People say “Trust your gut”, but this may be difficult if your gut isn’t functioning as it should! Keep reading to learn about what IBS is, and what strategies can be used to help manage it, so you can feel better from the inside out.
What is IBS?
IBS is a common functional gut disorder that is associated with the gut-brain connection (affecting 1 in 7 people in Australia) that is characterised by experiencing regular symptoms such as a change in bowel habits (constipation, diarrhea, or a mix of both), abdominal pain/cramping, excessive gas/wind, and bloating.
How is this condition diagnosed?
IBS is diagnosed using the Rome IV Criteria and needs to be completed by your doctor.
Rome IV Criteria:
Recurrent abdominal pain at least 1 day per week associated with 2 or more of the following:
Related to defecation
Onset associated with a change in stool frequency
Onset associated with change in the form of stool
Your doctor will also need to rule out other conditions that may present with symptoms similar to that of IBS including Inflammatory Bowel Disease (IBD) and Coeliac Disease. This leads to a correct diagnosis of IBS, and therefore symptoms can be managed appropriately.
What Causes IBS?
There is currently no known cause for IBS, however, there are certain factors that are thought to be associated with the onset of IBS symptoms:
People with IBS have a more sensitive gut, known as visceral hypersensitivity. This means that they have highly sensitive nerve endings within the large intestine, resulting in an increased perception of pain and discomfort during digestion.
Infectious gastroenteritis may lead to damage to nerve endings within the gut, which can result in an IBS diagnosis, known as Post Infectious IBS (PI-IBS).
Long-term or multiple courses of antibiotics can impact gut health by altering the diversity and composition of the gut microbiome. This imbalance in ‘good’ and ‘bad’ gut bacteria is called dysbiosis, and may also be a factor impacting IBS symptoms.
Although IBS symptoms can be extremely uncomfortable, it’s important to know that experiencing symptoms due to IBS, is not causing damage to the physiology or structure of the gut (as there is when someone with Coeliac Disease consumes gluten). The main goal of IBS management is to improve symptoms to optimise gut comfortability and reduce the stress associated with symptoms getting in the way of day-to-day life, whilst liberalising the diet.
The Low FODMAP Diet
First of all, what are FODMAPs?
FODMAPs stands for Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols. It’s a mouthful, I know. Although, they are simply carbohydrates that either draw water into the gut or ferment in the gut, producing gas as a result. This may cause the gut to stretch and can lead to excessive flatulence, bloating, abdominal pain discomfort, and changes in bowel habits.
The low FODMAP diet is a 3 phase process that aims to help people with IBS identify certain FODMAPs that are triggering their gastrointestinal symptoms. It is the only effective diet to manage IBS, with 75% of people experiencing improved symptoms.
It involves temporarily eliminating FODMAPs from the diet and monitoring symptom improvement, followed by strategically re-introducing each FODMAP group in order to determine personal tolerance to specific portions. This information is then used to create practical dietary strategies for long-term symptom management and nutritional adequacy.
There are a few important things to note about the low FODMAP diet:
Firstly, The low FODMAP diet is quite complex and should always be carried out with the support and guidance of a qualified dietitian.
The low FODMAP diet is not a ‘no FODMAP’ diet. It’s important to understand that if you have been advised by your dietitian to start a low FODMAP diet, that this will be temporary, and that staying on this restrictive diet long term can do more harm than good for your gut health.
Lastly, some people with IBS find that their symptoms are not triggered by FODMAPs, as their symptoms don’t improve on the low FODMAP diet. There are non-FODMAP-containing foods that can trigger IBS symptoms, including fatty and spicy foods, caffeine, alcohol, carbonated drinks, and consuming large meals.
Non-dietary management
As IBS is a disorder of the gut-brain connection, stress management may also help reduce and manage IBS symptoms. Some non-dietary management strategies that may be worth considering are gentle regular exercise (such as yoga, walking and leisurely swimming), meditation, gut-directed hypnotherapy, and cognitive behavioural therapy. As your gut has the ability to sense and respond to your emotions, don’t underestimate the power of self-care and prioritising rest and relaxation as part of managing your gut symptoms.
In summary, IBS is a functional gut disorder of the gut-brain connection and can be managed effectively with the low FODMAP diet with the guidance of a dietitian. However, it’s very important that if you suspect you are experiencing IBS symptoms, that you first consult your doctor and receive a correct IBS diagnosis to help you and your dietitian determine the best way to manage your symptoms. As uncomfortable and overwhelming as your symptoms may be, there is always support you can receive to improve your gut symptoms. If this is you, reach out and get the help you need, so you can start to feel as though you can trust your gut once again!
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