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A Dietician’s Guide To IBS


What is IBS?

Irritable bowel syndrome (IBS) is a functional gut disorder associated with a variety of gut symptoms such as diarrhoea, constipation, abdominal pain, bloating and wind. 

It is estimated that up to 20% of the Irish population are affected by IBS, with women being twice as likely to have this condition.

The exact cause of IBS is unknown in most cases, but it is believed that a number of factors are involved in it’s development, such as changes in the gut microbiome, visceral hypersensitivity, inflammation, altered communication between the gut and the brain, and abnormal gut motility, to name a few.

Symptoms & Getting a Diagnosis

There is a huge overlap between the symptoms experienced in IBS and a variety of other gut conditions, therefore it’s important to see your GP, whether your symptoms are new, or if you’ve had them for a while. Without the correct diagnosis, an individual will not receive the correct treatment, so as a first step, getting a diagnosis is key. 

As there is no definitive diagnostic test for IBS, diagnosis is primarily achieved through the exclusion of other gastrointestinal conditions such as Coeliac disease and inflammatory bowel disease (IBD). Diagnostic tests may encompass blood tests, stool analyses, and in some instances, a referral to a gastroenterologist may be warranted.

Once any physical causes of gut symptoms have been ruled out, a diagnosis of IBS may be given, if the individual’s symptom profile is in line with the Rome IV Criteria.  

Managing IBS Effectively 

Individuals with IBS may experience periods of remission interspersed with flare-ups, and for some, the symptoms may persist chronically, having a profound impact on their quality of life and emotional wellbeing.

There is currently no cure available for IBS, but thankfully the management options for IBS have improved significantly in recent years as our understanding of the condition has deepened. 

Recognising that each individual's experience with IBS is unique, tailored management strategies can make all the difference. Here's a glance at some of the various avenues for managing IBS:

Subtle dietary adjustments such as moderating caffeine, fat, spicy foods, and alcohol intake, alongside portion control, can yield substantial symptom relief for many. Tailoring fibre intake and pinpointing trigger foods under the supervision of a dietitian are further measures to explore if initial adjustments prove ineffective.

It's crucial to pay attention to your water intake since the gut relies on sufficient hydration for optimal function. Equally important is your food environment; steer clear of screens during meals, and practice slower, more mindful eating while seated at the table.

IBS symptoms aren't solely influenced by diet; we must consider factors beyond food. Exercise plays a pivotal role in both physical and mental wellbeing, contributing to alleviating the severity of IBS. Practices like yoga, known for their positive impact on the gut-brain axis often disrupted in IBS, can be particularly advantageous. Consistency is needed to see the initial results and lasting benefits of exercise and movement.

Effective stress management is vital for the long-term management of symptoms associated with IBS. Given its common association with gut symptoms, prioritising stress management should be a cornerstone of every individual's IBS management plan. Something as simple as taking daily breaks for activities like walking outdoors, or engaging in meditation or deep breathing exercises to promote relaxation of both the mind and the gut, can really make a huge difference.

Medications may be prescribed by your doctor for managing specific symptoms and in some cases, certain probiotics and supplements may have a role to play. However, it's important to note that while there are numerous supplements available, not all have been scientifically validated. Therefore, it's wise to seek professional advice before incorporating them into your regimen. Additionally, supplements may interact with prescribed medications, so it’s important to speak with your GP or pharmacist beforehand.

Conclusion

As you can see, there is no one size fits all when it comes to the complex condition of IBS, so it’s worth seeking personalised advice to determine the most effective path forward for managing the condition.

About Aoife McDonald

Aoife is a specialist IBS dietitian and founder of the Cork-based Digestive Health Clinic. She specialises in helping those with IBS to resolve their gut symptoms through her 1-2-1 nutrition programmes. Aoife also works with companies and organisations delivering nutrition seminars and carrying out personalised nutrition consultations with employees. 

Visit www.thedigestivehealthclinic.com to find out more.