Irritable bowel syndrome, or IBS sucks!
For those who suffer from it, it’s no walk in the park. IBS is a common chronic gastrointestinal disorder that involves problems with motility (how food moves along the digestive tract) and sensitivity (how the brain interprets sensations in the small and large intestines). Those affected by IBS may experience recurrent abdominal pain and irregular bowel patterns that are often painful. Symptoms are often chronic and intermittent and may last for months or years.
Interestingly, Canada has one of the highest rates of IBS in the world with five million Canadians currently suffering. IBS affects significantly more women than men and is one of the most common causes for work and school absenteeism. This is truly curious as Canada also have some of the highest rates of IBD (Crohn’s and colitis) and multiple sclerosis – there’s no shortage of research linking low vitamin D levels to diseases of the gastrointestinal tract and other autoimmune diseases but that’s for another time.
The low FODMAP diet has been scientifically proven to significantly reduce IBS symptoms in up to 76% of IBS sufferers (1). Therefore, the low FODMAP diet is often the first elimination diet doctors, nutritionists, dietitians, and gastroenterologists will consider. However, some low FODMAP foods contain other IBS triggers that need to be considered to gain good symptom control.
Often people who follow a low FODMAP diet don’t get the relief they were hoping for. This is super frustrating for both client and health professional. The gut can be finicky and with good reason. It’s naive to think we can throw anything at it without issue. With IBS, other aspects of your diet can be triggers for discomfort that need to be tackled to get relief.
6 common IBS triggers
Alcohol: alcohol is a gut irritant and can make IBS symptoms worse (2, 3). Beer can be risky to begin with because it contains gluten which can be a problem for some. Wines and mixed drinks usually contain sugar and carbonated mix which can be a problem too. Alcohol can cause your stomach to produce more acid than usual, which can cause gastritis, stomach pain, vomiting, and diarrhea (4). Alcohol can also be dehydrating, which can affect your digestion. Limiting alcoholic beverages may help reduce symptoms related to IBS. If you do decide you want to have an alcoholic beverage make sure you follow general guidelines for alcohol consumption. Also, monitor symptoms and consider reducing if your IBS is not improving. Have your alcoholic beverage with food and have at least two alcohol free days per week.
Caffeine: caffeine is universally known to help with pooping in those without any digestive health issue but it can be a real killer for anyone with gut issues. Caffeine can worsen IBS symptoms because it stimulates the gastrointestinal tract motility, which means food is moved through your digestive system quicker and can cause diarrhea in extreme cases (5). Remember that caffeine isn’t just found in coffee, it is also found in tea, cola, chocolate, and the now infamous energy drinks. If you think all you have to do is switch to decaf, not so fast. Many find decaf coffee may not be enough as it still contains low levels of caffeine. Coffee also has dozens of other naturally occurring organic acids which can be a problem on their own. Monitor and adjust as needed.
Spicy foods: spicy foods can also trigger IBS symptoms in some people (6). Chili and peppers contain capsaicin, which is responsible for the desired heat when added to foods. These can be hard to handle under the best of times and even more so for those with IBS. Going for blander foods can help reduce any irritation and symptoms that follow, especially in those with sensitive guts.
High fat foods, fried foods: foods high in fat can slow down stomach emptying and transit time or the time it takes food to make its way down the digestive tract. When food is slow to move, it can aggravate any sense of fullness, and can worsen constipation. On the other hand, foods high in fat, especially fried foods can irritate the gut and lead to diarrhea. If you’re having symptoms of IBS, reflect on your intake and consider reducing the consumption of chips, sausages, fast foods, high fat meats, pies, cheese, creamy sauces, cakes, crisps, biscuits, chocolate, mayonnaise, and full fat dairy products (ice cream, yogurt, full fat milk); you may find this to be beneficial (7).
Carbonated beverages: these beverages have carbon dioxide (CO2), the same stuff we breath out when we exhale, dissolved into them under pressure. Under normal circumstances, these beverages are perfectly harmless. Carbonated beverages (soft drinks, club soda, etc.) won’t cause IBS but they can lead to bloating and gas. When we drink them, we literally swallow the bubbles. Some of them make their way into the intestines where they can increase pressure. This leads to cramps and bloating and cause pain, making symptoms worse. (8).
Fiber: everyone needs fiber, however some high fiber foods are also high FODMAP and need to be removed while you are on the low FODMAP diet. Getting enough fiber is possible but you need to give some care to the foods you choose. Research indicates that those with IBS don’t tolerate insoluble fiber well and that increasing the insoluble fiber in their diets could worsen IBS symptoms (9, 10). Many low FODMAP foods contain this problem fiber found nuts, seeds, brown rice, and fruit and vegetable skins. These foods therefore can cause IBS symptoms because of the type of fiber they contain. If you’re having symptoms, try cutting back on those foods, and increase your intake of soluble fiber.