Irritable bowel syndrome (IBS) is common and challenging to treat. People who have IBS may feel incredibly frustrated because often doctors tell them there is no observable problem. All the same, they often suffer symptoms including abdominal pain, cramping, bloating, flatulence, diarrhea or constipation.
How Does Diet Affect IBS?
Gastroenterologists used to think that irritable bowel syndrome was mostly psychosomatic. (There’s more information below on talk therapy for this condition.) However, over the past several years, experts have come to a consensus that diet also plays an important role in triggering or controlling symptoms.
Low FODMAP Diet:
Following a low FODMAP diet may help (American Journal of Clinical Nutrition, June 2021). That stands for Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. These carbohydrates are fermented by intestinal bacteria, causing excess gas for some people. They are components of some healthful foods, such as wheat, rye, legumes, garlic, onions, milk, yogurt, figs, mangoes or blackberries.
A study in China recruited more than 100 people with IBS and asked them to follow either a traditional or a low-FODMAP diet. Those who followed the low-FODMAP diet for three weeks had fewer symptoms and fewer carb-fermenting bacteria.
There is growing interest in the dietary management of IBS. Although this study suggests that diet can make a difference, telling everyone who may have this condition simply to avoid whole grains, fruits, vegetables and dairy products would impoverish their diet. Moreover, carbohydrate-fermenting bacteria are usually considered important elements of the microbial ecosystem. Consequently, we’ll be watching for more targeted dietary interventions that can improve symptoms.
Other Natural Approaches for Irritable Bowel Syndrome:
Q. Are there any natural treatments for IBS? I think they should call it cranky colon or irritable intestine or something alliterative. Sadly, I’ve had it for several years and there is little to be done for it. I have occasionally had painful rectal spasms so intense I pass out.
Doctors don’t have anything to offer, and I am tired of this socially unacceptable ailment. Do you know of anything I could try?
A. Research suggests that peppermint can ease spasms in smooth muscle, especially the digestive tract. Enteric-coated peppermint oil has been helpful for people with IBS in some trials (Journal of Clinical Gastroenterology, July 2014). As a result, it might be worth a try.
Probiotics May Help Irritable Bowel Syndrome:
People with IBS often benefit from taking beneficial bacteria called probiotics. You have probably seen these advertised as capsules or in foods.
We heard from a reader who reported that probiotics helped his IBS:
“While I’m not cured, the symptoms are now much easier to handle.”
A systematic review covered 11 randomized controlled trials and concluded
“that multi-strain probiotics supplemented over a period of time have the potential to improve IBS symptoms” (Nutrients, Sep. 2, 2019).
Multi-strain probiotics evaluated included species of Lactobacillus and Bifidobacterium as well as Streptococcus thermophilus. Yogurt or kefir with live cultures may offer these strains and might prove beneficial.
Soluble Fiber Is an Option:
Soluble fiber such as that found in oats, barley, beans and psyllium can help control symptoms (American Journal of Gastroenterology, Sep. 2014). Of course, people following a low-FODMAP diet will exclude some foods rich in soluble fiber. Using a psyllium supplement may make sense to start with. Over the long term, a dietitian with experience helping those with irritable bowel symptoms might provide guidance.
Don’t Dismiss Talk Therapy for IBS:
Cognitive behavioral therapy can help a range of conditions from depression to insomnia. A small study showed that this type of targeted talk therapy might also improve symptoms of irritable bowel syndrome. Patients who responded well within the first four weeks of treatment were especially likely to maintain their favorable response (Clinical Gastroenterology and Hepatology, May, 2010).
Many people with IBS have noticed that their symptoms may worsen when they are under stress. No one can avoid stress completely, but this may help explain why cognitive behavioral therapy seems to ease symptoms. On the other hand, doctors might be putting the cart before the horse. New research suggests that mast cell activation (a type of immune response related to allergies) may trigger both IBS symptoms and psychological distress (Journal of Inflammation Research, April 14, 2021).