Irritable Bowel Syndrome (IBS)

Living Positively

Lifestyle changes for IBS

The following lifestyle changes may help to prevent or ease your IBS symptoms:
  • Exercise regularly to promote movement of the colon and reduce stress. Exercise can take many forms, but 20 to 30 minutes of activity at least three times per week can be helpful.
  • Get enough rest. A lack of sleep and fatigue can worsen the symptoms of IBS.
  • Minimize stress and tension. The brain and colon are linked through many complex pathways and emotional stress can disrupt intestinal function and cause pain.
  • Yoga, meditation, and slow, relaxed breathing techniques can help people with IBS manage stress.
  • Limit intake of caffeine, alcohol, carbonated drinks and fatty foods.
  • Follow through on an urge to have a bowel movement, if at all possible.

Dietary changes for IBS

Food intolerances have been linked to IBS symptoms for many years, however conflicting information often creates confusion and frustration as to what foods IBS patients should include, or avoid, in their diet. Recent research has identified six key strategies for the successful dietary management of IBS.
  • Rule out lactose intolerance. The symptoms of lactose intolerance (an inability to digest the sugar in milk) and the symptoms of IBS often overlap.
  • Limit insoluble fibre. The type of fibre in the diet is important for people with IBS. Insoluble fibre (cannot dissolve in water) which is found primarily in wheat bran, brown rice, seeds, nuts, dried fruit and whole grain breads, adds bulk to the stool and can aggravate IBS symptoms in some people. Peeling fruits and vegetables to remove the high insoluble fibre skin or peel can be beneficial.
  • Supplement with linseeds for constipation: Linseeds (also known as flaxseed) may help to relieve constipation, abdominal discomfort and bloating. For IBS patients with constipation, adding ground linseeds to the diet for a 3-month trial may help bowel function.
  • Reduce fermentable carbohydrates (FODMAPs): Fermentable carbohydrates (also known as FODMAPs), are small carbohydrate (sugar) molecules found in everyday foods that may be poorly absorbed in the small intestine of some people. FODMAPs are fermented (digested) by intestinal bacteria, which can lead to symptoms of abdominal pain, excess gas, constipation and/or diarrhea. Following a low-FODMAP diet may help to reduce gastrointestinal symptoms in 75% of IBS patients.
  • Try a probiotic. Probiotics are live microorganisms that, when taken in adequate amounts over sufficient time, may provide a health benefit. They are natural, ‘healthy’ bacteria that may help with digestion and offer protection from harmful bacteria in the intestines. Studies have found that, in some cases, probiotics may help to improve symptoms of IBS. If other dietary strategies have not been successful, a 4-week trial of a probiotic (in the dose recommended by the manufacturer) may be helpful. Probiotics are not medicine. They are available to purchase as capsules, tablets or powders, and can also be found in some fortified yogurts and fermented milk products. However, not all probiotics are the same. It is important to choose a product that is reliable, proven to be safe and offers benefits for the specific symptoms you want to relieve. Speak to your doctor or pharmacist about which probiotic may be right for you. It is important to take the probiotic in the dose and duration recommended by the manufacturer to achieve the best results.
  • Eliminate a suspected trigger food for 2-4 weeks: If a particular food seems to trigger IBS symptoms, eliminate the food from your diet for a period of 2 to 4 weeks. If symptoms do not improve during that time, the food is unlikely the cause of IBS symptoms.

Lifestyle Changes for IBS-C

Sometimes making simple changes to your lifestyle can be helpful for managing mild IBS-C symptoms such as:
  • Regular exercise not only increases your strength, it can also boost bowel activity.
  • Get enough rest. This allows your body to maintain basic function, repair and manage stress.
  • As already mentioned, stress can affect bowel function. Try to find ways to manage your stress at home, work or school through good time management practices and prioritizing your health.
  • Limit alcohol consumption
  • Don’t smoke

Dietary Changes for IBS-C

Some foods support good bowel health while others can increase constipation. It is important to recognize the impact certain foods have on your digestive and overall health. Below are a few suggestions that may be helpful:
  • Reduce gassy foods: If bloating is bothersome or you are passing more than usual amounts of gas, your doctor may suggest eliminating trigger foods such as: carbonated beverages, greasy, fried foods, and refined sugar.
  • Increase fluids: Try to consume adequate amounts of non-caffeinated, low sugar liquids each day. Healthy fluids include water, juices, milk and low sodium soups. Avoid liquids high in refined sugar or artificial sweeteners.
  • Increase Soluble fibres: Soluble fibres are derived from plants and cannot be broken down or absorbed. This fibre attracts water and turns into gel during digestion, slowing digestion and making stools soft and easy to pass.
  • Increase Insoluble fibres: Insoluble fibres are not broken down or absorbed by the digestive system. These fibres add bulk to stool, which helps move stool through the digestive tract.
  • Explore a Low-FODMAP Diet: Some individuals are sensitive to types of carbohydrates such as fructose, fructans, lactose and others. These are called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). FODMAPs are found in certain grains, vegetables, fruits and dairy products.

Lifestyle and Diet Changes for IBS-D:

  • Identify food triggers – Tracking foods you eat and logging the times you experienced symptoms/distress may help reveal connections between food and IBS-D. You should take detailed notes that should include the types and amounts of foods eaten and the time of consumption. It’s important to also record the time and description of distressing bowel events or related pain and discomfort. Below are some dietary considerations which you may want to discuss with your doctor and/or registered dietitian.
  • High-fat foods may worsen symptoms of IBS-D
  • Dairy products – lactose free products may be better tolerated
  • Avoid alcohol
  • A reduction of caffeine may be beneficial. This includes caffeinated drinks, such as coffee, tea, colas and energy drinks
  • Sorbitol sweeteners (found in some chewing gum) may be problematic
  • Drink plenty of water
  • Probiotic supplements such as lactobacillus acidophilus may help alleviate IBS symptoms including abdominal pain, bloating, and bowel movement irregularity. Ask your health care professional for more information.
  • A diet low in FODMAPs (fermentable oligo-saccharides, di-saccharides, mono-saccharides, and polyols), a group of short-chain carbohydrates, may help relieve symptoms. The diet is used in the short-term followed by re-introduction to assess tolerance to individual foods. Consult your health-care professional for more information.
  • Eating large meals also may trigger abdominal cramping and diarrhea. It’s best to eat smaller meals.
  • Fibre may be helpful in reducing symptoms of IBS-D. If a trial of a fiber supplement such as psyllium is used, fiber should be added gradually, because it initially may worsen bloating and gassiness. If you have IBS-D, look for foods with more soluble fiber, the type that takes longer to digest (such as that found in oats).
  • Stress is considered one of the triggers of IBS symptoms. Here are some healthy habits that may also help reduce IBS symptoms.
  • Exercise may improve and could reduce stress.
  • Get enough rest. This allows your body to maintain basic function, repair and manage stress.
  • Use relaxation techniques: deep breathing, visualization, Yoga.
  • Consult a professional trained in Cognitive Behavioral Therapy or Gut Directed Hypnotherapy.

How do I prepare to talk to my doctor about IBS?

Good communication with your doctor is an important part of effective management of a functional GI disorder like IBS. Before your appointment, take the time to keep a symptom journal that can help you and your doctor see patterns in your activities and identify specific triggers for your symptoms.

Include the following information in your IBS journal:

• Write down the symptoms that are bothering you and how long you have had them. • Write down key personal and medical information, including any recent changes or stressful events in your life. • Make a list of the triggers (food, stress, activity, menstrual cycle) that seem to make your symptoms worse. • Make a list of medications are you taking, including the conditions you take them for. Also note if any of your medications seem to affect your symptoms. • Talk to your family members and note if any relatives have been diagnosed with IBS, inflammatory bowel disease (IBD), celiac disease or colon cancer. • Questions to ask your doctor during your appointment. You may want to ask: • What do you think is causing my symptoms? • Are there other possible causes for my condition? • What diagnostic tests do I need? • Do these tests require any special preparation? • What treatment approach do you recommend trying first? • If the first treatment doesn’t work, what will we try next? • Are there any side effects associated with these treatments?

Living Positively

Lifestyle changes for IBS

The following lifestyle changes may help to prevent or ease your IBS symptoms:
  • Exercise regularly to promote movement of the colon and reduce stress. Exercise can take many forms, but 20 to 30 minutes of activity at least three times per week can be helpful.
  • Get enough rest. A lack of sleep and fatigue can worsen the symptoms of IBS.
  • Minimize stress and tension. The brain and colon are linked through many complex pathways and emotional stress can disrupt intestinal function and cause pain.
  • Yoga, meditation, and slow, relaxed breathing techniques can help people with IBS manage stress.
  • Limit intake of caffeine, alcohol, carbonated drinks and fatty foods.
  • Follow through on an urge to have a bowel movement, if at all possible.

Dietary changes for IBS

Food intolerances have been linked to IBS symptoms for many years, however conflicting information often creates confusion and frustration as to what foods IBS patients should include, or avoid, in their diet. Recent research has identified six key strategies for the successful dietary management of IBS.
  • Rule out lactose intolerance. The symptoms of lactose intolerance (an inability to digest the sugar in milk) and the symptoms of IBS often overlap.
  • Limit insoluble fibre. The type of fibre in the diet is important for people with IBS. Insoluble fibre (cannot dissolve in water) which is found primarily in wheat bran, brown rice, seeds, nuts, dried fruit and whole grain breads, adds bulk to the stool and can aggravate IBS symptoms in some people. Peeling fruits and vegetables to remove the high insoluble fibre skin or peel can be beneficial.
  • Supplement with linseeds for constipation: Linseeds (also known as flaxseed) may help to relieve constipation, abdominal discomfort and bloating. For IBS patients with constipation, adding ground linseeds to the diet for a 3-month trial may help bowel function.
  • Reduce fermentable carbohydrates (FODMAPs): Fermentable carbohydrates (also known as FODMAPs), are small carbohydrate (sugar) molecules found in everyday foods that may be poorly absorbed in the small intestine of some people. FODMAPs are fermented (digested) by intestinal bacteria, which can lead to symptoms of abdominal pain, excess gas, constipation and/or diarrhea. Following a low-FODMAP diet may help to reduce gastrointestinal symptoms in 75% of IBS patients.
  • Try a probiotic. Probiotics are live microorganisms that, when taken in adequate amounts over sufficient time, may provide a health benefit. They are natural, ‘healthy’ bacteria that may help with digestion and offer protection from harmful bacteria in the intestines. Studies have found that, in some cases, probiotics may help to improve symptoms of IBS. If other dietary strategies have not been successful, a 4-week trial of a probiotic (in the dose recommended by the manufacturer) may be helpful. Probiotics are not medicine. They are available to purchase as capsules, tablets or powders, and can also be found in some fortified yogurts and fermented milk products. However, not all probiotics are the same. It is important to choose a product that is reliable, proven to be safe and offers benefits for the specific symptoms you want to relieve. Speak to your doctor or pharmacist about which probiotic may be right for you. It is important to take the probiotic in the dose and duration recommended by the manufacturer to achieve the best results.
  • Eliminate a suspected trigger food for 2-4 weeks: If a particular food seems to trigger IBS symptoms, eliminate the food from your diet for a period of 2 to 4 weeks. If symptoms do not improve during that time, the food is unlikely the cause of IBS symptoms.

Lifestyle Changes for IBS-C

Sometimes making simple changes to your lifestyle can be helpful for managing mild IBS-C symptoms such as:
  • Regular exercise not only increases your strength, it can also boost bowel activity.
  • Get enough rest. This allows your body to maintain basic function, repair and manage stress.
  • As already mentioned, stress can affect bowel function. Try to find ways to manage your stress at home, work or school through good time management practices and prioritizing your health.
  • Limit alcohol consumption
  • Don’t smoke

Dietary Changes for IBS-C

Some foods support good bowel health while others can increase constipation. It is important to recognize the impact certain foods have on your digestive and overall health. Below are a few suggestions that may be helpful:
  • Reduce gassy foods: If bloating is bothersome or you are passing more than usual amounts of gas, your doctor may suggest eliminating trigger foods such as: carbonated beverages, greasy, fried foods, and refined sugar.
  • Increase fluids: Try to consume adequate amounts of non-caffeinated, low sugar liquids each day. Healthy fluids include water, juices, milk and low sodium soups. Avoid liquids high in refined sugar or artificial sweeteners.
  • Increase Soluble fibres: Soluble fibres are derived from plants and cannot be broken down or absorbed. This fibre attracts water and turns into gel during digestion, slowing digestion and making stools soft and easy to pass.
  • Increase Insoluble fibres: Insoluble fibres are not broken down or absorbed by the digestive system. These fibres add bulk to stool, which helps move stool through the digestive tract.
  • Explore a Low-FODMAP Diet: Some individuals are sensitive to types of carbohydrates such as fructose, fructans, lactose and others. These are called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). FODMAPs are found in certain grains, vegetables, fruits and dairy products.

Lifestyle and Diet Changes for IBS-D:

  • Identify food triggers – Tracking foods you eat and logging the times you experienced symptoms/distress may help reveal connections between food and IBS-D. You should take detailed notes that should include the types and amounts of foods eaten and the time of consumption. It’s important to also record the time and description of distressing bowel events or related pain and discomfort. Below are some dietary considerations which you may want to discuss with your doctor and/or registered dietitian.
  • High-fat foods may worsen symptoms of IBS-D
  • Dairy products – lactose free products may be better tolerated
  • Avoid alcohol
  • A reduction of caffeine may be beneficial. This includes caffeinated drinks, such as coffee, tea, colas and energy drinks
  • Sorbitol sweeteners (found in some chewing gum) may be problematic
  • Drink plenty of water
  • Probiotic supplements such as lactobacillus acidophilus may help alleviate IBS symptoms including abdominal pain, bloating, and bowel movement irregularity. Ask your health care professional for more information.
  • A diet low in FODMAPs (fermentable oligo-saccharides, di-saccharides, mono-saccharides, and polyols), a group of short-chain carbohydrates, may help relieve symptoms. The diet is used in the short-term followed by re-introduction to assess tolerance to individual foods. Consult your health-care professional for more information.
  • Eating large meals also may trigger abdominal cramping and diarrhea. It’s best to eat smaller meals.
  • Fibre may be helpful in reducing symptoms of IBS-D. If a trial of a fiber supplement such as psyllium is used, fiber should be added gradually, because it initially may worsen bloating and gassiness. If you have IBS-D, look for foods with more soluble fiber, the type that takes longer to digest (such as that found in oats).
  • Stress is considered one of the triggers of IBS symptoms. Here are some healthy habits that may also help reduce IBS symptoms.
  • Exercise may improve and could reduce stress.
  • Get enough rest. This allows your body to maintain basic function, repair and manage stress.
  • Use relaxation techniques: deep breathing, visualization, Yoga.
  • Consult a professional trained in Cognitive Behavioral Therapy or Gut Directed Hypnotherapy.

How do I prepare to talk to my doctor about IBS?

Good communication with your doctor is an important part of effective management of a functional GI disorder like IBS. Before your appointment, take the time to keep a symptom journal that can help you and your doctor see patterns in your activities and identify specific triggers for your symptoms.

Include the following information in your IBS journal:

• Write down the symptoms that are bothering you and how long you have had them. • Write down key personal and medical information, including any recent changes or stressful events in your life. • Make a list of the triggers (food, stress, activity, menstrual cycle) that seem to make your symptoms worse. • Make a list of medications are you taking, including the conditions you take them for. Also note if any of your medications seem to affect your symptoms. • Talk to your family members and note if any relatives have been diagnosed with IBS, inflammatory bowel disease (IBD), celiac disease or colon cancer. • Questions to ask your doctor during your appointment. You may want to ask: • What do you think is causing my symptoms? • Are there other possible causes for my condition? • What diagnostic tests do I need? • Do these tests require any special preparation? • What treatment approach do you recommend trying first? • If the first treatment doesn’t work, what will we try next? • Are there any side effects associated with these treatments?
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