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Dr Rebecca Luong

Apart from the low FODMAP diet are there any other effective treatments for IBS?


Irritable Bowel Syndrome (IBS) is defined as recurrent abdominal pain or discomfort which can be relieved by defecation, is associated with changes in stool frequency and/or stool consistency. Symptoms involve abdominal pain, discomfort, bloating, distension, cramping, constipation, diarrhoea and/or flatulence. IBS can affect an individuals’ quality of life such as affecting social engagements, increasing work absenteeism and reducing work productivity.

The cause of IBS is still unknown but it is proposed to be from disturbances to intestinal nerves which affects gut motility (bowel motions) and perceptions of the gut stretching.

What leads to the development of IBS?

  1. Genetic effects (family history and females tend to be twice as prone to IBS)

  2. Physical stress and infections, such as gastroenteritis

  3. Psychological factors (e.g. anxiety, depression, stress). Psychological factors have also been associated with exacerbating IBS symptoms.

  4. Perceptions of foods that cause symptoms and food intolerance

Types of IBS:

  1. IBS-C= constipation-predominant symptoms

  2. IBS- D= urgent diarrhoea-predominant symptoms

  3. IBS-A/IBS-M= alternating diarrhoea and constipation

Lines of treatment:

Primary

1. Lifestyle:

  • Diet- General healthy eating of regular meals, eating meals for 20 minutes, adequate fluid intake of 8 cups, limit alcohol to guidelines, limit caffeine to guidelines, limit processed foods, limit fruit to maximum 3 daily, limit fizzy drinks

  • Regular exercise

  • Create relaxation time

2. Symptom-targeted medications to reduce pain, diarrhoea and constipation if severe

Secondary

3. Diet modification- Low FODMAP diet (75% of IBS patients experience an improvement in symptoms), less gas-producing foods such sugar-free items (contains xylitol, mannitol, sorbitol) to also relieve diarrhoea and less resistant starch (legumes, under ripe banana, cooled cooked potatoes, 'hi maize' in certain breads and cereals), increase soluble fibre to relieve constipation/bloating/flatulence (psyllium husk, oats, 2tbs linseed daily), limit high insoluble fibre foods (bran), low fat meals (<6.7g fat over 2 hours to prevent increasing IBS symptoms) and limit spicy foods

4. Probiotic supplement

5. Anti-depressant medication

6. Counselling for psychological factors

Note: The National Institute for Health and Care Excellence state complementary alternative medicines "should not be encouraged for the treatment of IBS".

Do not do this on your own! See a dietitian to ensure you correctly trialled those dietary modifications to know whether it works for you, saves you time from re-trialling, provides additional support and guidance whilst maintaining nutritional adequacy!

Book an appointment for a comprehensive nutrition assessment with individualised strategies that work for you to relieve your symptoms today! Personalised gut-healthy eating for a happier life :)

 

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