Around 15% of the Irish population suffer from IBS and bloating is one of the most common symptoms. Read on to learn more about how to help resolve your IBS symptoms and beat the bloat for good or watch Heather sharing her tips on TV3.
What is IBS?
It’s a diagnosis of exclusion i.e. if you have these symptoms, more serious conditions like inflammatory bowel disease and bowel cancer should be ruled out first.
The causes of IBS are varied and it’s a hot research topic. Many types of IBS are thought to be related to the wrong balance of bacteria (dysbiosis) or bacteria in the wrong place in the gut (SIBO).
How do I know if I have IBS or something else?
If you have gut issues, your GP will probably want to start with blood tests or even a scope or scan to rule out a more serious issue. In most cases, these tests will be clear, which is good news. However, it can be very frustrating to be told that there is nothing serious wrong and you only have IBS.
Two other types of tests can help to identify the underlying cause of gastrointestinal symptoms
- The most common cause of IBS is now thought to be Small Intestinal Bacterial Overgrowth (SIBO), where bacteria normally found in the large intestine are found in the small intestine. This has been found in more than 50% of people with IBS symptoms. It is especially prevalent in those who suffer from bloating and reactions to a range of foods. SIBO can be identified by a simple breath test and a plan put in place to resolve the bacterial overgrowth
- Stool tests like the GI Map can also be very useful to identify if bacterial balance in the large intestine is an issue or other ‘visitors’ like parasites are present.
In many cases, the focus in IBS has been on dealing with symptoms. However, it’s important to identify the underlying cause of your IBS if it is causing you longer term issues and impacting your work or social life, so that it can be dealt with for good.
What can you do when symptoms strike?
There are a small number of natural remedies that can ease symptoms in the short term.
- Try sipping peppermint, fennel or ginger tea
- Peppermint capsules can be helpful for cramping as they have anti spasmodic effects
- Massaging the abdomen in a clockwise movement can help to relieve bloating and wind
Common triggers to avoid
If you have IBS symptoms and want to try to help things yourself, it can be useful to identify anything that might be triggering a symptom for you and these can also give clues as to the underlying cause of your IBS.
Common triggers include
- Eating large portions. If you don’t feel great after a large meal, then try eating smaller meals more frequently instead
- Eating very quickly, common in people who are stressed or in a busy environment. Digestion starts in the mouth and if your gut must process large chunks of food, it can cause problems. A meal should ideally take 20 minutes, or at least 10 and it’s important to chew properly
- This can lead to constipation, which can in turn cause wind and bloating. If you are not having a daily bowel movement or your stools look like sheep’s droppings, then you should increase your water intake. This is very common in children, especially in warmer weather, where they forget to drink enough
- Certain foods and drinks, known to irritate the gut in sensitive people. These include caffeine and alcohol. Fizzy drinks and chewing gum can also cause problems as they introduce additional air into the gut.
- Fibre intake. Our guts need plenty of fibre to feed beneficial bacteria and support digestion, but some forms like All Bran can be hard on the gut. Beans, cabbage and pulses contain a kind of carbohydrate called oligosaccharides that is poorly absorbed by us but is fermented by our gut bacteria. Many of us can tolerate these, but in people with an overgrown of bacteria in the small intestine (SIBO), these foods and others like bread, dairy products, garlic and onions can cause reactions.
- We know that there is a direct link between stress and IBS symptoms and symptoms can really flare up during stressful periods. Taking steps to manage stress on an ongoing basis can be helpful, like gentle exercise, mindfulness and getting enough sleep
What about food intolerances?
Food reactions / intolerances are a controversial topic. However, there is no doubt that some people do react to different foods. In many cases, they may have an underlying issue. This issue is exacerbated if they eat or overeat a certain type of food. For example, if you have SIBO, you may react to bread, dairy products and other seemingly random foods. In other cases, people may lack the enzymes they need to digest the food e.g. lactose intolerance
Food intolerances can be measured via blood. However, this is very controversial, and we don’t usually recommend it as it does not help to identify the underlying cause.
How to manage longer term
If you are prone to IBS symptoms, put some steps in place to avoid flare ups.
- Keep a food diary for a week or two, to try to identify any patterns that emerge. If you can pinpoint types of foods or activities that are linked to symptoms, then avoid for a few weeks to see if this makes a difference
- If wind, bloating and constipation are your main symptoms, try taking a probiotic supplement for 4 weeks. Look for one with at least a couple of different strains of bacteria including Lactobacillus and Bifidobacterium. Fermented foods like yoghurt, kefir and sauerkraut can also help to maintain bacterial balance longer term
- If you feel very full or bloated straight after eating, you may benefit from a digestive enzyme. As we get older, we produce less of these and some people feel a huge benefit from taking these at the start of meals, especially larger meals
- Some IBS patients benefit from following a Low FODMAP diet. This removes the fermentable carbohydrates (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) that feed bacteria and can trigger symptoms. However, it is restrictive (no wheat, dairy, pulses, sugar, restricted fruit and veg including onions and garlic) . These foods are needed longer term to feed beneficial bacteria essential for gut health, so it should only be followed for a month or two
Sample low Fodmap menu plan
|Breakfast||Gluten free toast with poached egg and spinach|
|Lunch||Greek salad with lettuce, tomato, cucumber, olives, chives and feta|
|Snack||Mandarin and palmful pecan nuts|
|Dinner||Baked salmon with steamed carrots and green beans, basmati rice|
Diet and lifestyle changes can be very helpful for people with IBS, although different things work for different people. It’s important to try to identify what is causing your symptoms and then deal with that.
Avoid following any restricted diet for more than a couple of months without getting professional advice. It is important to make sure you are eating a balanced diet and to help identify the cause of your gut issues.
To find out more about breath and stool tests, contact us on 01 4020777 or email firstname.lastname@example.org
Heather Leeson, Senior Nutritionist with Glenville Nutrition Ireland