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Is there an ideal diet for achieving balance between constipation and diarrhea with IBS?

Smartliving Guest asked this
July 15, 2011 at 11:46 AM



Irritable bowel syndrome (IBS), commonly known as “spastic colon”, results in frequent stomachaches, constipation, and/or diarrhea, not to mention gas and bloating. While most people strive to keep their gastrointestinal troubles under wraps, IBS is more common that you may realize affecting over 55 million Americans ( ). This disorder is a chronic condition without a cure in sight. Thankfully treatments are available including medications, supplements, and diet modifications.

There are several abnormalities which commonly occur during digestion with IBS, including malabsorption. This process allows food to pass through the small intestines undigested. If the food contains fermentable carbohydrates and reaches the large intestine, the inhabiting bacteria will ferment the food producing gas, bloating, and diarrhea. The entire process will prevent your body from digesting and absorbing key nutrients, placing you at greater risk for nutrient deficiencies. To help prevent malabsorption, limit the entire group of fermentable carbohydrates known as FODMAPs ( ). FODMAPs include lactose, fructose, fructans, sugar alcohols, dried peas, beans, and soy.

As a general rule of thumb constipation may be lessened with the addition of dietary fiber. Fiber is found in whole grains, fruits, and vegetables (link to fiber question/answer). If food does not seem to make a difference, try a fiber supplement containing psyllium such as Metamucil ( ). While fiber can also help diarrhea, soluble fiber will be more effective. Soluble fiber acts like a sponge, soaking up the water and helping to add bulk to the stool. You can easily increase the soluble fiber in your diet by adding oatmeal, fruit, and beans to your diet.

In addition to limiting FODMAPs and experimenting with dietary fiber, here are 10 tips to help you better manage your IBS symptoms:

  1. Plan frequent small meals into your day to reduce the stress placed on your digestive system.

  2. Slow down and enjoy your food in a relaxed atmosphere as stress may worsen symptoms.

  3. Maintain a food diary, recording what and when you eat, along with when your symptoms occur.

  4. Replace high-fat foods with low-fat options because large amounts of fat may stimulate diarrhea.

  5. Work with a dietitian and allergist to determine if you have a food sensitivity (ex: lactose, gluten) which may be worsening your symptoms (link to food sensitivity question/answer).

  6. Limit alcohol and caffeine as both may speed up the digestive process.

  7. Eat more whole foods to ensure you are getting the nutrients you need. Processed foods are often loaded with preservatives, food dyes, and other additives which may cause even more digestive issues.

  8. Avoid straws, carbonated beverages, and gum as all three can cause you to swallow air, worsening bloating.

  9. Limit high sugar foods and beverages, including juice. Many are made with high fructose corn syrup or plain old fructose; remember what we discussed about fructose malabsorption earlier?

  10. Exercise and drink water. Both may help ease constipation.

As you may have already noticed, IBS is a sensitive disorder affecting each person differently, so be sure to experiment with small changes in your diet as you learn how your body will react. If you have IBS it is important that you discuss your symptoms with your health care provider. You may find even greater benefit by teaming up with a registered dietitian who may be able to guide you toward a less problematic diet while also ensuring you are receiving the nutrients essential to your health.

There is a stellar book recently released by a colleague of mine, Kate Scarlata ( ), entitled Eating Well with IBS and I highly encourage you to read it. In addition to her straight-forward advice, Kate includes 160 mouth-watering recipes – IBS approved. Kate is a registered dietitian living with IBS, making her the ideal health expert to guide you toward the best diet for you. Just as Kate reminds us, IBS is not a “one-size-fits-all diagnosis” and a symptom-free diet may certainly require a bit of experimentation as you accommodate your body’s specific needs.

Jessica Corwin MPH RDN Health Coach answered
July 21, 2011 at 9:19 PM
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