Irritable bowel syndrome (IBS) is a common disorder of the digestive system that can lead to embarrassing and uncomfortable symptoms, such as abdominal pain, bloating, diarrhea, and constipation. While there is no cure for IBS, there are ways to manage the symptoms. By doing so, it becomes possible to improve the quality of life of people who suffer from it and to live to their full potential, a goal they often believe is unattainable in the active phase.

As a dietitian nutritionist specializing in gut microbiota, clinical experience combined with the latest scientific data allows us to discuss general recommendations through four separate tips. These will help manage IBS by focusing on daily macronutrient distribution, aerophagia, fermentable dietary fiber management and the use of a probiotic appropriate to the symptoms experienced.

1. Macronutrient Distribution – Carbohydrates & Fats

   One of the most important factors in alleviating IBS symptoms is the breakdown of macronutrients, such as carbohydrates and fats. Carbohydrates (sugars) are nutrients that provide energy to the body and are found in many foods, such as fruits, vegetables, grains, sweets, and legumes. Fats are also a source of energy found in foods such as nuts, seeds, vegetable oils, fried foods, meat and avocado.

   An excess of these macronutrients during the day or in a single meal can trigger certain symptoms specific to IBS (diarrhea, bloating, gas, etc.). Based on clinical experience, a maximum of 3 servings of carbohydrates in a single meal is usually well tolerated (e.g., 1 cup of whole-grain pasta, ¾ cup of quinoa + 1 fruit, 1 potato and 1 cup of root vegetables, etc.). Obviously, these recommendations must be individualized and consider other elements that have an impact on the onset of symptoms.

 

2. Aerophagia

   Aerophagia, or excessive air intake, can worsen IBS symptoms by increasing pressure in the stomach and intestines, which can lead to bloating and abdominal pain. Several ways to reduce aerophagia can help reduce the symptoms of IBS.

   The first step is to slow down the speed at which you eat and take the time to chew food thoroughly. It is also important to avoid chewing gum or drinking carbonated beverages. How about we also try to respect the instruction we give our children, which is not to speak with our mouths full!  It may seem childish but talking while chewing instantly causes air to build up in the stomach. The use of a straw is also not recommended.

   Another way to reduce aerophagia is to practice relaxation exercises, such as deep breathing or meditation, before eating. Eating mindfully, without stressors or screens, will help reduce the rate of eating and consequently, the build-up of air in the digestive tract, as well as promote healthy digestion! It's a win-win situation!

 

3. Fermentable Dietary Fiber Management

   Fermentable dietary fiber is a type of fiber that can be difficult to digest for some people with IBS. They are fermented quickly by bacteria in the gut, causing bloating and gas. However, dietary fiber is important for digestive and overall health, as it helps regulate bowel movements, prevents constipation, acts as food for the gut microbiota, and is part of the tools to control certain chronic diseases (cardiovascular disease, diabetes, obesity, etc.).

   The goal is to find the comfort zone to meet the nutritional requirements of fiber, but also to limit the intestinal discomfort associated with it. Choosing the right type of fiber for the symptoms becomes a valuable tool.

   Working with a healthcare professional is one of the steps to help clarify this, as is the introduction of a food journal and symptom diary. Certain foods rich in fermentable fiber, those known as FODMAPs (legumes, inulin, apples, avocados, wheat, etc.) can be eaten in smaller quantities and more evenly distributed according to a well-defined protocol to find the culprit foods and reduce the symptoms.

   It is also important to eat foods rich in soluble fiber, such as psyllium, certain fruits and vegetables, flax, chia and camelina seeds, which can help regulate bowel movements. These foods should be incorporated gradually and always combined with good hydration.

 

4. Integrating the Right Probiotic

   It is important to choose a quality probiotic and to talk to a healthcare professional to determine the right dosage and strain for your individual needs. In the context of IBS, the choice of probiotic will depend on the symptoms to be relieved: diarrhea, constipation, gas, stomach aches, etc.

   The Clinical Guide to Probiotics, suggests probiotic brands that have clinical studies supporting their use in specific settings. Probiotics supported by Level 1 studies can then represent an additional help in the management of symptoms. Introduction should be gradual and after 7 to 14 days, you should see an improvement in symptoms. If not, it may be that the probiotic chosen is not necessarily the right one for you. Other strains are preferable and will probably work better in synergy with your own bacteria.

   In addition to taking a probiotic, it is also important to feed the healthy intestinal bacteria with prebiotic foods (garlic, onion, leek, beet, squash, legumes, blueberries, apples, etc.), the food of choice for our permanent microbiota, but also for these new bacteria that work with our own in a transient manner (probiotics).  However, be careful, some of these foods can worsen the symptoms, hence the importance of always referring to a personalized approach to general recommendations.

In conclusion, irritable bowel syndrome can be a frustrating and difficult to manage chronic disorder. However, by using a combination of macronutrient management techniques, aerophagy, dietary fiber and probiotics, it is possible to reduce symptoms and improve quality of life. The best approach will be the one that meets your individual needs, your reality and allows you to put in place effective long-term solutions to manage the symptoms of IBS.