Dietitians Dish: Manage irritable bowel syndrome through nutrition
By Katherine Klingle
Ever get that swollen, painful feeling in your abdomen? It's hard to put your finger on what it is exactly, or what causes it, but it can make your life miserable. It may be Irritable Bowel Syndrome, or IBS. The National Digestive Diseases Information Clearinghouse classifies IBS as a syndrome vs. disease because it is a functional disorder, not an abnormal anatomy. The cause is not clear. Theories of its cause include immunity dysfunction, serotonin abnormality, hormonal abnormalities and simply ultra sensitive nerves and muscles in the bowel. An estimated one in five people have IBS, but up to 70 percent of those who do have it, do not receive medical help. Some people may experience constipation, and others have diarrhea, and some have episodes of both. Medical tests may help identify IBS and rule out other problems that may have similar symptoms. Strategies to control IBS symptoms may include medication, adequate rest and stress management. Your physician and pharmacist can advise you on the best medication to treat IBS if chosen. Your nutrition choices may also play a role in controlling symptoms.
Some aggravators of IBS may include caffeine, chocolate, milk (if you are lactose intolerant), alcohol, carbonated beverages, overeating and possibly gluten in a small number of people. In cases of IBS with constipation, adding dietary fiber may help. However, fiber intake should be individualized and some people may experience more discomfort and intolerance. Adequate fluid intake and exercise is always beneficial. In cases of IBS with diarrhea, limiting greasy foods, adjusting fiber intake and recording your response to caffeine, chocolate, carbonated beverages, lactose and gluten may be beneficial. Prune and other fruit juices can act as a cathartic in some people, so monitor your own response to these beverages. Sorbitol, an artificial sweetener found in some sugar-free products, such as gums, candies and cookies, may not be tolerated and may cause similar symptoms. Since there is no cookie cutter dietary recommendation for all sufferers of IBS, one of the best tools that dietitians recommend is a food diary. Keeping track of what you eat, symptoms you have and when they occur can help identify which foods trigger your discomfort. Simple behavior changes can help also. If you chew gum, sip through a straw or eat quickly, you may experience bloating that can add to your discomfort. Some gas forming vegetables, such as cabbage, broccoli, cauliflower, corn, Brussels sprouts, beans, leeks and onions, should be assessed for personal tolerance. Excessive dietary restrictions may be unnecessary and lead to dietary deficiencies, so it is important to keep the food diary to pinpoint what foods are triggers.
The sooner you identify if and which foods cause problems, the happier your tummy will be.
A simple, but helpful website for more information is www.digestive.niddk.nih.gov.
Katherine Klingle is a registered and licensed dietitian. Send questions or comments to firstname.lastname@example.org.