Irritable Bowel Syndrome is a functional gastrointestinal disorder of the gut brain interaction.
Symptoms can include the following:
- abdominal pain
- altered bowel habits
The criterion for diagnosis includes:
- Recurrent abdominal pain that lasts an average of 1 day a week in the last 3 months and associated with 2 or more of the following:
- Related to defecation
- Associated with change in frequency of stool
- Associated with change in appearance of stool
- The criterion must be fulfilled for the last 3 months with symptom onset of at least 6 months before official diagnosis.
- IBS-C: constipation predominant
- IBS-D: diarrhea predominant
- IBS-M: mixture of constipation and diarrhea
- IBS-U: unclassified symptoms that cannot be categorized into one of the other 3 subtypes
How to Manage Symptoms
For some reduction in:
- fatty foods
- carbonated drinks
- gas producing foods
- alcohol may aid symptoms
Eating soluble fibre and taking a probiotics may also be beneficial. Also, ensuring regular eating habits to regulate the bowels, along with eating small more frequent meals, and ensuring staying hydrated are all beneficial tips to try. It can be helpful to keep track of your food intake in the form of a food diary to identifying what foods contribute to symptoms. Situational triggers are also important to take note of. For example, if you notice before a big presentation or exam your symptoms tend to worsen this is something that is important to mention to your health care team.
Managing IBS is very individualized and complicated as each case is different. Nutritional guidance from our team of dietitian’s can help support you with your own individualized case!
What are FODMAPs? What do they have to do with IBS?
Often IBS is lumped with discussions of FODMAPs.
O: Oligosaccharides (e.g., artichokes, garlic, and onions)
D: Disaccharides (e.g., cow milk, ice cream, cottage cheese)
M: Monosaccharides (e.g., apples, honey, dried fruit)
P: Polyols (e.g., cherries, snow peas, cauliflower, sweeteners)FODMAPs are short-chain carbohydrates and sugar-alcohols that are poorly absorbed in the small intestine. Although they are not the cause of IBS they are fermented in the large intestine (as they are not absorbed well in the small intestine, they continue to move down our GI tract) and thus lead to production of gas, bloating, abdominal discomfort, diarrhea, and constipation.
Using the FODMAP diet is an effective approach to symptom management of IBS.
The diet consists of 3 phases:
1) Elimination of high FODMAP Foods
2) Reintroduction of high FODMAP Foods
3) Avoiding/decreasing intake of noted triggers when possible
The elimination takes about 6-8 weeks and then the reintroduction of food groups occurs slowly. If you are looking for some great low FODMAP recipes check out our low FODMAP Cookbook.
The FODMAP diet is quite restrictive and confusing, it is recommended to work with a dietitian with gut health experience. The Low FODMAP diet is not meant to be followed long-term diet as this can be quite restrictive if you eliminate all these foods.
Canadian Digestive Health Foundation. (n.d.). Irritable Bowel Syndrome. https://cdhf.ca/digestive-disorders/irritable-bowel-syndrome-ibs/statistics/
Ellis, E. (2019, August 29). Irritable Bowel Syndrome. Eat right: Academy of Nutrition and Dietetics. https://www.eatright.org/health/wellness/digestive-health/irritable-bowel-syndrome
Sunnybrook Health Sciences Centre. (2017). Clinical nutrition resource handbook. Sunnybrook Health Sciences Centre Registered Dietitians.