Eating with Irritable Bowel SyndromeSymptoms, Treatment, and Tips
-- By Becky Hand, Licensed & Registered Dietitian
Imagine experiencing severe abdominal pain, along with alternating bouts of both constipation and diarrhea. Even worse, your doctor can find no physical explanation or effective treatment for you, despite these very real symptoms. Unfortunately, this is a very real scenario for people with Irritable Bowel Syndrome (IBS).
Symptoms & Diagnosis
Common symptoms of IBS include abdominal pain, feeling bloated, flatulence or gas, diarrhea and/or constipation, and mucus in the stool.
When you have IBS, diagnostic tests typically reveal no physical abnormalities in the colon that might explain your symptoms. So, IBS is usually diagnosed by a process of elimination. A diagnosis is made after symptoms have been continuous or recurrent for at least 3 months and other diseases (such as Crohn’s disease and ulcerative colitis) have been ruled out.
When managing IBS, experts have seen much greater treatment success when the "team approach", which includes a physician, dietitian, and psychiatrist/psychologist, is implemented.
Because food, eating, and cooking habits can be very complex, SparkPeople strongly suggests that you see a qualified dietitian for both nutrition and diet therapy. Making different food choices and changing eating habits can help with symptom relief, but it's important to determine what works for each individual.
Therefore, keeping a diary is vital. Use it to record when symptoms occur, what you ate around the time of the occurrence, as well as activities and emotional feelings. This diary will help everyone—you, the dietitian, and other health professionals together—to both identify specific concerns and also to develop an appropriate plan. <pagebreak>
General Eating Tips
- Consume meals and snacks on a regular, consistent schedule. Avoid skipping meals. Try 5-6 smaller meals daily. The stomach is more sensitive when it is empty.
- Chew thoroughly and eat at a leisurely pace. If you must eat in a hurry, serve yourself half portions.
- Avoid swallowing excess air because this may trigger symptoms. Sip—don't gulp—your beverages, don't drink through a straw, don't talk while chewing, and eat with your mouth closed.
- Drink 8 cups of water daily.
- Ask your physician if she recommends taking Metamucil or Citrucel daily. Do NOT use the sugar free varieties, which may contain ingredients (artificial sweeteners, sugar alcohols, etc.) that aggravate IBS symptoms.
- Carry Fibercon capsules when you have to unexpectedly wait too long between meals or wait at a restaurant.
- Peppermint may help to relieve spasms. Try Altoids, hot mint tea, or peppermint oil capsules.
- Slowly increase fiber in your diet to 25-35 grams per day. Include a variety of grains such as wheat, rye, barley, oat, farro, kamut, couscous, soy, and quinoa. To learn more, read Figuring Out the Facts on Fiber.
- Always eat soluble fiber first, whenever your stomach is empty. Make soluble fiber foods the largest component of every meal and snack. Foods rich in soluble fiber include: oatmeal, pasta, rice, potatoes, French bread, sourdough bread, soy products, barley, and oat bran. Nuts, beans, and lentils are also a good source of soluble fiber. However, nuts also include fat and lentils also contain some insoluble fiber.
- Never eat insoluble fiber on an empty stomach, in large quantities at one sitting, or without soluble fiber. Foods rich in insoluble fiber include: wheat bran, whole grain products, and whole wheat products.
- Limit fat intake to 25% of your total daily calories. Never eat high-fat foods on an empty stomach or without soluble fiber.
Possible Trigger Foods
The following foods are sometimes bothersome to those with IBS. It is a good idea to monitor your tolerance for these foods (not to eliminate all of the foods listed). You may want to pick one food below that you eat frequently, remove it from your menu for 2 weeks and see if there is a difference in symptoms. Then reintroduce the food and see what happens. You should experiment with only one food at a time and in small portion sizes.
- Legumes, lentils and beans, such as kidney, lima, navy, pinto, black, chickpeas, mung, and garbanzo.
- Caffeine found in coffee, tea, carbonated beverages
- Herbs such as guarana, mate, and kola nut
- Carbonated beverages
- Broccoli, cauliflower, cabbage, Brussels sprouts, kohlrabi, and other gas-producing vegetables in the cabbage family
- Other gas producing foods such as beets, corn, cucumbers, leeks, and onions
- Sugar alcohols such as sorbitol, mannitol, xylitol, which are found in sugar-free gums, candies, mints, and jams, as well as some liquid medications
- High-fat or fried foods, such as fried meat, fried potatoes, fried vegetables, doughnuts, pastries, cream sauces, and oily sauces
- Lactose, found in dairy products. Read more about Lactose Intolerance and a Healthy Diet.
- Cereals such as bran, wheat, oat, and cornmeal
- Try to find a treatment option that includes the team approach of a physician, dietitian and psychiatrist/psychologist.
- Try to get 30-60 minutes of moderate exercise each day.
- Introduce a daily practice of yoga, meditation, or Tai Chi to significantly reduce stress-related attacks.
- Make sleep a priority. Sleep loss decreases you ability to handle stress and can make you more susceptible to attacks.
- Do not smoke.
- Make sure dentures fit properly.