How to Manage Irritable Bowel Syndrome - Food for Thought - Harvard Commentaries

Irritable Bowel Syndrome (IBS) is a gastrointestinal syndrome that causes abdominal pain, gas and bloating. It affects 10% to 15% of people in North America. This makes it the most commonly diagnosed gastrointestinal condition.

However, most people with IBS do not seek medical help. They choose to manage the disorder on their own. The good news is the symptoms of IBS can be controlled through diet.

Bloating
Abdominal pain
Abdominal discomfort

These have no known cause. But some people with IBS have constipation; others have diarrhea. Some alternate between the two. For some people, the symptoms subside for a few months and then return from time to time. Other people have constant gastrointestinal irritation.

Irritable bowel syndrome is often confused with inflammatory bowel disease (IBD). Although these two conditions have similar symptoms, they are different.

IBD is a lifelong disease. People with IBD have either Crohn's disease or ulcerative colitis. These diseases cause permanent damage to the intestinal wall. Sometimes surgery is necessary.

On the other hand, IBS is an irritation of the gastrointestinal tract. It doesn't cause any injury to the lining of the intestinal wall. IBS is thought to be triggered by stress. Treatments often include stress management and nutritional management.

IBS has no cure. The best way to manage it is to avoid environmental and dietary triggers. Try the following:

Keep a food diary to become more aware of food triggers and patterns in your symptoms.

Decrease stress with relaxation techniques, exercise or hobbies.

Try to eat at the same time every day. Chew your food slowly.

Avoid drinking through straws, drinking carbonated beverages or chewing gum. These produce more gas and can increase discomfort.

Eat small, frequent meals throughout the day instead of three large meals. This helps to ease digestion.

Milk and milk products – ice cream, sour cream, cream cheese, cream soups, butter, cheese, dairy desserts (such as pudding)

High fat foods – fast foods, processed foods and fried foods, such as French fries and fried chicken

Gas-forming vegetables – cabbage, broccoli, cauliflower, green peppers, corn, brussels sprouts or excessive amounts of raw vegetables

Alcohol and caffeine

Legumes, such as beans and lentils

Spices and seasonings, especially those that are pepper based or spicy.

Elimination diets are the best way to identify trigger foods and manage your symptoms. You remove all common trigger foods from your diet then slowly add them back in, week by week. If the food added back in causes symptoms, it can be considered a trigger food. If it does not cause any symptoms, keep it in your diet.

It helps to keep a food and symptom diary during the elimination diet. You can track which foods cause irritation. It's also important to realize that your IBS symptoms could return when you're under stress, regardless of what you eat.

Recent research suggests there is a connection between stress levels and bowel activity. Your body reacts to all types of stress in the same way. It doesn't know the difference between emotional stress, such as anxiety or physical stress, such as a recent surgery. Nerves connect the bowel to the brain. The bowel is partly controlled by the stress responder in the brain. The bowel responds more severely to the slightest stress in people with IBS. That's why stress management is equally as important as diet in managing IBS.

Regular exercise, such as walking, jogging and stretching (yoga and Pilates)

Getting enough sleep

Relaxation therapies, such as meditation and mindful breathing techniques

Counseling or peer support

Reducing or eliminating stressors

Although IBS can be frustrating, simple changes to your lifestyle and diet can relieve symptoms and lead you to a happy and comfortable life.

Angie Palomaki is a recent graduate of the Brigham and Women's Dietetic Internship. She completed her B.S. in Nutrition Management from Rochester Institute of Technology.