Centre multisports
Centre multisports

Irritable Bowel Syndrome

2024-04-30  |  Joanie Séguin, Dt. P. Nutristionniste
Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder. People who suffer from it may experience abdominal pain, bloating, flatulence, and changes in the frequency and consistency of bowel movements.

The causes of IBS are unknown but likely multifactorial, ranging from genetics to the presence of inflammation, an altered microbiota, or even visceral hypersensitivity. Around the world, unfortunately, 1 in 10 people is affected by IBS, with a frequency twice as high in women. Those affected are sometimes forced to limit their activities due to the uncomfortable and sometimes even painful symptoms they experience. However, some strategies can be implemented to improve the quality of life of those suffering from it. Here are a few potential solutions, which should ideally be guided by a registered dietitian:

Avoid foods or habits that may worsen symptoms:

  • Alcohol: Alcohol has a stimulating effect on the digestive system. 1 in 3 people with IBS is said to have an intolerance to wine or beer.
  • Caffeine: Coffee has a stimulating effect on intestinal transit in many people, which can therefore worsen symptoms in those with IBS.
  • Capsaicin and salicylates (Spicy foods): Spicy foods can exacerbate symptoms, particularly abdominal pain.
  • Insoluble fiber: This type of fiber can increase stool volume and cause more symptoms for some people. It is therefore recommended to avoid them if that’s the case.
  • Irregular meal schedule: Skipping a meal or having irregular meal times can increase symptoms.
  • Suboptimal macronutrient distribution: A balanced diet helps many people with IBS significantly reduce their symptoms. A registered dietitian can guide individuals through this type of dietary change.
  • Stress periods: Stress may trigger the onset of symptoms and/or intensify them.

By changing some of these basic habits, many people with IBS manage to significantly reduce their symptoms. To go further, the FODMAP diet can also be used to reduce discomfort even more. This diet involves removing FODMAP-rich foods from the diet and then reintroducing them by group to identify which categories are causing the discomfort. The stricter phase of this diet is only followed for a short period. Using this method, 70% of people with IBS experience a reduction in symptoms. The best results are achieved when the diet is explained and supervised by a registered dietitian.

But what is a FODMAP? It’s an acronym for four types of short-chain carbohydrates that are fermentable and found in many common foods:

  • Oligosaccharides: Small chains of sugars (Fructans and galacto-oligosaccharides (GOS))
  • Disaccharides: Chains composed of two sugars (Lactose)
  • Monosaccharides: One sugar (Fructose)
  • Polyols (Sugar alcohols/Sugar substitutes): Mainly xylitol, mannitol, and sorbitol

FODMAPs are partially (or not at all) digested and absorbed in the intestine. In the small intestine, FODMAPs can cause a water shift that may lead to diarrhea. In the large intestine (colon), undigested FODMAPs are fermented by the bacteria present in the colon. This fermentation increases gas production and can cause symptoms like bloating, abdominal distension, flatulence, abdominal pain, and constipation.

But where are these FODMAPs found? The “Monash University FODMAP Diet” app offers a very complete and detailed list, but here’s a shortened version:

  • Fructans: Some vegetables (e.g., garlic, onion, asparagus…), wheat and rye products, inulin, and some nuts (pistachios and cashews)
  • Galacto-oligosaccharides (GOS): Legumes
  • Disaccharides (Lactose): Dairy products (e.g., cow’s milk)
  • Monosaccharides (Excess fructose): Some fruits (e.g., pears, apples, mangoes…), honey, agave, molasses, high-fructose corn syrup, and some vegetables (e.g., snow peas…)
  • Polyols (Sugar alcohols/substitutes): “Diet” products, sugar-free gum and candy, and certain fruits (e.g., blackberries, apricots, cherries…)

In short, there are some solutions to ease the suffering and discomfort of people living with IBS. However, it’s important to note that the first step should be obtaining an official diagnosis from a doctor to ensure the pain is not caused by another more serious underlying condition. Afterwards, a registered dietitian will be well equipped to guide you through the management of your IBS, because no one should have to put their life on hold due to such discomforts.

 

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