Registered Dietitian Laura Clark and monthly columnist at Honest Mum shares the latest research and her tips for IBS sufferers.
Over to Laura.
April is Irritable Bowel Syndrome (IBS) awareness month so I wanted to take the opportunity to update you all on what’s new in gut health and the management of this condition.
If you suffer from IBS, you won’t need an awareness month to remind you: symptoms range from wind and/or bloating, diarrhoea or constipation, or both, low abdominal pain, which may ease after opening the bowels, feelings of urgency and generally worsening symptoms after eating.
It can be a debilitating condition, which is often inappropriately down played. This leads many people to self– diagnose and head to the supermarket or health food shop for solutions, which is where things can get confusing!
Research into the dietary treatment of IBS has come on in leaps and bounds which is great news, however, as with all nutrition advances, it is open to exploitation by the food industry as marketing doesn’t always convey what the science actually tells us. There are lots of buzz words when it comes to gut health and what applies to an IBS sufferer may differ from the general population so let’s take a closer look.
These are live bacteria which when digested in the right amount have the potential to pass on a health benefit to us through improving levels of ‘good’ bacteria and reducing the levels of not so good ones. However, in healthy individuals, it has been difficult to prove a health benefit and as such there are no authorised health claims attached to probiotics. If you’re looking to improve your gut health, focusing on a varied diet containing lots of plant-based foods and fibres is a good place to start.
What you need to know if you have IBS.
For IBS, certain strains from the lactobacillus, bifidobacterium and saccharomyces groups have been shown to be beneficial in the management of symptoms.
If you want to trial a probiotic, it’s important to do so for a minimum of 4 weeks and only trial one at a time.
These are types of fibres that provide the food for good bacteria to thrive. They are found naturally in foods such as artichoke, chicory and leeks and are increasingly being added to foods for example inulin or FOS added to yogurts.
Prebiotics are a good way to increase the amount and type of fibre in your diet, feeding your beneficial bacteria and potentially improving the type of stool you produce and/or regulating your bowel habit.
If you find they aggravate your symptoms this could be because of certain fodmaps they contain (see below).
These are growing in popularity – not only do they contain live bacteria they also provide the food on which these bacteria thrive. The fermentation process involves live bacteria feeding on the sugar that the food contains, breaking it down and releasing substances that can benefit our gut. Improving the types and diversity of our gut bacteria by giving them the food they love, is probably beneficial for gut health overall (although we have yet to see robust data demonstrating the benefits of fermenting). Food examples include Kefir, Kombucha, Tempeh, Kimchi, Pickles, Sauerkraut and Miso.
The Low FODMAP diet
Research has identified a group of compounds (Fructans, Oligosaccharides, Monosaccharides and Polyols) known to pass into the large bowel undigested. Here, they are broken down and fermented by the colonies of bacteria present there, drawing water into the bowel and releasing gas.
In those with IBS, whose bowel walls are hyper sensitive this causes symptoms such as gas, bloating, pain and altered bowel habit. When foods containing fodmaps are eliminated from the diet, symptoms often improve. This has led to many people putting themselves on a low fodmap diet or being told to google it by their GP!
The low fodmap diet is designed to be followed really well for a short period of time. It is not a diet you should remain on indefinitely.
It is based on the principle that you can identify through a structured reintroduction programme, which particular fodmaps you react to and in what doses, as it is highly unlikely you will have issue with all of them.
Food high in fodmaps are those traditionally known to be good for bowel health, for example certain whole grains, pulses, lentils, fruits and vegetables. Fermented foods or prebiotics may also be high in fodmaps.
We have evidence to show levels of certain good bacteria drop when on a low fodmap diet, so it is really important you don’t remain on a restricted diet for a long period of time.
Whilst effective for many, it is worth noting that far less complicated adjustments to your diet can also make a huge difference and are considered , so don’t get complicated unless you really have to.
I hope that was helpful. I’ll have more updates for you as data emerges.
If you want to see me or any other registered dietitian for advice check out www.freelancedietitians.org.
Read more of Laura’s posts here: How to Lose Weight as a Busy Mama, Food Assumptions and How They Affect Their Children, and Confessions of a Dietitian Mum: What I Actually Feed My Children.