IBS

Irritable Bowel Syndrome (IBS) symptoms such as cramps, bloating pain and diarrhoea or constipation – normally rumble on for a while, but often get worse when patients hit their 30s, though is it unknown why.   In fact it is unknown what causes the condition itself, either – and there is no known cure.   Increasingly research suggests simple lifestyle changes could help prevent/minimize symptoms.

In a study just published in the journal Gut, not smoking, vigorous exercise and getting at least seven hours’ sleep appears to have the biggest effect – possibly because smoking raises inflammation, while exercise and sleep help regular bowel function and support immunity.

An even more recent study, reported just this month, has confirmed the benefit of cutting out certain carbs, showing that this can be more effective than medication.   Researchers at the University of Gothenburg randomly allocated patients with moderate to severe IBS symptoms to a low-carb FODMAP diet (where you cut out particular carbohydrates, knows as FODMAPs, that our small intestine often struggles to absorb);  or medication to treat their particularly symptoms.

The patients who followed either of the dietary plan did much better than those on the medication, with 76% of the low FODMAP group, and 71% of those on the low-carb diet, reporting significantly improved symptoms, comparted to 58% in the medication group.

After 6 months, while some had returned to their previous eating habits, 68% of the FODMAP group were still reporting benefits, compared to 60% on the low-carb diet.   By this point most of those who had started on medication were also on one of these diets and were delighted with the results.

So what’s going on?  One of the more plausible theories about IBS is that it’s the result of an overly sensitive large bowel (or colon), or immune system, either of which could be the result of having had a previous gut infection.   Once your gut has been sensitized by an infection, there are certain carbs that can trigger an attack of IBS.   These are the FODMAPs – or fermentable oligosaccharides, disaccharides, monosaccharides and polyols.   The trigger foods vary with the individual, but typically include:-

Dairy – mike, cheese, yoghurt and ice cream.   Wheat based foods – bread, cereal, biscuits and pasta.  Beans and lentils.   Vegetables – artichokes, asparagus, onions and garlic.  Fruits – apples, cherries, pears and peaches.

FODMAPs in these foods can be poorly absorbed so reach the colon largely undigested, here they are fermented by gut bacteria which produce gas and cause bloating.   The low FODMAP diet was developed at Monash University in Melbourne, Australia, 15 years ago, and has been shown to improve IBS symptoms and help patients identify their triggers (because it is highly restrictive, it is not meant to be used long term and should be supervised by a medical professional).