What is IBS?
IBS – Irritable Bowel Syndrome is a chronic and debilitating functional gastrointestinal disorder, which affects 15% – 20% of the UK population. It will often come and go throughout a person’s life and can be a painful and upsetting condition. Irritable Bowel Syndrome most often occurs in young people in their twenties. It is twice as common in women as in men.
Common symptoms include:
- abdominal pain or discomfort;
- bloating or distention;
- diarrhoea and/or constipation;
- wind or flatulence.
Other features such as lethargy, nausea, backache and bladder symptoms are common in people with IBS and may be used to support the diagnosis. Precipitating factors such as stress, anxiety and a hectic lifestyle add to the burden of IBS increasing symptoms further. Its exact cause is unknown.
Getting diagnosed with IBS
Many of these symptoms can also occur in people who have other conditions such as inflammatory bowel disease (Chrohn’s disease and Ulcerative colitis), Coeliac Disease and Bowel cancer. It is essential that you see you Gp to discuss your symptoms and seek medical advice to confirm your diagnosis (there are clear Rome criteria for this).
Getting help
IBS can severely impair quality of life and evidence suggests that dietary changes can significantly improve these symptoms. Various dietary intervention strategies are available for people with IBS and a dietitian will investigate clinical history, anthropometry, symptom profile, dietary pattern, nutritional intake previously implemented dietary measures, prior to providing dietary advice.
General helpful ideas include: keeping active; having regular meals; eating slowly and chewing food thoroughly, limiting alcohol and caffeine; relaxation; reducing fatty foods and cooking using fresh ingredients.
More specialised diets e.g. low lactose, soluble fibre modification and using probiotics may also be considered. Recently there has been growing scientific evidence for a nutritional approach called “Low FODMAP Diet”.
Helpful websites for IBS are:
http://www.nice.org.uk/guidance/cg61 – NICE guidelines 2015 – The National Institute for Health & Clinical Excellence (NICE) Guidelines on the diagnosis and management of Irritable Bowel Syndrome).
http://www.theibsnetwork.org/ – This is a UK charity which gives support and practical information on managing IBS
The Low FODMAP diet.
The Low FODMAP diet originated in Australia and was developed by a team at the Monash University in Melbourne. Researchers at Kings College in London have adapted the diet to the UK and are involved in on-going clinical trials on the management of IBS with dietary changes. They are also involved in the post-graduate training of Dietitians in this highly specialised dietary modification.
Over the last 10 years scientific studies and clinical trials have shown the diet low in FODMAPS to be highly effective in treating IBS related symptoms (there can be a reduction in gut symptoms in over 70% of people who suffer with IBS) when counselled by a FODMAP trained Dietitian.
What is a low FODMAP diet?
FODMAPS are an acronym referring to:
Fermentable;
Oligo-saccharides;
Di-saccharides;
Mono-saccharides
and
Polyols.
These are types of carbohydrates found in foods that are fermented in the gut and are generally poorly absorbed by the digestive system. They are found in a range of foods including wheat, certain fruits and vegetables and some milk based products. The diet may appear complex but the dietitian will be able to explain clearly and help you with the implementation.
How long do I have to follow the diet?
The first stage is to restrict high FODMAP foods from the diet for at least 4 weeks noting any improvements in symptoms of IBS.
The second stage is to reintroduce the specific type of FODMAPS in a structured systematic way with the supervision of the dietitian to ascertain the tolerance of higher FODMAP containing foods and this takes between 1-2 months.
The third stage is to consider long term eating habits with modified FODMAP food choices. The specialist dietetic input is essential to prevent nutritional deficiencies and assist with long-term health.
Can I just get a list of foods from the internet?
There are a number of lists of high and low FODMAP foods on the internet but many of the sites are not UK based or up-to-date. Many of the foods listed may be hidden within packaged foods and the FODMAP trained dietitian can assist in understanding food labels and also give ideas when eating out.
The dietitian will assist in meal planning, recipe ideas and individualised support considering family meals, work commitments and practical solutions where possible.
If the low FODMAP diet is not followed properly, it is less likely to be effective in controlling your gut symptoms. Therefore it is a good idea to get the specialist help in the first instance.
