Tired of dreading each meal out of fear you’ll need to run to the bathroom shortly after? For those with irritable bowel syndrome (IBS), symptoms (diarrhea, constipation, bloating, cramps and gas) tend to get worse following a meal.
“Diet has a major impact on IBS symptoms,” says Leslie Shaw, RD, of the Cleveland Clinic’s Digestive Disease Institute. People with this disorder often find relief by changing how they eat and what they eat.
Write It Down
“Food triggers vary from person to person,” Shaw says. “It takes some time and effort to learn what foods are considered ‘safe’ for you and which ones provoke symptoms,” she says.
Drink some peppermint tea. Peppermint acts as a muscle relaxant and painkiller, according to Grace Keenan, MD, medical director of Nova Medical Group in northern Virginia. Allergic to peppermint or have acid reflux (which peppermint can exacerbate)? Try fennel tea, which reduces bloating and gassiness.
Start by keeping a food diary. Put a notebook in the kitchen and another one in your purse or pocket, and write down everything that you eat every day for one month. Include portion sizes and how your belly feels for the remainder of the day. Write down any symptoms. This information can help you and your registered dietitian or doctor come up with an eating plan that works.
Pull the Triggers from Your Diet
Even though people with irritable bowel syndrome react to different foods with different symptoms, there are a few common dietary denominators. As you keep your food diary, take particular note of how you react to the following:
- Dairy foods: Intolerance to lactose, the sugar in milk, has been found in up to 40 percent of people with IBS. Fortified orange juice or soy milk can help ensure you get adequate calcium and vitamin D, or you can take supplements to get these bone-building nutrients.
- Fatty foods: Foods that contain high amounts of fat can bring on strong contractions in the colon. Typical culprits: red meats, dairy products, butter, eggs, pastries and doughnuts, oils and fried foods.
- Gas-producing foods: If flatulence is one of your symptoms, try limiting beans, onions, broccoli and cabbage. Other items to reduce in your diet: carbonated drinks, including soda, which can cause abdominal pain. Additionally, swallowing too much air with your meals may add to your discomfort, so eat slowly.
- Caffeine: Cut back on or eliminate foods and beverages with caffeine, including coffee, tea, chocolate, soft drinks and energy drinks. Caffeine can cause IBS symptoms to flare.
- Fructose: Avoid products with high-fructose corn syrup (read labels to ascertain its presence — it’s frequently found in processed foods) and sugar alcohols (sorbitol, mannitol), found in “diet” foods. Both can aggravate IBS.
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Fill Up on Fiber
While you’re cutting back on fat and other triggers, it’s a good idea to fill up on fiber. Fiber helps prevent both constipation, by increasing the speed of bowel movements to make them more regular, and diarrhea, by absorbing excess water in the colon. Simply eating more whole grains, fruits and vegetables will boost your fiber intake. “Aim for 25 to 35 grams of fiber per day, but add fiber to your diet slowly,” Shaw says. “If you add too much fiber at one time, you could increase your GI distress.”
Keep in mind that the kind of fiber is as important as the amount. Large amounts of insoluble fiber (found, for instance, in whole wheat and wheat bran) may worsen IBS symptoms, particularly constipation, because it holds on to water and adds bulk; it also worsens diarrhea. Focus instead on increasing the amount of soluble fiber (found in oats, barley and potatoes) you eat to 10 to 20 grams per day. If you need help getting enough, try soluble fiber supplements such as Metamucil or Benefiber, which you can mix into water and drink, or even add to your morning yogurt.
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While researchers try to better understand IBS and how to treat its symptoms, practitioners are working with several possible approaches. These are some management methods you might consider discussing with your health care provider:
- Get enough fluids. Aim for six to eight glasses of water per day to keep your digestive system on track. Water and other fluids help regulate your bowel movements: If you’re constipated, drinking water softens stools; if you have diarrhea, it works with fiber to bulk up your stools.
- Eat mini-meals. Avoid skipping meals or overeating. You may feel better and digest with more ease if you eat six mini-meals (smaller portions) throughout the day instead of three large meals.
- Engage with enzymes. People with IBS may be in short supply of digestive enzymes, which are specialized proteins that break down food or make it available for your body to use. If your doctor tests your stool and finds that you’re lacking in digestive enzymes, then you may benefit from taking supplements to make up for the shortage.
Go with the pro. Some studies have shown that certain probiotics — dietary supplements of beneficial bacteria — bring significant improvement to IBS patients by reducing diarrhea or constipation. Look for probiotics in many yogurts and in specific supplements. For IBS, three strains appear to be particularly helpful: Lactobacillus GG, Bifidobacterium and Bacillus coagulans.
— by Julie Evans