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Health & Fit Are There Foods to Avoid on an Irritable Bowel Syndrome Diet Plan?

19:35  26 november  2021
19:35  26 november  2021 Source:   self.com

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There isn't just one diet that helps relieve irritable bowel syndrome. © MEHAU KULYK/SCIENCE PHOTO LIBRARY There isn't just one diet that helps relieve irritable bowel syndrome.

Irritable bowel syndrome (IBS) can take the fun out of eating sometimes, especially if you’re still learning what types of foods set off your symptoms. Unfortunately, that means there isn’t just one irritable bowel syndrome diet that helps everyone with the condition feel better.

“What works for one person with IBS might not work for someone else,” Christine Henigan M.S., R.D., L.D.N., a clinical dietitian at Jefferson Lansdale Hospital in Philadelphia, tells SELF.

For example, some people with IBS notice their symptoms are calmer when they add more fiber to their diet, while others have better luck eating less fiber—kind of confusing, right?

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That’s why finding the best IBS diet for you may take a bit of experimentation, and you might even have to work with your doctor or a registered dietitian to develop the diet that truly keeps your symptoms in check (and still brings you joy at dinnertime).

What is IBS? | IBS food triggers | Common IBS diets | Other triggers to note

What is irritable bowel syndrome, exactly?

IBS is a functional gastrointestinal (GI) disorder characterized by a group of symptoms that occur when your brain and GI tract have trouble understanding each other, including abdominal pain or cramping, bloating, and uncomfortable changes in your bowel habits, including diarrhea, constipation, or both, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). These symptoms vary depending on the type of IBS you’re dealing with, which can include:

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  • IBS with constipation (IBS-C), which means you have less than three bowel movements per week, incomplete bowel movements, and/or hard-to-pass stools.
  • IBS with diarrhea (IBS-D), which is characterized by frequent stools that are loose or watery.
  • IBS with mixed bowel habits (IBS-M), which is, you guessed it, when you experience a combination of constipation and diarrhea.
  • Post-infectious IBS, which develops suddenly after a GI infection, per the International Foundation for Gastrointestinal Disorders. Generally, people with this type of IBS mainly deal with diarrhea, but can also have mixed symptoms. Some people feel better with time even without medication, but the recovery period is different for everyone, typically ranging from weeks to months, sometimes even longer.

IBS sets off these symptoms because the condition changes how your bowel muscles contract. Those who have weaker intestinal contractions will experience more constipation since food passes through their digestive system slowly. On the other hand, those who have stronger intestinal contractions end up with diarrhea, since food moves through their system much faster, according to the Cleveland Clinic.

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This can be extremely painful, but IBS doesn’t cause damage to your GI tract like inflammatory bowel disease (IBD) can. Both set off symptoms that can be debilitating, but IBD is an umbrella term for conditions that cause chronic inflammation in various parts of the digestive tract due to an irregular immune response, which includes ulcerative colitis and Crohn’s disease.

The exact causes of IBS aren’t totally understood, but experts believe a combination of factors may play a role, such as genetics, going through stressful or traumatic events during childhood, having certain mental health conditions like depression or anxiety, bacterial infections in the GI tract, small intestinal bacterial overgrowth (SIBO), or food sensitivities, per the NIDDK.

What are some common IBS food triggers?

Various foods can spur IBS symptoms, but these triggers aren’t the same in each person and depend on the type of IBS you’re dealing with. However, there are some common culprits1 to be aware of:

  • High-fat foods: Studies show that eating foods rich in fat—particularly creamy or fried foods—can slow your digestion and lead to excessive gas, bloating, and constipation2. Some people’s digestive systems may also have a harder time absorbing fat, which can actually set the stage for diarrhea.
  • Sugar: Sugar stimulates your GI tract, causing it to release water and possibly loosen your bowel movements. Fructose is one of the most common forms of sugar that leads to diarrhea, as it’s so abundant in fresh fruit and fruit juices.
  • Sugar substitutes: Many “sugarless” candies and gums contain sugar alcohols (like sorbitol, mannitol, isomalt, maltitol, or xylitol) which can also cause diarrhea, Henigan says.
  • High-fiber foods: This one is a bit tricky. Insoluble fiber in particular, which is found in nutritious foods like legumes, oats, and cruciferous veggies, moves through the GI tract very quickly. So, while eating more of these foods may actually help people who deal with constipation, it can make matters worse for those who deal with diarrhea.
  • High-FODMAP foods: This stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are short-chain carbohydrates your body may have a hard time digesting. This can lead to gas and boost the amount of fluid in your colon, ultimately leading to diarrhea. FODMAPs can be found in tons of foods, like onions, garlic, apples, beans, cabbage, apples, dairy, and so much more, per Johns Hopkins Medicine.
  • Caffeine: This stimulant is found in beverages like coffee, tea, and soda (and even foods like chocolate). Caffeine can make diarrhea worse because it increases gastric acid production, which breaks down food so it moves through the GI tract more quickly.
  • Alcohol: The effects of alcohol on IBS aren’t entirely clear yet, but research suggests people who deal with the condition may notice worsened symptoms when they drink higher amounts of booze (four or more drinks in a day)2. Alcohol is known to change how quickly you digest food and may interfere with nutrient absorption, possibly leading to bowel movement changes (commonly diarrhea, but sometimes constipation as well).
  • Lactose: This is a sugar found in milk. Some people don’t make enough lactase, which is an enzyme that allows you to digest lactose. If you have IBS and lactose intolerance, you may experience a double whammy of stomach cramps, bloating, gas, and diarrhea. In this case, one condition can easily be mistaken for the other.
  • Spicy foods: The issue with these is that they’re often high in fat. However, spicy foods also often contain capsaicin, which gives red chilis their heat. This compound may not be the root cause of IBS flares, but it can make certain symptoms, like abdominal cramping, burning bowel movements, and heartburn feel so much worse.

What types of diets are used to manage IBS symptoms?

“The best diet for IBS is the one that helps relieve your symptoms,” Laura Krauza M.S., R.D.N., a clinical dietitian at St. Lucie Medical Center, HCA hospital in Port St. Lucie, Florida, tells SELF.

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Remember, that means there isn’t just one irritable bowel syndrome diet to follow, but there is plenty of research on certain styles of eating and how they contribute to symptom relief. Before we dive into those, though, it’s important to remember that you should never attempt to drastically overhaul your diet if you have a GI condition without expert supervision. Working with a gastroenterologist or a registered dietitian who specializes in GI disorders can help you determine the best way to slowly make changes that feel sustainable. What’s more, a pro can help you develop a plan so you don’t cut out too many foods at once to avoid the risk of nutrient deficiencies.

Here’s a closer look at the most popular diets used to help manage IBS symptoms, and what the science really says about them so far:

Elimination diet

The term “elimination diet” is pretty broad and can refer to any instance where you attempt to eliminate a food that you suspect is stirring up symptoms, according to Ginger Hultin M.S. R.D.N., registered dietitian and author of Anti-Inflammatory Diet Meal Prep and How to Eat to Beat Disease Cookbook.

There are many types of elimination diets, meaning there isn’t just one script to follow. For example, you might just remove certain dairy products from your diet to start with. Eventually, you may decide to remove many types of food at once, like all dairy and all alcohol. After you eliminate potentially problematic foods, you closely monitor your symptoms for about three weeks. Then, you slowly start to reintroduce each “eliminated” food one at a time to see if your body has a reaction to it. If you don’t experience any symptoms when you reintroduce a food, then it can likely be ruled out as a cause of your GI woes.

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Most of the diets below could fall under the elimination diet umbrella, and we can’t stress enough that it’s crucial to do this type of diet with some form of expert supervision. “This is definitely a diet that needs support from an expert, so it’s safer and can be personalized to your unique needs,” Hultin tells SELF.

Low-FODMAP diet

As we mentioned, FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols and they are naturally “found in foods that aren’t completely digested or absorbed in the intestines and can therefore cause irritation and IBS symptoms in some people,” Hultin says. And there is ample research to back up a low-FODMAP eating plan for people with IBS. In fact, one 2017 meta-analysis of six randomized controlled trials published in Nutrients3 concluded that a low-FODMAP diet significantly reduced abdominal pain and bloating in people with IBS.

Per the U.S. National Library of Medicine, the following carbs are FODMAPs:

  • Fructans, which are found in garlic, onions, and wheat
  • Fructose, which are found in fruits, honey, and high fructose corn syrup
  • Galactans, which are found in beans and legumes
  • Lactose, which is found in cow’s milk products
  • Polyols, which are found in fruits with pits, such as apples, avocados, or cherries, and in sugar alcohols

Even though a low-FODMAP plan is known to help people with IBS, this is one that really requires the help of an expert because FODMAPs are found in so many nutritious foods, like apples, grapes, peaches, pears, mushrooms, broccoli, Brussels sprouts, artichokes, beans, peas, whole-grain bread—you get the idea. “The FODMAP list is extensive and following this diet can be challenging and restrictive,” says Hultin. “Typically, it’s done to try and identify trigger foods with the hope to liberalize the diet as much as possible while reducing IBS symptoms.”

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The process should also be individualized, so the length of time that you follow the plan and the number of foods you eliminate at once will depend on your current diet and symptoms. After you get a good idea of what foods make you feel worse—through the elimination process we’ve detailed above—you can work closely with your dietitian to figure out a diet that works best for you. So, you might actually be able to eat some FODMAP foods that don’t trigger your symptoms.

High- or low-fiber diet

Fiber is a non-digestible carb found in plant-based foods, like fruits, vegetables, and grains—it’s essential for a balanced diet because it keeps you feeling fuller for longer after you eat, helps control blood sugar, and plays a role in keeping cholesterol in check, per the Mayo Clinic.

In general, foods high in fiber prompt you to “go” more regularly. As we mentioned previously, this can be problematic if you deal with diarrhea. For example, a 2015 study of more than 200 people with IBS published in Advances in Nutrition4, found that about half of the participants’ IBS symptoms improved after eating very low amounts of fiber for four weeks. However, some people also were given bulking agents to prevent constipation, so more research is still needed to determine what the optimal fiber intake should be for people with IBS, especially because some fiber is still needed in the diet.

On the flip-side, eating more fiber can be helpful in reducing constipation, if your IBS swings in that direction. Much of the research on fiber and IBS specifically use psyllium, a type of supplemental soluble fiber found in products like Metamucil. For example, a three-month randomized control trial5 of over 200 IBS patients found that supplementing with 10 grams of psyllium per day improved abdominal pain or discomfort after just two months. (Just note that experts generally recommend reaching for whole foods rich in fiber over supplements.)

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No matter which end of the fiber spectrum you fall on, talk to your doctor or dietitian about potentially decreasing or increasing your intake if you suspect it has a big impact on your IBS symptoms.

Some examples of high-fiber foods include:

  • Raspberries
  • Pears
  • Bananas
  • Beans
  • Broccoli
  • Chia seeds
  • Pistachios
  • Lentils
  • Whole wheat pasta
  • Quinoa

Some examples of low-fiber foods include:

  • Applesauce
  • Avocado
  • Barley
  • Carrots
  • Green beans
  • Potatoes
  • White rice

Low-fat diet

“While not proven to help or hurt symptoms of IBS, high-fat meals can cause gas and bloating,” Henigan says.

Does that mean you need to eat a low-fat diet to feel your best? Not necessarily, but if you notice that your IBS symptoms get worse on days when you eat particularly rich and fatty meals—especially creamy dishes, cured meats, fried foods, or fast food like pizza—then that’s something worth paying attention to.

If fat seems to be your culprit, your doctor or dietitian may recommend following an elimination plan to identify specific fatty food triggers, and then assess your fat intake to see what kind of adjustments can be made based on your personal needs.

Gluten-free diet

Gluten is a protein found in wheat, barley, and rye. If you have celiac disease, eating gluten sets off a wonky immune response that triggers lots of inflammation, leading to some really severe symptoms that can cause intestinal damage. Many people with IBS report experiencing symptoms after eating foods that contain gluten, even if they don’t have a wheat allergy or celiac disease, research shows. Experts refer to this as “non-celiac gluten sensitivity.”

“While it is not necessary to avoid gluten if you are not diagnosed with celiac disease, some individuals with IBS feel relief when avoiding gluten,” Henigan confirms. One possible reason for this? These individuals may actually be responding to the elimination of FODMAPs, as many foods that contain gluten also contain FODMAPs. For others with IBS, eating foods that contain gluten is no big deal and a welcome part of their diet.

If you’re unsure about gluten, check in with your doctor, who can run the appropriate tests to determine whether or not you have celiac disease or a wheat allergy. If you’re cleared of both and still suspect gluten may be doing more harm than good when it comes to your bowel habits, you can work with your doctor or dietitian to develop an elimination diet for gluten specifically. You may find that only certain foods that contain gluten—but also contain, say, tons of fiber—may be the culprit, so you may not need to avoid all gluten completely. Once you ID your specific triggers, you can create a balanced plan that works for your needs.

Lactose-free diet

Hultin says that if you feel bloated or gassy (or other annoying GI symptoms) after eating lactose, then you might want to check in with your doctor about getting tested for lactose intolerance. “The symptoms of lactose intolerance are very similar to the symptoms of IBS, so it is important to rule the former out,” she says.

If you have IBS and you’re lactose intolerant, then steering clear of cow’s milk products may help you prevent a flare-up. “People with lactose intolerance need to avoid foods that contain lactose, including cow’s milk, cheese, yogurt, sour cream, ice cream, buttermilk, cream cheese, butter, and prepared foods that could have these ingredients in them,” Hultin says.

Instead, according to the Mayo Clinic, you may want to switch to dairy products that are lower in lactose if you can tolerate them, like ricotta cheese or kefir, as well as plant-based milks and yogurts.

Is your diet the only IBS trigger you should be aware of?

IBS is a complex condition, so it’s important to remember that while food is a big piece of the puzzle, it’s not the only thing that could be triggering your symptoms. For example, going through a heavy period of stress, taking certain medications like NSAIDs, not getting enough exercise, and not getting enough sleep can all contribute to an IBS flare-up, depending on the person, per the NIDDK.

That’s why it’s so important to work closely with your doctor if your digestive symptoms are starting to take an overwhelming toll on your life. They can prescribe certain medications that help relieve your specific IBS symptoms and help guide you on the best lifestyle changes you’ll need to make to feel more in control of your condition.

Sources:

1. World Journal of Gastroenterology, Diet in Irritable Bowel Syndrome: What to Recommend, Not What to Forbid to Patients

2. Journal of Nurse Practitioners, Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management

3. Nutrients, Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis

4. Advances in Nutrition, Low-Residue and Low-Fiber Diets in Gastrointestinal Disease Management

5. BMJ Clinical Research, Soluble or Insoluble Fibre In Irritable Bowel Syndrome In Primary Care? Randomized Placebo-Controlled Trial

Related:

  • Can Stress Cause Diarrhea and Constipation?
  • Does Lying Down After Eating Really Cause Gas?
  • How to Know If Your Abdominal Pain Is Physical or Mental

You Might Be Following A Plant-Based Diet Without Even Realizing It .
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