Irritable Bowel Syndrome (IBS)

IBS is a medical term used to describe various gut symptoms after pathology has been ruled out using the appropriate diagnostic testing. It is a very common condition affecting around one in five adults.

It is important to have a diagnosis of IBS confirmed and other conditions such as coeliac disease and inflammatory bowel disease (IBD) ruled out. If you think you may be suffering with IBS, discuss with your GP to assess whether a referral to a specialist may be required.

An assessment for IBS should be considered if you have had any of the following symptoms for at least six months:

  • Change in bowel habits-Constipation (IBS-C) or Diarrhoea (IBS-D) or a mix of both (IBS-M)

  • Abdominal bloating, distension

  • Other features such as fatigue, nausea, and bladder symptoms are common in people with IBS and may be used to support the diagnosis

What changes can I make to help with IBS symptoms?

Food can have an impact on symptoms. Symptoms vary from one individual to another and can be worse for some than others. Here are some strategies that may help;

  • Eat three regular meals a day and try not to skip any meals or eat late at night

  • Smaller meals more often may ease symptoms

  • Avoid rushing meals or eating on the go where possible. Take time to chew food well and take some time after meals to relax which can help promote better digestion

  • Limit alcohol intake

  • Reduce caffeine intake

  • Reduce high fat/fried foods including chips, fast foods, ready meals, cream-based sauces, batter, cheese, pizza, snacks such as crisps, chocolate, cake and biscuits, fatty meats such as burgers and sausages

  • Limit fresh fruit to three portions per day

  • Avoid carbonated drinks and chewing gum

  • Limit artificial sweeteners

IBS and Stress-The Gut Brain Axis

There is a strong link between IBS and stress. The gut and brain communicate through the gut brain axis. Stress can influence gut function and may lead to changes in gut motility and sensitivity. Stress can increase the hormone cortisol which can impact digestion. Here are some strategies to incorporate into your daily routine to help manage stress

  • Take time to relax daily– mindfulness/meditation for even 10 minutes per day can have a positive impact

10 Minute Daily Meditation

https://open.spotify.com/track/7tnesh1ClZdJgJLP1H0ea3?si=BT33Pv3BT_OQa_Ggso7vBA

5 Minute Daily Yoga Routine

https://youtu.be/4C-gxOE0j7s?si=I6Jr_BIwQat9PLxg

  • Try to get out in nature and get as much day light where possible

  • Take regular exercise such as walking, cycling, swimming, strength training or whatever exercise it is you enjoy and will stick to. Cold dips are great if there is a safe place in your locality  

  • Take time to relax while eating meals and chew your food well

How A Dietitian can help to manage symptoms

  • A food and symptom diary analysis to identify any particular triggers or patterns and help identify a potential root cause

  • Identifying the indication for trial of the low FODMAP diet. This is a diet restricted in fermentable carbohydrates. It is not advised to be carried out without the support of a dietitian to assess first if it is necessary and to ensure that the diet is nutritionally adequate given it is very restrictive.

  • Support on dietary changes to promote a healthy gut microbiome to improve overall digestion in the long-term    

Summary

1. It is important to have a diagnosis of IBS confirmed and other conditions such as coeliac disease and inflammatory bowel disease ruled out

2. Try simple dietary changes first – you may find that major changes are not needed

3. Aim for regular, healthy, balanced meals

4. Limit alcohol, caffeine, and fizzy drinks

5. Take time to eat in a calm environment and chew food well  

6. Take time to relax and try daily techniques to manage stress

7. Seek specialist advice if you are struggling or dietary intake becomes limited