Is there a cure for Irritable Bowel Syndrome (IBS), or is it a condition one must manage long-term?
Whether you are struggling with ongoing symptoms or newly diagnosed, the question of whether IBS is a lifelong burden may weigh heavily on your mind.
Currently, there is no definitive cure for IBS. However, there are numerous strategies to effectively manage its symptoms through lifestyle adjustments, dietary modifications, and stress management techniques. It is important to note that the approach to symptom management may differ depending on what sub-group of IBS you have (learn more about sub-groups here).
In general, across the IBS sub-groups, pain and bloating can be managed using a low FODMAP diet, specific probiotics, and psychological therapies.
For those with constipation-predominant IBS (IBS-C), incorporating soluble fiber, can help regulate bowel movements.
For more on the benefits and types of fiber, read The Gut-Loving Guide on Fiber.
Long-term Management Techniques for IBS
1. Lifestyle and Diet
Low FODMAP diet:
Certain food groups, such as those high in Fermentable Oligo-, Di-, Monosaccharides And Polyols (FODMAPs) have been shown to exacerbate IBS symptoms. Therefore, a diet low in FODMAPs can be helpful to manage some symptoms such as pain and bloating.
To learn more about the Low FODMAP diet visit Understanding FODMAPs.
Identifying triggers:
Common trigger foods that can exacerbate IBS symptoms include:
Alcohol - can cause reflux
Caffeine - can cause reflux
Fatty foods - can slow down digestion
Milk products/lactose - IBS can co-exist with lactose intolerance, exacerbating symptoms
Sugar alcohols (e.g. mannitol, sorbitol, xylitol) such as those found in gum - may cause bloating, gas, or diarrhea
Chocolate
Beans
Garlic/onion
Gassy vegetables
Regular Meals/Snacks:
Establishing a regular pattern for when you eat your meals and snacks can be an important first step to managing symptoms.
2. Pharmacological Treatment
Pharmacological therapies, which is the treatment of disease or symptoms through the use of medication (drugs), can be helpful for reducing symptoms such as constipation, diarrhea, and pain or bloating.
Digestive enzymes, supplemental fibers, and probiotics are considered forms of pharmacological treatment because of their targeted effects on gut microbiota, potential to manage GI disorders, and overall promotion of health.
Supplemental fibre: psyllium, ground flaxseeds (bulking agents).
Probiotics - specific strains of probiotics may potentially help minimize symptoms.
Digestive enzymes - useful to enable people to follow a less restrictive diet long term, as enzymes digest the FODMAPs they are sensitive to.
3. Psychological Therapies
The health of our gut can impact our mental health and vice versa. This “communication” between the gut and brain is called the gut-brain axis. Therefore, gut health can have an impact on our stress levels and our stress levels can impact our gut.
An example of how gut health impacts our brain/mental health is serotonin.
Serotonin, a hormone released by our brain, not only plays a role in memory and happiness, but it also plays a large role in gut motility.
Our gut (intestine) produces approximately 95% of the body’s serotonin, while only about 5% is produced in the brain. Bacteria in our gut are required for the synthesis of serotonin. In some cases of IBS (e.g., IBS-C), serotonin production in the gut is increased but the uptake of it from the gut is decreased, resulting in increased serotonin levels within our gut.
Stress Management
Stress can exacerbate IBS symptoms, impacting the onset, severity, and duration of symptoms. Stress can alter gut motility, increase how sensitive your intestine is, and impact yoru immune function. Stress management techniques and psychological interventions can be very helpful in alleviating IBS symptoms.
Below are some examples of some techniques to help manage stress:
Peppermint oil - smooth muscle relaxant
Yoga/ meditation
Cognitive behaviour therapy (CBT)
Sleep hygiene - having a consistent and relaxing bedtime routine
Summary Table of Long-term Symptom Management for IBS
Given the long-term management required for IBS, seeking guidance from healthcare professionals is crucial, especially before starting any lifestyle modifications.
It is often necessary to use a combination of symptom management strategies tailored to the individual for effective symptom relief.
Dietitians in particular can help by providing support while you identify trigger foods, implementing dietary modifications such as the low FODMAP diet, and recommending personalized plans for your unique needs.
Connect with your Gut Loving Dietitian today!
Tip: You may be covered! Check to see if you have insurance coverage for your dietitian consultations!
Written by: Clare Douglas, 4th Year UBC Dietetic Student
References:
Currò, D., et al. (2017). Probiotics, fibre and herbal medicinal products for functional and inflammatory bowel disorders. British Journal of Pharmacology, 174(11), 1426–1449. doi: 10.1111/bph.13632
Farmer, A. D., Wood, E., & Ruffle, J. K. (2020). An approach to the care of patients with irritable bowel syndrome. Canadian Medical Association Journal, 192(11), E275–E282. https://doi.org/10.1503/cmaj.190716
Nelms, M. N., & Sucher, K. P. (2019). Nutrition Therapy and Pathophysiology (4th ed.). Cengage Leanring.
Terry, N., & Gross Margolis, K. (2017). Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance. Handbook of Experimental Pharmacology, 239, 319–342. doi: 10.1007/164_2016_103
Tang, Y., & Yang, W. (2020). Inflammation and Irritable Bowel Syndrome: An Overview. Frontiers in Physiology, 11, 450. https://doi.org/10.3389/fphys.2020.00450
Unlock Food. (2023). Irritable bowel syndrome. Retrieved from https://www.unlockfood.ca/en/Articles/Digestion-Digestive-health/Irritable-Bowel-Syndrome.aspx
Qin, H.-Y., et al. (2014). Impact of psychological stress on irritable bowel syndrome. World Journal of Gastroenterology, 20(39), 14126–14131. doi: 10.3748/wjg.v20.i39.14126
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