Irritable Bowel Syndrome
October 25, 2017
Jaundice
October 25, 2017
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Irritable Bowel Syndrome Diet Sheet

Desired changes in conducting life and food-intake for handling IBS

Diet and lifestyle management can be used as a treatment for irritable bowel syndrome (IBS). When looking to treat symptoms of IBS, using a staged approach is most useful. It may be as simple as eating healthily and changing lifestyle factors, or there may be slightly stricter and specific ways to manage symptoms.

A food and symptom diary, before making any dietary changes, is a helpful way to identify foods that may be triggering a response in the body. All food and drink consumed for one week and any symptoms experienced should be recorded. One should try to record an approximate quantity eaten and the time of day. Symptoms may not always be caused by what one eats so other factors that may be involved, may be considered..

Measure one – eating and living consciously

One should aim at consuming:

Plenty of fruit and vegetables.

Plenty of starchy carbohydrates. Examples include bread, rice, cereals, pasta, potatoes, chapattis and plantain.

Some milk and dairy products (2-3 portions per day). If one is lactose intolerant , dairy alternatives such as soya, rice or oat milk and yoghurts that are enriched with calcium can be included.

Some meat, fish, eggs and alternatives such as beans and pulses.

Limited amounts of foods high in fats and sugars.

Limited amounts of saturated fat that is found in animal products such as butter, ghee, cheese, meat, cakes, biscuits and pastries. These can be replaced with unsaturated fats found in vegetable oils such as sunflower, rapeseed and olive oil, avocados, nuts and seeds. plenty of fluid – at least two litres daily, such as water or herbal teas.

Changing the way of living to improve index

One needs to have a regular meal pattern.

Meals should be eaten in a relaxed way.

Meals should not be skipped

One should sit down to eat, and chew food well.

One should not eat late at night.

Exercise regularly, such as walking, cycling, or swimming. If finding time is difficult, it should be incorporated it into one’s day. For example, cycling to work, getting off a train, stopping early and walking and using steps instead of lifts when possible.

Therapeutic relaxation

If one has a hectic lifestyle, stress and anxiety may also be causing IBS symptoms. There are many complex connections between the brain and gut (small intestine). Psychological factors, the nervous system, and muscle contractions in the gut all interact with each other, causing IBS symptoms. This is known as the brain-gut axis. Therefore, stress management can be effective in easing symptoms.

Create time for relaxation.

Make the most out of leisure time.

Try relaxation therapies such as meditation.

Exercise – try yoga or taking a walk.

Get enough sleep.

Seek support or counselling.

changes in food as per the index

Sometimes, a healthy balanced diet and lifestyle changes aren’t enough to improve symptoms. Therefore, it may be that more specific changes to the diet are needed. Many people report that diet affects their symptoms. Therefore, modifying what they eat can help to manage symptoms.

Cutting down on caffeine

Caffeine can stimulate activity in the colon, which may worsen symptoms of diarrhoea. Tea and coffee should be limited to no more than three cups per day. Filter coffee contains higher amounts of caffeine (140 mg) compared to instant coffee (100 mg) and tea (75 mg). So, if filter coffee is included in one’s diet, one may want to limit this to two cups per day.

Limiting consumption of alcohol and fizzy drinks

Fizzy drinks and alcohol can worsen symptoms of diarrhoea. One’s intake of these drinks should be limited to improve symptoms. One should aim to have at least two alcohol-free days each week and no more than two units each day.

A unit of alcohol is:

One 25 ml shot of spirits.

Half a pint of standard-strength lager/beer (3-4% alcohol by volume)

One small 125 ml glass of wine (11% alcohol by volume).

Reducing intake of tough starches

These are starches that are resistant to digestion in the gut (small intestine). Therefore, they reach the colon intact and are fermented by the germs (bacteria) in our gut. This produces gases and waste products, leading to symptoms of, bloating, wind and diarrhoea. People who have IBS react to smaller doses of resistant starches than those who don’t have IBS. Reducing resistant starches may also improve symptoms of diarrhoea.

Reduce intake of foods containing tough starches

Processed foods such as crisps, oven chips, supermarket pizza’s, biscuits and cakes, breakfast

cereals.

Foods that have been cooked and left out to cool – ef, cold potato/pasta salads.

Ready meals.

Partially baked bread – eg, garlic bread or pizza bases.

Whole grains, pulses, sweetcorn, green banana and muesli that contains bran.

Dried pasta (use fresh instead).

Pastry.

Savoury snacks.

Cook fresh food whenever possible and eat food that you’ve cooked straight away. This will help to reduce intake of resistant starches.

Customising fibre intake as per the symptoms

Fibre can be a confusing subject for many IBS sufferers. For some people, reducing high-fibre foods can help to improve symptoms. For others, increasing fibre can help to improve symptoms, so it is very much dependent on the individual. Fibre intake can be adjusted according to personal symptoms. A food symptom diary can be maintained and changes monitored.

Firstly, it may help to clarify what exactly dietary fibre is and how it may affect symptoms. There are two types of fibre which work differently in the body. Generally, reducing insoluble fibre may help with symptoms but if an increase in fibre is necessary, this should be from soluble fibre.

Insoluble fibre

This type of fibre is not dissolved in water. It is not readily broken down, so it passes through the digestive system mostly intact. It absorbs water, adds bulk to stools, and allows waste to be passed through bowels more quickly. Reducing this type of fibre may help to improve symptoms of diarrhoea.

Foods to reduce or avoid:

Skin, pith and pips of fruit and vegetables

Wheat and bran

Corn (maize)

Nuts and whole grains

Soluble fibre

This type of fibre does dissolve in water and can be broken down by the natural bacteria in the bowels. It softens stools (faeces) and makes them larger. Increasing this type of fibre may help to improve symptoms of constipation. Foods to include are:

Oats

Barley

Psyllium and ispaghula

Nuts and seeds

Fruit and vegetables

Beans and pulses

Whole grains (eg, wholemeal bread, brown rice and whole wheat pasta) may also help with constipation. Although increasing fibre may help to improve symptoms, it may also generate gas and cause pain and bloating. Monitoring is important to help identify this and to adjust your fibre intake according to your symptoms.

If fibre intake is suddenly increased, this can cause symptoms of wind and bloating. Introduce high-fibre foods gradually to allow the gut to become used to the extra fibre. Introduce one new food over a 2- to 3-day period and monitor any symptoms. For example, have porridge for breakfast on the first day; then add beans or extra vegetables to a casserole two days later; then maybe have an extra piece of fruit 2 to 3 days later.

Consume plenty of fluids

Fibre needs water, so one should aim to drink at least 8 to 10 cups of water daily or other fluids such as herbal teas or sugar-free squash. People suffering from diarrhoea will need to make sure they are replacing these lost fluids. Drinking water will also help to improve constipation.

Making golden linseeds a part of diet

Including these in the diet may improve symptoms of wind, bloating, constipation and diarrhoea. They are a source of insoluble and soluble fibre, and can be added to casseroles, stews, soups, porridge, cereals, yoghurts and desserts. Include one tablespoon each day.

Cutting down on greasy foods

Some people find that fatty foods are difficult to digest and can cause symptoms of diarrhoea; therefore, reducing fat in the diet may help:

Limit cakes, biscuits, chocolates and pastries.

Cut down on fatty meat products such as sausages, pies and pastries.

Use lower-fat dairy products – eg, low-fat yoghurt, cottage cheese, semi-skimmed milk.

Choose tomato-based sauces rather than creamy sauces – although some tomato sauces can be oily so check the label.

Use small amounts of cheese (a matchbox size is a portion) – stronger-flavoured cheeses may help you to use less.

Care should be taken when using dressings and sauces such as mayonnaise and salad cream. Small amounts should be taken and one should try the reduced-fat versions.

Cut off visible skin of meat and choose leaner cuts of meat.

Use minimal oil/butter when cooking (use an oil spray, or measure using one teaspoon of oil per person, per meal).

Try different cooking methods such as steaming, boiling, microwaving, roasting, grilling and poaching rather than frying.

Cutting down on fructose

Fructose can cause diarrhoea in some people, particularly when eaten in large quantities. Sometimes fructose is not well absorbed, and can draw water from the body into the bowel, causing osmotic diarrhoea. If fructose is not well absorbed, it is fermented in the colon and gases are produced, causing wind and bloating in some IBS sufferers.

One should try limiting fruit intake to no more than three portions each day. One should have only one small glass (150 ml) of fruit juice per day. Having more vegetables will help to meet the recommendation of at least five portions of fruit and vegetables each day. A portion is about 80 g, or what might fit in the palm of one’s hand. A portion of dried fruit is about one tablespoon.

It might be useful to limit honey, which contains fructose. Sometimes ‘high-fructose corn syrup’ or ‘corn syrup solids’ are added to processed foods, so try avoiding or limiting these. The labels should be checked for these ingredients.

Avoiding sorbitol

Sorbitol is poorly absorbed and has a laxative effect when it enters the colon, so this can cause symptoms of bloating and diarrhoea. IBS sufferers may be sensitive to smaller amounts of sorbitol.

Sorbitol is found in artificial sweetener, low-sugar sweets, drinks, mints and gum and often found in diabetic or slimming products. Also the labels of these products should be checked for mannitol and xylitol, which have a similar effect.

Try probiotics

Probiotics may be useful in improving symptoms of IBS, although they do not work for everybody. Probiotics can help to balance our gut bacteria. The ‘good’ bacteria in probiotics compete with ‘bad’ bacteria for space in the gut. This means that there are fewer ‘bad’ bacteria, making it a healthier gut environment. This can help with digestion and to improve symptoms of wind, bloating and diarrhoea.

There are a number of probiotic products available, including yoghurts, drinks and supplements such as tablets, capsules or sachets. Probiotics need to be taken in the recommended dose every day for at least four weeks. Monitoring symptoms can help to identify any benefit. Other brands contain different mixtures of bacteria, so trying a different product may help if there is no success with one particular brand.

Elimination diets

Some people find that even after making these dietary changes, their symptoms are still not improving. Avoidance of single foods or following elimination diets might have some benefit for people with IBS. Such dietary regimes should only be followed under the assistance of a dietician.

Food intolerance

Some people with IBS may have a food intolerance. Testing and diagnosing a food intolerance involves a hydrogen breath test which can be arranged by a doctor. However, this is not always available or appropriate. Diets that exclude suspected foods can help to identify a food intolerance.

If it is thought that particular foods are causing symptoms, a dietician may advise you to exclude these foods for a certain time period. This is to monitor whether symptoms improve when these foods are taken out of the diet. After this time period (usually 2-4 weeks) the foods are gradually re-introduced to see if symptoms come back. Common intolerances include lactose (found in milk and dairy products), wheat (found in bread, cereals and pasta) and caffeine (found in tea, coffee or cola).

The low FODMAP diet

There is a growing body of evidence that the low FODMAP diet is effective in improving symptoms of IBS. FODMAP stands for:

Fermentable

Oligo

Di

Mono-saccharides

And

Polyols

These are a group of short-chain carbohydrates that are not very well absorbed in the gut (small intestine). These carbohydrates are easily fermented and cause more fluid to enter the large bowel, leading to gas, bloating and diarrhoea. Reducing the total amount of these fermentable sugars may

CONCLUSION

One of the most common gut disorders is Irritable bowel syndrome (IBS)The cause is not known. Symptoms can be quite variable and include tummy (abdominal) pain, bloating, and sometimes bouts of diarrhoea and/or constipation. Symptoms tend to come and go. There is no cure for IBS, but symptoms can often be eased with treatment.

It’s unclear as to what exactly causes IBS in adults and a variety of factors are involved. These include sensitivity of the gut, inflammation of the lining in the digestive tract and disturbance of movements in the bowels. Many of those who have the condition report that making dietary changes can help them to manage their IBS, ease symptoms and improve quality of life.