Despite being a condition affecting around one in five people in the UK, there’s still a lack of certainty around the actual cause of irritable bowel syndrome (IBS). Perhaps as a result of that, there isn’t yet a ‘cure’ for IBS, meaning sufferers are left having to manage their symptoms, rather than erase them completely.
Marilia Chamon is a gut health specialist at Gutfulness Nutrition. She explains that IBS is a “functional gastrointestinal disorder characterised by abdominal discomfort and alterations in bowel habits. These changes in bowel habits include diarrhoea, constipation or both.
“Most recently, IBS has been considered a disorder of the gut-brain axis, meaning there is a miscommunication between the gut and the brain, resulting in increased sensitivity of the gut.”
For many, IBS can flare up at different times. Stress can aggravate symptoms, and so can certain foods. As for diagnosis of IBS, Chamon says that it’s done by using a specific diagnostic criteria called the ‘Rome IV’.
“An IBS diagnosis should only be considered if you experience abdominal pain for at least one day per week for three consecutive months,” she says, “associated with two or more of the following: related to opening your bowels, associated with a change in stool frequency, or associated with a change in stool form.”
IBS diagnosis is also done by analysing symptoms and ruling out other possible conditions. “IBS shares similar symptoms with inflammatory bowel disease (IBD) and coeliac disease,” explains Chamon. “Therefore it is of extreme importance to rule those medical conditions out before getting an IBS diagnosis.”
With April marking IBS Awareness Month, these are some of the most effective strategies for reducing the condition’s impact.
Common IBS Symptoms
- Abdominal distention (bloating)
- Abdominal pain and cramping
- Alternating bowel habits (constipation and/or diarrhoea)
- Gas and trapped wind
How to ease IBS
1. Follow low-FODMAP
FODMAP stands for ‘fermentable oligosaccharides, disaccharides, monosaccharides and polyols’, (we’ll use the acronym from now on). Essentially, they are short-chain carbohydrates that don’t get absorbed in the small intestine.
“They pass through to the large intestine and are fermented by gut bacteria,” explains Chamon. “This fermentation process produces gas and happens in everyone. Because of altered communication between the gut and the brain, individuals that suffer with IBS have an abnormal response to the fermentation of FODMAPs.”
Foods falling under the FODMAP category include dairy foods, various fruits, cereals and vegetables (famously garlic and onion), and legumes. They can all result in IBS sufferers having to deal with gas, bloating and cramps.
“The low-FODMAP diet is usually the starting point for symptom management,” says Chamon, “as it decreases the amount of fermentable carbohydrates for a limited time. It involves three steps and should be done with the guidance of a FODMAP-trained nutritionist, otherwise it can become restrictive and difficult to implement.”
Followed correctly, a low-FODMAP diet can be an effective, science-based tool for the management of IBS. In fact, Chamon says that 75% of people with IBS experience symptom relief with such an approach.
2. Avoid trigger foods
Like FODMAPs, there are other foods that can exacerbate IBS symptoms, leading to cramping, bloating, diarrhoea and/or constipation. “Caffeine, fried and fatty foods, carbonated drinks, spicy food and alcohol are all gut irritants that can trigger digestive symptoms,” says Chamon.
If you suspect that any of these foods are causing symptoms, start a food diary. Begin by writing down everything you eat over a given time period, noting down how you feel after. With time, you should be able to identify the worst culprits.
3. Pop peppermint oil
Carminative (flatulence-relieving) herbs like peppermint are rich in ‘volatile oils’ that influence gut motility by increasing contractions, speeding up transit time and lowering the chances of gas to build-up. These herbs relax the smooth muscle in the GI tract, helping to expel gas and reduce symptoms of bloating.
“In randomised controlled trials, peppermint oil was superior to placebo in improving IBS symptoms,” says Chamon. One study, published in the Journal of Clinical Gastroenterology, found that peppermint oil is a ‘safe and effective short-term treatment for IBS’.
There isn’t research yet to suggest that peppermint tea can offer the same effects, but if you find that a mug does help with digestion, it’s not going to do your IBS arsenal any harm.
4. Stretch yourself
When symptoms of trapped wind, bloating and cramps are getting in the way of your day-to-day, yoga can help. “Yoga encourages deep breathing and promotes blood flow to internal organs,” explains Chamon, “restoring balance and helping activate the parasympathetic nervous system.”
And while IBS may primarily cause digestive upset, it can also lead to other issues like fatigue, anxiety and headaches. A study published in Evidence-Based Complementary and Alternative Medicine found that yoga’s calming qualities help alleviate these secondary symptoms.
Particularly relaxing poses include child’s pose and ‘pawanmuktasana’, which is a move renowned for helping to promote digestion and avoid constipation.
5. Hypnotise your gut
“Due to the miscommunication between the gut and the brain, mind-body techniques and alternative therapies can be highly successful in symptom management,” says Chamon. There’s even research to back up the effectiveness of gut-directed hypnotherapy.
Research out of Monash university in Australia even found this type of treatment was as effective as the low-FODMAP diet in helping to relieve bloating and abdominal pain.
6. Take probiotics
By 2028, the global probiotics market is predicted to be worth a whopping $90.57 billion. Probiotics are live microorganisms that, when ingested, are thought to have a positive effect on the gut microbiome (the collection of microorganisms in the gut).
“The effectiveness of probiotics in IBS has been extensively studied and specific strains can help minimise symptoms,” says Chamon.
7. Favour fibre
Fibre, the roughage of plant-based foods that the body can’t digest, can be a double-edged sword for anyone with a sensitive gut. Although it can help to reduce constipation and keep things moving, fibre can also lead to more bloating and gas – especially if the intake isn’t matched with a healthy fluid intake and exercise.
In the UK, we’re advised to eat at least 30g of fibre a day, but the type and quantity are key. “The wrong fibres can exacerbate symptoms,” explains Chamon. “Some of the most studied fibre supplements for IBS include psyllium, flaxseed, and partially hydrolysed guar gum (PHGG).”
These are available in powder forms, and can be easily added to smoothies or breakfast bowls. If you’re new to fibre, or are hoping to increase your intake, do so gradually to avoid any unwanted side effects.
8. Stop stressing
Stress can trigger IBS symptoms, so it follows that certain stress-reducing activities can help to ease cramping, bloating, wind and pain. Exercise can help to calm the mind, while helping to keep things moving in the gut. That said, overdoing it can be a huge stressor for the body, so it’s best to find a happy medium.
At night, turn off technology 30 minutes before bed to avoid the sleep-disrupting blue light, and aim for a solid seven to nine hours of shut-eye. Meditation and journaling can also help.
Look for probiotic supplements that include the following strains:
For abdominal pain relief:
- Bifidobacterium breve
- Bifidobacterium longum
- Lactobacillus acidophilus
To relieve bloating:
- Bifidobacterium breve
- Bifidobacterium infantis
- Lactobacillus casein
- Lactobacillus plantarum
For a mood boost:
- Bifidobacterium longum
Words: Lucy Gornall