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IBS

Irritable bowel syndrome (IBS)

Sufferers of Irritable Bowel Syndrome (IBS) can find relief by following natural guidelines. I have found that with a change to a healthful, fiber-rich, Nutrition diet, successful resolution of IBS typically occurs within a few months.  

https://www.drfuhrman.com/content-image.ashx?id=5c4hhvagftk4o7q1x9nlbmIrritable bowel syndrome is a gastrointestinal condition that hinders normal daily life for 11 percent of the population. The characteristic symptoms include chronic, relapsing digestive tract discomfort accompanied by cramping, pain and bloating, with diarrhea and/or constipation.1 Often, pain and bloating do not improve with conventional treatments for IBS, which aim mostly to treat diarrhea or constipation.  Treatments which safely address the pain and bloating in addition to diarrhea and constipation have the potential to greatly improve quality of life for sufferers of IBS. The cause of IBS is unclear, but many patients have resolved their symptoms naturally with a combination of a high-nutrient diet, exercise, and supplements.

New research has established dietary changes as meaningful for improving IBS symptoms, and high-fiber – especially high-soluble fiber – foods as an important therapeutic tool.2 I recommend a diet of high-nutrient foods with attention to soluble fiber. Soluble fiber, as is abundant in chia seeds, for example, absorbs water, forming a viscous gel. By forming gels in the digestive tract, soluble fiber acts to counteract diarrhea (by absorbing water) and constipation (by adding bulk to the stool). A high-soluble fiber diet has been found to improve IBS symptoms.  In addition to chia seeds, beans and oats are rich in soluble fiber. Whole grains (other than oats) contain primarily insoluble fiber. Most vegetables, fruits, beans, nuts and seeds contain a combination of soluble and insoluble fiber.3

A healthful diet for IBS completely avoids sugar, white flour, processed foods, and foods cooked in oil as these are significant triggers for IBS. For many sufferers, changes in diet can be adjusted to minimize gastrointestinal discomfort, for example adding more cooked vegetables, beans, pears, and oats in the beginning while slowly increasing high-fiber raw vegetables, which are higher in insoluble fiber and may be difficult to tolerate at first. A good place to start could be with small amounts of raw vegetables at each meal, chewed very well; eventually, the goal would be to work up to larger, well-chewed leafy green salads with shredded raw vegetables, such as beets, cabbage, and carrots. Whole grains, also high in insoluble fiber, may aggravate symptoms early on, and are best introduced slowly.4

Probiotics, exercise, and avoiding dietary triggers – which may vary between individuals – are also important parts of the recovery process from IBS. Probiotic supplements have been shown in randomized controlled trials to improve pain and bloating associated with IBS, and peppermint oil supplements may also be helpful.5-7

Trials on exercise have also produced positive results in patients with IBS. Exercise is thought to help by accelerating colon transit time and helping to normalize the altered gut motility commonly seen in IBS patients.8,9

Common dietary triggers include wheat, gluten, dairy, and fructose; restricting or avoiding one or more of these substances may help IBS improve. IBS sufferers should also discuss any medications they are taking with a physician, as some prescription and over the counter drugs may exacerbate symptoms.

References

  1. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA 2015, 313:949-958.
  2. Moayyedi P, Quigley EM, Lacy BE, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol 2014, 109:1367-1374.
  3. Higdon J, Drake VJ: Fiber. In An Evidence-based Approach to Phytochemicals and Other Dietary Factors New York: Thieme; 2013: 133-148
  4. Bijkerk CJ, de Wit NJ, Muris JW, et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ 2009, 339:b3154.
  5. Hoveyda N, Heneghan C, Mahtani KR, et al. A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome. BMC Gastroenterol 2009, 9:15.
  6. Ford AC, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 2008, 337:a2313.
  7. Khanna R, MacDonald JK, Levesque BG. Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Clin Gastroenterol 2014, 48:505-512.
  8. Johannesson E, Simren M, Strid H, et al. Physical Activity Improves Symptoms in Irritable Bowel Syndrome: A Randomized Controlled Trial. Am J Gastroenterol 2011.
  9. Chey WD, Rai J. Exercise and IBS: no pain, no gain. Gastroenterology 2011, 141:1941-1943.
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