Diet and IBS
Many sufferers try a form of general exclusion diet to try to work out their trigger foods, but it can be tough to see a pattern without expert guidance. Keeping a food diary and correlating it with your symptoms is a good idea, but remember that foods may take hours or even days to cause symptoms and be wary of cutting out so many foods that you leave yourself malnourished.
If you’re trying the exclusion approach it makes sense to start with the foods and drinks that upset a lot of IBS sufferers: coffee and anything caffeinated, alcohol, foods that cause gas like beans and legumes, carbonated drinks, very fatty and fried foods and anything with sweeteners like sorbitol.
Smartphone apps can be a big support when you’re tracking your symptoms. The Cara app tracks diet, stress and any drugs you are taking and tracks them against your symptoms before analyzing patterns and helping you identify triggers. You can send all data from the app to an email so you can share it easily with a dietician or doctor.
The Low Fodmap Diet App has been developed by Monash University in Australia and offers a comprehensive database of low fodmap foods, recipe ideas for meals and snacks and a list of certified low fodmap foods from big brands around the world.
If your IBS is linked to SIBO – small intestinal bacterial overgrowth – then your treatment will be designed to kill the excess bacteria. This is usually done with an antibiotic to start with, so a short course of Xifaxan may be suggested.
Advice on diet will also be given, with the goal of any diet being to provide as little food as possible to the bad bacteria in your gut. Drugs called prokinetics can be helpful as they move things along your gut faster than usual and stop the bad bugs hanging around in unwanted places.
Taking a probiotic can also help – indeed, all IBS sufferers may benefit from this, not just those with SIBO. Products containing Lactobacillus have shown a benefit in suppressing SIBO; try VSL#3 for starters as it contains multiple strains of good bacteria.
Lifestyle Changes for IBS
Talking about stress in relation to IBS can be a tricky subject because in the past many doctors treated IBS as a psychosomatic disorder that was found in anxious, nervous patients who needed to calm down and get a grip. This patronizing attitude led to the “It’s all in your head” mantra that you still sometimes hear to this day.
Nowadays most doctors know better, of course, but it’s still important that every last IBS patient knows that they are not causing their own problems by being feeble. If your doctor recommends reducing stress it is not because the stress has caused your IBS, it’s that stress reduction can be one piece of the puzzle that helps you get control of your body and soothe your bowel.
Choose something that works for you, whether that’s yoga, mindfulness, a long walk in the woods or a more structured form of therapy such as cognitive behavioral therapy. Avoid smoking and alcohol as they can over-stimulate the bowel. Use a hot water bottle or a modern electric heat pad to ease the pain.
Sensitive bowels can over-react to small changes so a regular schedule of sleeping and mealtimes can make a real difference. Diarrhea sufferers sometimes find smaller, more frequent meals ease their symptoms because they don’t set off the gastrocolic reflex that tells us we need the bathroom.
Finally, if you’ve tried a range of different treatments and you’re still suffering badly, make sure you see a specialist gastroenterologist – and if you still don’t get any help, see another one!
It can be tough to ask for a second opinion, but doctors are only human, they have their own blind spots and biases like we all do and don’t always make the right call. And if they’re offended by you seeking out another view to try to ease your suffering, they probably weren’t a great doctor in the first place.