IBS For Dummies Cheat Sheet
Irritable bowel syndrome (IBS) is a condition that affects between 6 percent and 15 percent of the population, but diagnosis and treatment are often misunderstood. This Cheat Sheet gives you the lowdown on what IBS is, how it’s diagnosed and treated, and dietary tips to manage your IBS.
How is IBS diagnosed?
Irritable bowel syndrome, or IBS (not to be confused with inflammatory bowel disease, or IBD), is a disorder of gut-brain interaction (DGBI) that involves a disruption in the normal two-way communication between the gut and the brain. IBS shows up as a cluster of digestive symptoms, with different underlying factors contributing to these symptoms but no physical damage present in the digestive tract. IBS is not a serious or life-threatening condition, but it can have a big effect on your quality of life.
Diagnosis by a medical professional is an essential first step in taking control of IBS. No single test can positively confirm you have IBS, so diagnosis involves two phases:
- Confirming symptoms that fit the IBS pattern: The defining features of IBS are:
- Abdominal pain that’s related to bowel movements.
- Abnormal bowel movements, either more or less often than normal for you, or with a different appearance than usual. The bowel movements may be loose and watery (a condition known as IBS-D, for diarrhea) or hard and lumpy (known as IBS-C, for constipation).
- Ruling out other conditions that may account for the symptoms: Depending on your personal situation, your doctor may order a series of tests to rule out various other conditions, including celiac disease, colorectal cancer, endometriosis, IBD, small intestinal bacterial overgrowth, and thyroid disorders.
Comprehensive IBS management
No single intervention will fix irritable bowel syndrome (IBS). The state-of-the-art approach to IBS treatment involves adjusting your diet and several other aspects of your lifestyle to restore proper gut-brain communication.
Mind-body interventions are often a missing piece of the treatment puzzle for people with IBS. These interventions successfully reorganize brain connections to normalize the body’s function. They work by restoring the balance between your body’s sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) nervous system functions and normalizing pain processing in the brain. Effective mind-body interventions for IBS include
- Cognitive behavioral therapy (CBT), which involves unlearning the negative thoughts and behaviors around your gut symptoms and stress
- Breathing exercises
- Meditation
- Mindfulness-based stress reduction
- Yoga
- Clinical hypnosis or gut-directed hypnotherapy
Besides diet and mind-body interventions, the following lifestyle factors are most likely to have an impact on your IBS symptoms:
- Getting daily moderate-intensity physical activity/exercise
- Getting enough sleep (seven to nine hours per night)
- Staying healthy by avoiding infections
Lifestyle strategies such as diet, mind-body interventions, and physical activity are free of side effects and work well for improving IBS symptoms as well as quality of life. Nevertheless, several effective medications exist and many people with IBS include a medication as part of their comprehensive IBS treatment plan to stabilize their symptoms over the long haul.
Diet for IBS success
Changing what and how you eat is the number-one way to gain control over your irritable bowel syndrome (IBS) symptoms. A first step is implementing some simple strategies around how you eat:
- Implementing regular mealtimes
- Eating smaller, more frequent meals instead of large meals
- Eating mindfully, free of distractions
A next step is to make some basic changes to what you eat and drink in order to support your health and eliminate the most common gut-irritating ingredients:
- Reducing your intake of alcohol, caffeine, and carbonated drinks
- Staying hydrated by drinking enough water
- Avoiding artificial sweeteners and ultra-processed foods that contain many additives
- Limiting fatty and fried foods
Many people go further and implement a bigger dietary change. By far the most studied and effective diet for improving IBS symptoms is called low-FODMAP. (FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, so you can see why people just use the acronym). FODMAPs are types of carbohydrates that are difficult to digest in IBS. When FODMAPs travel through the digestive tract of someone with IBS they aren’t properly absorbed; when they reach the large intestine, they’re broken down, which leads to symptoms such as bloating, gas, cramps, and diarrhea or constipation. The low-FODMAP diet works to reduce consumption of these food components. This diet is highly effective for reducing IBS symptoms, and involves three separate phases: restriction, reintroduction, and personalization. However, the restricted foods are not always intuitive so it takes extra effort and guidance to make sure you’re adhering to the diet.
Several other diets may be effective for relieving IBS symptoms:
- National Institute of Clinical Excellence (NICE) diet: Relatively easy to implement, this diet, from the U.K., reduces symptoms almost as much as a low-FODMAP diet. It involves restricting a few dietary components such as caffeine and high-fiber foods, and eating mindfully with small, regular meals.
- FODMAP gentle diet: This is a toned-down version of a full low-FODMAP diet. FODMAP gentle removes key high-FODMAP foods such as wheat, milk, and onions from the diet and is relatively easy to implement on your own.
- Gluten-free diet: This diet eliminates only gluten (a protein naturally found in wheat and some other grains), so it’s easier to grasp and implement than the low-FODMAP diet. Wheat is a major source of FODMAPs in most people’s diets and is not allowed on the gluten-free diet.
- Mediterranean diet: This well-rounded diet is focused on fruits, vegetables, whole grains, nuts, seeds, olive oil, and fatty fish, the combination of which can help maintain the health of the gut. It’s a proven diet for supporting long-term health, although it may only reduce IBS symptoms to a modest degree.
To successfully change your diet to help manage IBS, consult with a registered dietitian before you begin.
