Living with IBS: What can you do about it?

 By Joanna Foley,

If you're living with a constant state of undiagnosable GI distress you should consider learning more about IBS.

Dealing with negative digestive symptoms can take a big toll on your quality of life. If you have trouble with your gut, you’re probably eager to understand what may be causing your symptoms and what you can do about it. Keep reading to learn about what exactly IBS is so you can determine if it may be affecting you, and steps you can take to achieve relief.

What is IBS?

Irritable bowel syndrome (IBS) refers to a collection of digestive symptoms and is the most common functional gut disorder. It is estimated to affect about 10-15% of the population and is more common in women than in men. IBS differs from other gut disorders like chrons, ulcerative colitis, and celiac disease because there are no structural abnormalities involved with it. This means your digestive tract might appear normal, but there is something off with the way it works.

Doctors and researchers aren’t completely clear on what causes IBS, but people with sensitive guts and intestinal permeability are more likely to experience it. Intestinal permeability occurs when small gaps form along the lining of your gut wall, which allows for microorganisms to pass through and irritate your digestive system, and may affect other organs as well. In addition, research shows that having an imbalance in the good and bad bacteria in your gut, which makes up your microbiome, can lead to IBS development. This imbalance is known as dysbiosis, and it can cause low-grade inflammation in your gut and contribute to IBS symptoms, including:

• Abdominal pain
• Bloating
• Stomach cramping
• Diarrhea
• Constipation
• Changes in bowel frequency or consistency

The frequency and severity of IBS symptoms can vary. Various factors such as food, stress, and hormonal fluctuations, may trigger symptoms.

How is IBS diagnosed? 

There are no specific tests or procedures to diagnose IBS. Instead, it is often a diagnosis of exclusion, which means a diagnosis can be made only after ruling out other potential issues. Since there is a lot of overlap between IBS symptoms and other potentially more serious conditions, it’s important to work with a physician to get an accurate diagnosis and not self-diagnose. Your doctor may diagnose IBS if you experience symptoms at least once per week for the last 3 months and your symptoms first started at least 6 months ago.

There are different types of IBS, and it is typically classified based on usual stool consistency, as described below-

• IBS with diarrhea (IBS-D) involves loose stools >25% of the time and hard stools <25% of the time
• IBS with constipation (IBS-C) involves hard stools >25% of the time and loose stools <25% of the time
• Mixed IBS (IBS-M) involves a mixture of both hard and loose stools >25% of the time
• IBS unclassified (IBS-U) involves both hard and loose stools <25% of the time

How to treat IBS naturally

Unfortunately, there is no known cure for IBS. However, symptoms can be managed through diet and lifestyle changes, which can help heal the gut and reduce the likelihood of flare ups. In more severe cases, medication can be used in addition to these changes. Treating IBS is important to help prevent complications associated with IBS, which may include mood disorders, poor quality of life, hemorrhoids, and poor nutrition.

How to treat IBS varies from person to person, since each person has unique triggers for IBS. It is always a good idea to keep a food and symptom diary when making any diet and lifestyle changes to help identify and keep track of what works and what may be triggering to your unique symptoms and circumstances.

Diet and lifestyle tips for managing IBS symptoms include-

1. Minimize gas-producing foods and beverages. Examples include cruciferous vegetables (like broccoli, cauliflower, kale, and brussels sprouts), as well as beans and carbonated beverages. Chewing gum and drinking through a straw can also cause air to be swallowed and contribute to gas.
2. Reduce or avoid fried or other high-fat foods. Fat is a common trigger for symptoms of IBS. It is still important to include healthy fats like olive oil, avocados, nuts, and seeds, but you may need to reduce the quantity eaten and should stay away from less healthy fat sources.
3. Avoid or minimize dairy products high in lactose. It is common for people with IBS to also have lactose intolerance, which can create symptoms like gas, bloating, and bowel trouble. High lactose products include milk, ice cream, and soft cheeses like ricotta. Lower lactose dairy that may be better tolerated includes hard cheeses like parmesan, greek yogurt, and nondairy or lactose-free milk and yogurts. 
4. Try eating smaller, more frequent meals. Taking in too much food at once can cause IBS symptoms, so spreading out your food intake more gradually may help. Eating slowly and being sure to chew your food well is also recommended.
5. Avoid artificial sweeteners and sugar alcohols. Research shows that artificial sweeteners like aspartame and sucralose can alter the gut microbiome in a negative way, which may contribute to IBS. Similarly, sugar alcohols like xylitol and erythriol attract water into the intestines and are fermented by bacteria in your colon, which can trigger symptoms of IBS like diarrhea.
6. Minimize caffeine and alcohol. These can both irritate your gut.
7. Be mindful of the type of fiber you consume. Fiber creates bulk in your stool, but not all fiber is the same. Soluble fiber dissolves in water and is generally better tolerated by people with IBS. Food examples include oats, citrus fruits, apples, and beans. Insoluble fiber tends to be less tolerated in IBS, so foods that contain it such as wheat, nuts, and potatoes may need to be limited. However, what you tolerate may vary so it's best to experiment and try to notice patterns. Drinking enough fluids is essential when eating a fiber-rich diet to help keep your bowels moving and reduce constipation.
8. Experiment with supplements, such as probiotics, soluble fiber supplements, and peppermint oil. Probiotics are a type of live, beneficial bacteria that can help treat dysbiosis and improve symptoms of IBS. Probiotic supplements that contain multiple strains of bacteria are best, since different strains serve different purposes. The strains Bifidobacterium infantis have been specifically studied and found to have positive results in improving IBS symptoms. Peppermint supplements may also help soothe the gut, and soluble fiber supplements may help improve the frequency and consistency of bowel movements if you are not able to get enough fiber through food alone.
9. Physical activity. Exercise helps keep the digestive tract moving and may help relieve some symptoms of IBS including constipation, bloating, and gas. However, it is not recommended for diarrhea. Exercise can also help relieve stress and contribute to mental well-being. What type of exercise to do will vary depending on your type of IBS and symptoms you are having. In general, gentle and low impact exercises like stretching, walking, and swimming are best tolerated. Various type of stretches can specifically help relieve gas, and research has shown yoga to be an effective therapy for IBS sufferers.
10. Stress management. Psychological stress has been shown by research to be a major contributing factor to IBS. All forms of stress can change the way your body digests food and fluids, and can contribute to gut issues. Talking to trusted loved ones or a professional counselor, setting boundaries, and prioritizing doing things you enjoy are just some ways to help keep stress levels at bay.

Other tips for managing IBS 

Sometimes stubborn symptoms of IBS need additional support. If you find that the above tips are not sufficient, trying out an elimination diet can be helpful. The most widely studied elimination diet for IBS is called the low FODMAP diet, which you can read more about in this post.

It’s important to keep in mind that elimination diets like low FODMAP are only intended to be followed short-term and are not meant as a first line of defense since they can restrict many nutritious foods and may negatively affect the gut microbiome in the long run. Therefore, they should only be tried if symptoms are not able to be managed by other interventions.

In Summary 

IBS can be a tricky and frustrating condition to deal with. Thankfully, there are many things you can do to soothe your gut and manage your symptoms. For your best chance at finding relief, it is best to work with a qualified and trained healthcare practitioner to help determine what action steps you should focus on and for guidance along the way.