It seems everywhere you go, someone new is trying out a gluten free diet, and complaining of feeling bloated, uncomfortable, or suffering from diarrhoea or constipation. Does this mean they have IBS? But wait. What is IBS, and how do we manage it?
What is IBS?
Approximately 20% of Australians suffer from irritable bowel syndrome, commonly known as IBS. IBS is a chronic condition, meaning long term management is required. Symptoms include stomach cramping, abdominal pain, bloating, wind, constipation and diarrhea. It is also common for there to be periods in your life where symptoms are worse, or are better.
How do we manage it?
IBS, for most people is triggered by consumption of high FODMAP foods, whilst stress, anxiety, lack of sleep and physical activity all play a role as well. What is a FODMAP I hear you ask? FODMAPs stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. They are different types of carbohydrates that may not be digested or absorbed properly, which can then result in fermentation in the gut. Common high FODMAP foods include avocado, onion, garlic, kidney beans, bread, pasta, milk, apples, pears and mushroom (along with a whole lot of other things!). Management of IBS through elimination of high FODMAP foods, then reintroduction is the best way of determining triggers, and then managing symptoms, without unnecessarily restricting your diet.
Why not just stay low FODMAP? Most people do not react to all the high FODMAP groups of foods. Identifying these means that we can include the groups of foods that weren’t a problem, then determine tolerance levels of those that were. This is recommended because:
• Most people with IBS can maintain suitable symptom control with reintroduction of some high FODMAP foods. This makes it easier to make informed choices when not in control of food choices, and better management of symptoms on a daily basis.
• Avoiding unnecessary restrictions helps to ensure a nutritionally adequate diet.
• Many high FODMAP foods are also high in prebiotics. These fibres provide food for the healthy bacteria that are found in your gut. Research indicates that long-term avoidance of these may affect the health of your gut microbiome.
What if FODMAPs doesn’t help you?
Three out of four people with IBS following a low FODMAP diet report a marked improvement in their symptoms, however that still leaves some individuals wondering ‘what is going on?’. Other things can trigger symptoms of IBS. These include fatty foods, spicy foods and caffeine.
As previously mentioned, stress and anxiety also play a key role in symptom management; managing these helps with reducing symptoms, regardless of if FODMAPs helps management for you or not.
Chloe McLeod is an Accredited Practicing Dietitian and Sports Dietitian passionate about motivating Australians to create positive relationships with food and educating them on making holistic health changes so they live the best lives they can. Chloe specializes in sports nutrition and food intolerance management, and runs the online program ‘The FODMAP Challenge’.