching to lactose-free milk, and another only had to remove hummus and chickpeas.
With IBS, everyone is different. If you can avoid overeating your trigger foods, you can enjoy a varied and healthy diet without eliminating whole food groups. The emphasis is on eating a low-FODMAP diet, not a no-FODMAP diet. Managing symptoms is all about finding a balance. IBS doesn’t mean you can never eat any of these foods again.
So… what are FODMAPS?
FODMAPS stands for: Fermentable oligo-saccharides, disaccharides, monosaccharides and polyols. They’re carbohydrates some people don’t break down very well, which causes IBS. Some examples:
Fructose/fructans: apple, pear, mango, honey, canned fruit, dried fruit, fruit juice, wine, tomato paste, wheat, rye, onion, leek, asparagus, inulin (a kind of soluble fibre, check food labels for it).
Galactans: broccoli, Brussels spouts, cabbage, baked beans, kidney beans, chickpeas, lentils, and soybeans.
Polyols: apricots, plums, cherries, watermelon, avocado, mushrooms, cauliflower, artificial sweeteners.
Lactose: cows’ milk, yoghurt (2tbsp per day is usually tolerated), ricotta, cottage cheese (2tbsp per day is usually tolerated), cream cheese.
Ice cream, custard.
From the editors of Good Health Choices