2024-01-28 23:52:13
Canada has one of the highest rates of irritable bowel syndrome: 5 million Canadians are estimated to suffer from it. It is estimated that only 40% of people who suffer from it consult a health professional, the others try to relieve their symptoms by changing their eating habits. Update on this syndrome which significantly affects quality of life.
Symptoms
Irritable bowel syndrome (IBS) affects women more than men. It encompasses several symptoms, including abdominal pain, cramping, bloating and excess gas. There are several subtypes of IBS: with predominantly constipation (IBS-C), with predominantly diarrhea (IBS-D) or mixed (with alternating diarrhea and constipation: IBS-M)1. Although it is bothersome, this syndrome is benign and does not increase the risk of intestinal cancer.
1 Stool consistency is assessed using the Bristol scale. There are 7 types of consistency, type 1 and 2 stools are associated with constipation, type 6 and 7 are associated with diarrhea.
Bristol scale
- Type 1 – Hard, broken into pieces, like walnuts.
- Type 2 – Sausage-shaped, but lumpy.
- Type 3 – Like a sausage, but with cracks on the surface.
- Type 4 – Like a sausage or snake, but smooth and soft.
- Type 5 – Soft pieces with well-defined edges.
- Type 6 – Shredded pieces, clumped together into a pasty material.
- Type 7 – Bland, damp, no solid bits. Fully liquid
Triggers
There are no recognized risk factors for IBS, but it is common for the syndrome to develop following food poisoning, the use of antibiotics, hormonal fluctuation or even traveler’s diarrhea. Stress and anxiety can exacerbate symptoms.
Diagnostic
In order to establish a diagnosis, food intolerances such as lactose and gluten (celiac disease) as well as inflammatory bowel diseases (ulcerative colitis and Crohn’s disease) must be ruled out.
Treatment
While your doctor may prescribe certain medications (antispasmodics, antidepressants, antidiarrheals, laxatives, analgesics) depending on the type of IBS, dietary changes are most important to relieve symptoms.
Firstly, we can limit the food components which irritate the intestine:
- Caffeine
- The alcohol
- Fizzy drinks
- Foods high in fat
- Spicy foods
- Sorbitol and other sugar alcohols
If the changes above are not enough, the low FODMAP diet is ideal.
The low FODMAP diet
This is the recommended diet for the treatment of IBS. By limiting the consumption of certain carbohydrates which ferment in the intestine (oligosaccharides, disaccharides, monosaccharides and polyols), symptoms are significantly reduced. Monitoring takes place in three stages: the elimination phase, the reintroduction phase and the maintenance phase. In total, 75% of people with IBS see their symptoms improve with this approach.
FODMAPs are found in a wide variety of foods: fruits, vegetables, legumes, dairy products and grain products. Each person has their own tolerance threshold, hence the importance of personalizing the approach.
As this approach is complex, it is in your best interest to seek guidance from a nutrition professional. Monash University in Australia, a pioneer in nutritional research on IBS, offers several tools to put this dietary approach into practice (www.monashfodmap.com). In particular, there is a list of nutritionists teaching the FODMAP approach in Quebec.
An application (available in French) allows you to find the lowest FODMAP foods in all food categories. There are also several recipes that respect the principles of the diet.
While gluten (a protein) is often blamed, it is more the fructans (a type of carbohydrate) in wheat, rye and barley that are problematic. Cereals such as oats, corn, rice, millet, quinoa, buckwheat and teff are much better tolerated. As for fruits, as fructose can cause symptoms, fruits such as pineapple, kiwi, tangerine and orange should be favored.
Fibers
There are two types of fiber: insoluble and soluble. While the former are generally less tolerated, the latter can relieve certain symptoms. They are found in particular in oats and psyllium.
The importance of the food diary
Keeping a diary recording everything you eat and drink in a day while noting your symptoms (pain, bloating, frequency and consistency of stools, etc.) allows you to better target problematic foods. Restricting the consumption of too many foods is not desirable, as it affects food variety, which is a guarantee of health.
It is also important to maintain an eating routine, without skipping meals. Stress management strategies will also have a significant effect on symptom relief.
Supplements
People suffering from IBS display an imbalance in the microbiota (dysbiosis) as well as low microbial diversity. Probiotics might therefore optimize the intestinal flora. The clinical guide to probiotic products sold in Canada (https://aeprobio.com/wp-content/uploads/2023/01/2023_ProbioticGuide_CanFr.pdf) recommends a few probiotics for IBS relief including Align® and TuZen®.
Peppermint oil in capsules might reduce intestinal discomfort and abdominal distension. However, it should be avoided in people who suffer from gastroesophageal reflux.
Photo Adobe Stock
To know more :
►The FODMAP solution: to put an end to stomach aches
Cinzia Cuneo
Les Éditions du Journal
►Discover other tips on my blog: www.isabellehuot.com
1706490421
#irritable #bowel #syndrome
