Irritable bowel syndrome is a term that has been thrown around a lot in the last number of years. 7-21% of the global population has been diagnosed with IBS as of 2016. What is it? IBS “is a chronic gastrointestinal disorder characterised by fluctuating abdominal pain or discomfort associated with an altered bowel habit in the absence of organic disease.” People will be diagnosed with IBS after a scope or other testing that has ruled out other causes of gastrointestinal upset including irritable bowel disease and celiac disease. IBS has been dividied into 3 primary subtypes: diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), and mixed type (IBS-M or IBS-A) which presents with constipation and diarrhea.
The cause of IBS has not been pinpointed to one trigger or condition, the research is suggesting at this point that there are many contributing factors that are at play. Stress, food sensitivities, gut dysbiosis, and medications have all been linked to causing IBS. Due to the variability in the causes, the treatment has to be multifactoral and individual.
The role of food sensitivities
Food sensitivities are different from food intolerances and food allergies. Food intolerances, such as lactose intolerance, occur when you are unable to digest a particular food because of a missing enzyme or genetic condition. In the case of lactose intolerance you are missing the enzyme lactase which is responsible for the breakdown of lactose. Food allergies, such as a peanut allergy, are mediated by an immune particle called IgE. IgE mediated reactions are immediate allergic reactions causing massive amounts of inflammation which cause airway constriction and difficulty breathing and skin reactions i.e. hives.
Food sensitivities are mediated by a different immune particle called IgG. IgG mediated reactions have a slower or delayed onset which can take 24-48 hours to manifest. These reactions also cause inflammation, but instead of causing airway constriction or hives, it causes more generalized reactions. Symptoms of these reactions can be brain fog, mood changes, joint pain, muscle soreness, abdominal pain or cramping, changes in bowel movements, and migraines. I run food sensitivity panels that test for these IgG reactions to get to the root cause of some of the above conditions.
The good news is that food sensitivities can change based on your food choices and what you are doing to repair your gut lining. After running a food sensitivity test I will instruct my patients to avoid the reactive foods for at least 6 weeks, after that period of time we trial some of the reactive foods. Most people can incorporate several of the previously reactive foods back into their diet without any issues!
How to eat for your IBS
Okay so we have talked about the role of food sensitivities in causing IBS, now we have to discuss to eat properly for if you have IBS. In school I was presented with so many different ways to treat IBS, from identifying food sensitivities, to low FODMAP, to probiotics. There is so much information out there regarding IBS, so I have outlined the most effective treatments here to clear up the confusion.
- Avoid alcohol. Yup, I said that. What I am not saying is that you can’t have the occasional drink at special events, but cut back on the amount you drink on a regular basis because it will worsen your IBS. Alcohol affects the speed of the food moving through your intestines, the absorption of nutrients from your food, and increases the permeability of your gut lining. Increased gut lining permeability will worsen any sensitivities to foods that you may have. Yikes.
- Spicy food. Spicy foods may aggravate IBS symptoms for some people, and more commonly in people with heartburn, diarrhea predominant IBS, and in men.
- Increase fibre. The standard amercian diet (SAD) is low in fibre, high in saturated fat, high in carbohydrates, low in protein, and low in fruits and vegetables. Increasing fibre from whole grains, fruits and vegetables may help with the symptoms of constipation and diarrhea.
- Fermented foods. They are a great source of probiotics and prebiotics which may help soothe your digestion. They are also a great source of fibre which we already know is fantastic for the gut.
- Elimination diet. This is an alternate way to “test” for food sensitivities. It involves cutting out all possible food triggers from your diet for 1 month, then introducing one food back into your diet every couple days while monitoring for any changes in how you are feeling.
If you are interested in learning more about how to eat for your IBS you can book an appointment with me and we will discuss your case and how to best address your symptoms.
Yours in health,