For sufferers of irritable bowel syndrome (IBS), newly published guidelines for managing IBS with diet support the use of several different approaches.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder affecting between 5 and 15 percent of people. Symptoms of IBS include abdominal bloating, pain, flatulence, diarrhoea and altered bowel habits. The condition can be difficult to diagnose because other conditions share the same symptoms. Currently, there is no specific diagnostic test for IBS.
The cause of IBS is unknown, but environmental factors such as changes in routine, emotional stress, infection and diet are all known to trigger an attack.
Dietary guidelines for managing IBS
Wading through the complex research into treatments for IBS, the American College of Gastroenterology in their recently published guidelines have found support for several dietary treatment for IBS that could help.
The first recommendation is increasing the amount of fibre eaten each day, especially the more soluble form found in psyllium. There is good evidence for a benefit of supplementing the diet with 10 grams of psyllium per day. In contrast, bulking up on more insoluble fibre such as bran can make IBS worse, rather than better.
Two other treatments that were considered worth investigating were probiotics and peppermint oil. For probiotics, it is not clear yet which ones in terms of species of bacteria and the form they are found in are best. Part of the ‘soothing and calming’ benefit of peppermint oil on the gastrointestinal system may come from its menthol content.
On the horizon, there is some promise that gluten-free and low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diets can help reduce symptoms of IBS, but it is a clear case of ‘watch this space’ at present.
Outside of diet, managing IBS guidelines also support the use of antidepressant medications and psychological therapy. And while not appearing in the guidelines, there is some interesting work being done in the area of mindfulness in helping to manage IBS, something I’ve blogged about before.
What it all means
For long-term sufferers of difficult-to-treat IBS, there is merit in trying the different types of dietary treatment for some relief from IBS.
Jeff says
Agree about the comments re fibre. Other things that have helped me are the very reliable slippery elm, the soothing “organic” chamomile tea and of course a range of very good essential oils. applied transdermally. Also digestive enzymes to suit should also part of an IBS protocol and not the least a good probiotic. A good one for me has been Ethical Nutrients IBS Support
Michelle Robinson says
Hi Tim,
Fantastic news about the benefits of psyllium for IBS sufferers!
Just wondering if you have found any studies trialling Slippery elm powder. I have had positive feedback from a couple of IBS patients who have included this in their diet. I understand slippery elm is not as rich in soluble fibre as psyllium, however was wondering if studies have found the mucilage content to be beneficial? Very interesting!
Cheers,
Michelle
Tim Crowe says
Hey Michelle – thanks for your comment. I haven’t seen any research pop out in my journal feeds about slippery elm so if it potentially does have a benefit, there hasn’t been a lot of published research to look into it. Tim
Jodie says
I’ve found psyllium to be highly effective. Hardly surprised here. Great article Tim!
Pat Shaw says
I found FODMAP recommendations to be harmful. Some of the foods included (ie: broccoli) are very gassy and cause pain. I follow Heather Van Vorous and her recommendations and have been pain free for weeks. I do not venture away from her teachings (I did once and PAID with having my pain come back in spades). If you don’t already know, she hosts the website “helpforibs” the most helpful website devoted (over 12 years!!!) to helping those affected by ibs.
Tim Crowe says
Thanks for your comment Heather and agree, that while other sources may have higher soluble fibre content, it is psyllium specifically that has been the most well-studied in clinical trials which were what informed the guidelines.
Heather Van Vorous says
Psyllium is not soluble fiber. It’s about 1/3 insoluble. There are much better choices for soluble fiber foods, and for soluble fiber supplements.