Irritable Bowel Syndrome (IBS) is a functional gastrointestinal condition. In other words, it is a group of symptoms that can’t be explained by anatomical conditions or disease (there isn’t a physical reason causing it that can be fixed / cured).
These symptoms are uncomfortable, for some painful and include wind, bloating, diarrhoea and constipation – sometimes a mix of all of these. There are different types of IBS: IBS-C (constipation predominant), IBS-D (diarrhoea predominant) or IBS-M (mixed). IBS is often diagnosed after ruling out gastrointestinal issues including Coeliac Disease and Inflammatory Bowel Disease (IBD) as well as Bowel Cancer and using certain criteria (Rome IV criteria).
While not a physical disease, IBS has the potential to dramatically impact quality of life.
Unfortunately, more than 50% of IBS sufferers report feeling like health care professionals do not take their condition seriously, even though effects can be severe and the condition is a leading cause of absenteeism from work and loss of productivity.
So what causes IBS?
Unfortunately, the simple answer to this is we don’t for sure.
We do know there is a link between our gut and our brain. Stress and anxiety can lead to exacerbated gut symptoms which in turn can increase stress levels – resulting in a vicious cycle.
IBS may be triggered by infection or environment – many sufferers report symptom onset came at a particularly stressful time or during a big change (for example, during family stress or changes to work load etc).
How do we treat IBS?
There is no one treatment for IBS. Being a functional condition, it can’t be cured as there is no disease to “fix” – but symptoms can be managed. First line symptom control methods include:
- Minimising stress where possible
- Relaxation techniques including practices such as yoga
- Determining triggers such as caffeine, alcohol, spicy foods or foods with high fat content
- Eating small, regular meals
- Eating slowly and chewing food properly
Following incorporation of these options, a low FODMAP diet may be encouraged. FODMAPs are a type of carbohydrate that are not digested by us humans and therefore reach our large intestine. Here they provide fuel for the good bacteria (so they are quite important for our gut health!)
FODMAPs are healthy foods to include in our diet in general
Unfortunately, while munching away on these carbohydrates, the bacteria can cause the above symptoms. This is normal but can occur excessively in some people. Long term harm is not caused, but it can be painful and embarrassing. This is where a low FODMAP diet can assist.
This is not a lifelong “diet” but the process provides relief for approximately 75% + of IBS sufferers. With the help of a dietitian, the first step is an elimination phase, where all high FODMAP foods are taken out of the diet. If improvement is seen, FODMAPs are then reintroduced in a controlled way. This allows participants to determine what FODMAPs are triggers and which are not and can therefore be included in a balanced diet to optimise gut and overall health while avoiding IBS symptoms.
The low FODMAP diet is not a cure, rather a way of controlling symptoms of IBS