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Irritable bowel syndrome (IBS) is when you have abdominal pain, often with severe bloating, gas, and frequent diarrhea and/or constipation that can’t be explained. Symptoms can appear all of a sudden or up to three hours after eating. Symptoms may improve briefly after a bowel movement. While its cause is unknown, IBS does not cause lasting damage of the intestines. Changing diet can reduce symptoms of IBS.
Drink plenty of liquids each day. Aim for eight or more cups of water, on top of other liquids daily. Healthy bowels need plenty of water to work well and extra water is needed when fiber is increased. Be sure you urinate at least two times in an eight-hour period.
Eat small meals more often. Try to spread out your food throughout the day by eating 4-5 smaller meals, rather than 2 or 3 large meals.
Limit fatty foods and total fat at meals. High fat intake can cause the colon to spasm in some people. Limit fat to 15-20 grams at a meal.
Increase soluble fiber. Soluble fiber stays in your gut longer, which may help to digest food. Food sources of soluble fiber are: dried or canned beans, oats, barley, fruits and vegetables. Fiber supplements may help. Start with 1 serving of methylcellulose (like Citrucel™) or psyllium (like Metamucil™) per day. Slowly increase dose to get desired effect.
Avoid or limit “non-dietary” fibers (inulin, chicory root). These are often added to wheat or bran cereals and fiber fortified foods (granola bars, yogurt). These fibers may increase gas and other symptoms.
Relax while you are eating. Take time to chew foods well and to sip drinks slowly. Avoid washing food down with liquids. When you don’t chew foods well, they take too long to digest which can cause bacteria in the bowel to ferment, causing gas.
Reduce coffee. Coffee can increase diarrhea and spasms in the intestines for some people. Decaf coffee may still cause symptoms.
Avoid or limit alcohol. Alcohol can make IBS symptoms worse.
Try peppermint oil. Taking 90 mg of enteric-coated peppermint capsules up to three times daily may help reduce symptoms. These relax the muscles of intestinal tract. IBgard®, Mason® and Heather’s Tummy Tamers® are some good brands. They are sold online and at drug stores.
Ask a registered dietitian about a low FODMAP diet. This diet limits some sugars and starches that can cause IBS symptoms. The low FODMAP diet is a short-term learning process which helps you learn specific food triggers as well as how to manage them.
Think about spices. Reduce spices such as hot sauce, spicy barbecue sauce, hot chili peppers, garlic, and curry. Small amounts may be okay. Keep a food log to help figure out if a certain spice is causing symptoms.
Avoid or limit foods that cause problems for you. Each person is unique. Carbonated drinks or certain fruits and vegetables may cause your IBS symptoms. Sometimes it is the amount of food that is the problem and choosing smaller portions may help.
Make time to manage your stress. IBS symptoms often get worse when you are stressed. Take a class to learn how to manage your stress or consult with a health psychologist.
Exercise on a regular basis. Exercise helps digest food and can reduce stress. Aim for 30 minutes of moderate exercise three to four times per week to try to reduce IBS symptoms. (Exercise causes the bowel to become active, so plan to exercise at the time of day that you tend not to have symptoms.)
To Find out More
National Digestive Disease Information Clearing House -NIH www.niddk.nih.gov/health/digest/nddic.htm
The American Gastroenterological Association www.gastro.org
What is the most important thing you learned from this handout?
What changes will you make in your diet/lifestyle, based on what you learned today?
If you are a UW Health patient and have more questions, please contact UW Health at one of the phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.
Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached: (608) 890-5500.
Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770