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How Should I Handle Irritable Bowel Syndrome?
A doctor’s advice on IBS symptoms, triggers, diet and treatment
VIDEO: My Stomach Has Been Getting Upset After Eating. What Can I Do?
I’ve been diagnosed with irritable bowel syndrome. What’s the best way for me to manage it?
Being told you have irritable bowel syndrome (IBS) can feel unsettling, but it’s also the first step toward getting a handle on symptoms that, while uncomforable, are also very manageable.
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IBS is what we call a “functional” gastrointestinal disorder. This means the digestive tract can look normal on tests, but it doesn’t always behave normally. Hallmark symptoms, which include abdominal pain or cramps, excessive bloating and gas, and changes in bowel habits — diarrhea and constipation, or a combination of both — stem from a gut that is more sensitive and reactive than usual. The communication between your brain and your digestive system could be off, leading your intestines to overreact to certain foods, stress or even normal digestion.
You’re far from alone. While it’s more commonly diagnosed before age 50, many older adults live with it, often undiagnosed or recognized later in life. Some research suggests that between 10 and 20 percent of older adults experience IBS symptoms, though estimates vary. But there’s good news: IBS does not damage the intestines or increase your risk of colon cancer. It’s a chronic condition, but also one you can deal with effectively.
Let’s talk about what helps.
Start with awareness. One of the most powerful tools is also the simplest. I suggest you keep a food and symptom diary. Track what you eat, when you eat it and how you feel afterward. Over time, patterns will emerge. IBS triggers tend to be highly individual. What bothers you may be fine for another person who has IBS.
Changing your diet can make a real difference. You might benefit from adjusting how and what you eat. Eating smaller, more regular meals is often helpful. Eat slowly and chew thoroughly. Avoid overeating, especially late at night. Staying hydrated is also important.
Some foods are gentler on the digestive system: lean proteins like chicken or fish, well-cooked tender vegetables, oatmeal and rice. Others are more likely to trigger symptoms, including high-fat foods, carbonated beverages, certain dairy products and gas-producing vegetables like broccoli and cabbage.
You might want to consider the low-FODMAP approach. FODMAP is an acronym for a tongue-twisting list of carbohydrates that tend to be difficult for people to digest. (They are fermentable oligosaccharides, disaccharides, monosaccharides and polyols.)
For many patients, a temporary low-FODMAP diet, under medical or a dietitian’s guidance, significantly reduces bloating, gas and pain. This plan limits certain carbohydrates, including wheat and beans, which are poorly absorbed and can irritate the gut.
The plan is not usually permanent, but it can help you identify specific triggers and “reset” symptoms. One study found that more than 50 percent of patients on the low-FODMAP diet experienced significant improvement in their abdominal pain, compared with 20 percent of the control group. Low-FODMAP items can also help folks with food intolerance, which often contributes to bloating, gas and stomach pain. (For more information on the low-FODMAP diet, read The Diet for Irritable Bowel Syndrome.)
What about fiber? Not all of it behaves the same way. Soluble fiber, found in foods like oats, is often better tolerated. The key is to increase it gradually and pair it with plenty of water.
Some people may find relief with probiotics, which help balance gut bacteria, though the scientific evidence is mixed. If you try them, you’ll ideally take them with your doctor’s guidance.
Don’t overlook stress. The gut and the brain are closely connected. Stress doesn’t cause IBS, but it can absolutely worsen your symptoms. Techniques to reduce stress, such as walking, breathing exercises and practicing yoga and mindfulness, could make a noticeable difference.
If lifestyle and diet changes aren’t enough, medications can help target specific symptoms such as diarrhea, constipation or abdominal pain. A gastroenterologist can tailor a treatment to your particular pattern.
When should you worry that your symptoms point to something more? Certain red flags require prompt attention. If you experience unintentional weight loss, blood in the stool or rectal bleeding, persistent diarrhea that wakes you from sleep, anemia (having too little iron in your blood), fever, ongoing vomiting or pain that is not relieved by a bowel movement, contact your doctor.
Those signs don’t necessarily mean something serious is going on, but they warrant a closer look to rule out conditions such as inflammatory bowel disease, celiac disease or, less commonly, colorectal cancer.
You may not be able to eliminate IBS, but there’s a good likelihood you will significantly improve your quality of life with the right combination of diet, lifestyle adjustments and, when needed, medical support.
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