The IBS diet from an IC perspective

IBS (long version, Irritable Bowel Syndrome) has become a buzzword, and that’s not a bad thing. It means more attention is being paid to a very real and serious medical condition. Do you have IBS? Or are you wondering if perhaps all the pain and discomfort you are dealing with in your stomach and bowels could be IBS? In this article we’ll will explore the dietary guidelines which can profoundly help improve your IBS symptoms as well we’ll look at some of the ties that both the IBS and the IC diets share in common.

Like IC, IBS is pretty much a diagnosis of exclusion. IBS is increasingly on the rise, and unlike IC it has garnered a fare amount of public attention and support (did you know that April is IBS awareness month). Though estimates vary it’s thought that about 15-20% of the North American population may have some degree of IBS.

The prime symptoms of IBS are bloating (both peppermint and fennel tea can do wonders for this), abdominal cramps, diarrhea, constipation or a combination of both, continually feeling the need to have a bowel movement, and irregular stools (strange colour, shape, consistency, presence of pus, etc - blood should never be present in stool and may indicate bowel conditions like Chron’s Disease or Colitis).

Though medications (primarily antispasmodic drugs) are available to help treat IBS, and many of them may help you. One of the key aspects to treating IBS though, is understanding how and why food can either help us or harm us.
I developed IBS before I got IC, and I had a very rough time with it for a while. I got to the (dreaded) white rice and water stage. No one needs to get to this point; it walks a fine line between malnutrition and starvation. A “wounded” G.I. needs to be coddled that much is true, but not putting any nutrients into will do more harm than good.

I was not getting the help/treatment that I needed from the medical community (at the time) and most doctors simply said, “oh IBS isn’t serious, just eat more fibre”. There’s an over simplification if there ever was one! I had been reading extensively on IBS and began my own elimination diet. In a matter of weeks I realized that these were the worst trigger foods. Eating (at that time) even just a small portion, a nibble in some cases could cause me to make 10 or even 15+ trips to the bathroom. Here are the foods that I found were the biggest triggers for my IBS:

The list goes on and on, but these were the foods that I literally did away with. A very popular IBS diet on the market lists these and other foods. The qualm I have with this diet is that it lumps everyone with IBS together and essentially says, “do this and this, no exceptions”. Well I hate to spoil the message there but that diet says no dairy products, as long as I don’t eat too much (like a half-litre of ice cream) I have no problem with dairy. In place of dairy some IBSers use soy products; soy products like soy protein (what is often called soy ground “meat”), soy cheese, soymilks, etc all bothered my IBS then and still do today (plus the bladder nowadays to). I think that each person is different, what worked for me might not entirely work for you. I don’t push any whole diet over another per se. I feel strongly that it’s important to go through the process of an elimination diet, adding only one food at a time, and waiting at least 5 days before introducing a new (the next) food. By doing this you can get a more accurate picture of what are your trigger foods. The catch-22 is that sometimes a food on it’s own can be tolerated but a combination of foods can be “deadly”, it’s a strange chemistry really. Keep track (in a journal or on the computer) of which foods bother you, and roughly how much you ate of that food and what other foods you ate in conjunction with it. (Remember to keep your fluid intake up - water is your friend!)

I began drinking peppermint tea for IBS flares and taking peppermint capsules and ginger capsules (both available at most good quality health food stores, look for as “pure” a product as possible). Fennel can also help the G.I. tract.

Over time other medical conditions came along, IC and Vulvodynia (with Vulvodynia some patients benefit from a low oxalate diet) put me back at square one and the elimination diet began again. It might seem daunting but a couple/few months of “work” will help you for years and years to come.
These days my IBS is not typically a big problem; I still don’t eat most of the foods on the list (notice how many are similar to the list of “bad” foods for ICers?), but I have been able to incorporate a few things back into my diet. I feel that it was changing my diet so drastically that “saved” me from months and months (if not years) more of utter IBS agony. I also take an anticonvulsant medication called Gabapentin; I believe that it helps my IBS by reducing muscle/intestinal spasms.

You can try cutting out or entirely reducing dairy, this might help you (if you think dairy is the culprit you might want to get tested for both milk protein allergies and lactose intolerance- two different things). Too much sugar isn’t good for anyone, but the thing about sugar (by sugar I mean most commercial white and brown types) is that it doesn’t seem to pose a big problem (in reasonable quantities) for most IBSers. I wouldn’t recommend using artificial sweeteners (I would say this to everyone in the world, actually), they can cause a host of G.I problems (like bloating, cramping, and diarrhea). As long as you are not diabetic and have not be told to lower your sugar intake for other medical reasons, completely cutting out sugar (honey is fine, opt for organic) is totally at your digression. I lowed my sugar intake but still eat some from time to time.

Fibre is the cornerstone of the “IBS diet”. Fibre is separated into two (main) forms, “insoluble fibre” (IF) and “soluble fibre” (SF). In a nutshell, soluble fibre (SF) is really important in when planning your diet around IBS. Ironically, SF is not often found in most foods that people associate with the word “fibre”! (Go figure!) Like bran, spinach, and whole wheat. SF occurs in the starches of some foods. What makes SF great is that it passes right through the gastrointestinal tract because the G.I. tract cannot digest it due to the nature of its sugar molecules (this is a simplified explanation of the process which occurs). SF soaks up un-needed liquids in your colon, forms a gel of sorts to help “bulk you up”, and helps to stretch the G.I. muscles of the colon. These actions help to slow the speed at which food needs to be expelled and helps control diarrhea, as well as “lubricating” the colon to help combat constipation (making it easier for matter to make it’s way through the colon).
SF also calms and helps to regulate the digestive system by helping to stabilize the spasms (contractions) of the intestines, and in turn helps to get bowel habits (whether you are suffering from constipation or diarrhea or a combo of both) back on track. All of these benefits will really help cut down on tummy pains, cramping, constipation, diarrhea, and bloating.

You can find good levels of SF in tons of foods like:

Many other foods also have SF. It’s probably a good idea for anyone with G.I. troubles to take a SF supplement like Equalactin, Citrucel, Fibercon or Acacia Tummy Fibre. This will help make it easier for you body to cope with IF. However not all supplements are created equal and you may want to try several brands to see which ones work best for you. Some are now available in pill (capsule) making them practical and easy to take with you anywhere. Watch out, certain brands contain the artificial sweetener sorbitol

IF is like the Devil’s advocate of the IBS world because it can be both beneficial and harmful-good and bad. IF is what most people associate with the word fibre.

Most of the healthiest foods known to man have high levels of insoluble fibre. Foods like:

But the thing about IF is that it works in much the same way as a fat! Therefore making it a hefty G.I. trigger (stimulant). For those of us with IBS this can spell trouble! But IF isn’t fat and it doesn’t have to be avoided like the plague. Instead remedy the problem by eating IF with SF (at the same time). As long as IF foods are tolerated by your IBS and IC (and/or other medical conditions) eat plenty of them, your body needs them even if they can “harm” you alone (without SF, please try not to eat them alone). Incorporating SF into your diet and keeping it there in large quantities is the best way to make IS tolerable.

Some foods contain both fibres, this is usually because there exterior is insoluble but their interior is soluble. Foods in this category include zucchinis, apples, most beans and tuber vegetables. When it comes to grains I find that for IBS, oatmeal and brown rice are great.

According to the USDA adults should aim for 25 to 35 grams (more is fine) of fibre a day and soluble fibre should comprise one third of that amount. Western diets typically lack fibre. Regions in the word like Japan and parts of China, the Mediterranean and some other areas eat (on average) far higher amounts of fibre than us Westerners. Cutting down on, or eliminating entirely you consumption of fast foods, overly processed foods (chips, commercial mac and cheese, most candies, etc), and chemicals in your diet will give room for you to replace those meals with healthier ones, that hopefully contain good fibre levels.

I am not aware of any diet that is primarily based on herbs. Herbs are an important part of cooking though they give pizzazz to a great deal of our dishes. Where would stuffing be without sage or pesto without basil? I have found that except for dill, too much garlic and celery seeds I can tolerate most herbs in reasonable quantities. Though not a herb, technically, chilli pepper flakes and seeds (and powder) should be avoided as they are stimulants for the G.I. tract and bladder irritants (also watch out for spices like paprika, hot curries, and cayenne for the same reasons).

When the term herb becomes one of medical meaning, it reaches beyond the varieties we grow and use every day and incorporates things like ginseng, stevia, kava, and many, many others. Stretching into the realms of Eastern medicine and more traditional healing practises. It’s really a good idea to talk to a trained herbalist if you want to try and use herbs as treatment for IBS, IC, or any other medical condition. And remember some herbs can interact with prescription meds so always let your doctor know what herbs you are taking.

It is possible to eat for both IC and IBS (and other medical conditions), and still get a well-rounded, medically “safe” (for your body) diet. I don’t suggest that you do away with carbs, despite the diet fads out there; it’s medically shown that our bodies need to consume carbohydrates. As well you want to get adequate amounts of healthy fats into your diet such as olive and canola oils, flax seed (lin seed) oil, and the natural oils in many fish like tuna and salmon. If anything eating for IBS will steer you towards weight loss, not weight gain. This will come as a result of eliminating high fat foods and fried foods, and adding more fresh produce and grains into your diet.

Where IC patients may be helped by diet modification (less flares, less continual pain for some ICers), IBS can be dramatically, drastically improved (for many) by altering your diet and adhering to the guidelines. Changes won’t probably occur overnight. It most likely took you body a while (often years) to reach it’s present state, so positive changes may take time to occur. But just by cutting out the main trouble foods, you will greatly reduce your chances of having an IBS flare (or attack as some IBSers call them), as well over time you may find that you are more comfortable eating. By this I mean that you don’t dread what is going to happen to you after ever meal.
Have fun with your cooking and meal preparation, I find it handy to have smaller meals through out the day, as opposed to one large “lump” meal in the evening or midday. Believe me, after you experience a few days of no IBS symptoms chances are you’ll forget the words fast food even exist, and you’ll find yourself wondering how you ever managed to “survive” before. At least that’s how I felt, and still feel today.

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