All Health Diets Recipes Family Sex & relationships Search

• You are here:
• goodtoknow
• Health
• Your condition
• Irritable bowel syndrome (IBS)

What are the treatments for irritable bowel syndrome?

Many people are reassured that their condition is IBS, and not something more serious such as colitis. Simply understanding about IBS may help you to be less anxious about the condition, which may ease the severity of symptoms. Symptoms often settle for long periods without any treatment. In some cases, symptoms are mild and do not require treatment. If symptoms are more troublesome or frequent, one or more of the following may help.

Fibre

The advice about fibre in treating IBS has changed somewhat over the years. Fibre (roughage) is the part of the food which is not absorbed into the body. It remains in your gut, and is a main part of faeces (stools). There is a lot of fibre in fruit, vegetables, cereals, wholemeal bread, etc. It used to be said that eating a high fibre diet was good at easing IBS symptoms. Then various research studies showed that a high fibre diet can, in some cases, make IBS worse. So, one recent guideline on IBS (from Clinical Knowledge Summaries - cited at the end) states that "high fibre diets are not recommended for people with IBS". But since that guideline was published, a review of treatments for IBS (Ford et al - cited at the end) concluded that fibre was good at easing symptoms in some people with IBS. So, the role of fibre can be confusing!

What seems to be the case is that the type of fibre is probably important. There are two main types of fibre - soluble fibre (which dissolves in water) and insoluble fibre. It is soluble fibre rather than insoluble fibre that seems to help ease symptoms in some cases. So, if you increase fibre, have more soluble fibre and try to minimise the insoluble fibre.

• Dietary sources of soluble fibre include oats, ispaghula (psyllium), nuts and seeds, some fruit and vegetables and pectins. A fibre supplement called ispaghula powder is also available from pharmacies and health food shops. The recent review of treatments for IBS mentioned earlier mentions ispaghula as the fibre supplement that seems to be the most beneficial.
• Insoluble fibre is chiefly found in corn (maize) bran, wheat bran and some fruit and vegetables. In particular, avoid bran as a fibre supplement.

Foods, drinks and lifestyle

A healthy diet is important for all of us. However, some people with IBS find certain foods of a normal healthy diet can trigger symptoms or make symptoms worse. Current national guidelines about IBS include the following points about diet which may help to minimise symptoms:

• Have regular meals and take time to eat at a leisurely pace.
• Avoid missing meals or leaving long gaps between eating.
• Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas. This helps to keep the faeces (stools) soft and easy to pass along the gut.
• Restrict tea and coffee to three cups per day (as caffeine may be a factor in some people).
• Restrict the amount of fizzy drinks that you have to a minimum.
• Don't drink too much alcohol. (Some people report an improvement in symptoms when they cut down from drinking a lot of alcohol, or stop smoking if they smoke.)
• Consider limiting intake of high-fibre food (but see the section above where an increase may help in some cases).
• Limit fresh fruit to three portions (of 80 g each) per day.
• If you have diarrhoea, avoid sorbitol, an artificial sweetener found in sugar-free sweets (including chewing gum) and drinks, and in some diabetic and slimming products.
• If you have a lot of wind and bloating consider increasing intake of oats (for example, oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon per day). You can buy linseeds from healthfood shops.

Individual food intolerance

Some people with IBS find that one or more individual foods can trigger symptoms, or make symptoms worse ('food intolerance or sensitivity'). If you are not sure if a food is causing symptoms, it may be worth discussing this with a doctor who may refer you to a dietician. A dietician may be able to advise on an 'exclusion diet'. For example, one meat, one fruit, and one vegetable. Then, advise on adding in different foods gradually to your diet to see if any cause the symptoms. It may be possible to identify one or more foods that cause symptoms. This can be a tedious process, and often no problem food is found. However, some people say that they have identified one or more foods that cause symptoms, and then can control symptoms by not eating them.

The foods that are most commonly reported to cause IBS symptoms in the UK are: wheat (in bread and cereals), rye, barley, dairy products, coffee (and other caffeine-rich drinks such as tea and cola), and onions.

Probiotics

Probiotics are nutritional supplements that contain 'good' bacteria. That is, bacteria that normally live in the gut and seem to be beneficial. Taking probiotics may increase the 'good' bacteria in the gut which may help to ward off 'bad' bacteria that may have some effect on causing IBS symptoms. You can buy probiotic capsules (various brands) from pharmacies. The dose is on the product label. You can also buy foods that contain probiotic bacteria. These include certain milk drinks, yoghurts, cheeses, frozen yoghurts, and ice creams. They may be labelled as 'probiotic', 'containing bacterial cultures', or 'containing live bacteria'.

There is some evidence that taking probiotics may help ease symptoms in some people with IBS. At present, there are various bacteria that are used in probiotic products. Further research is needed to clarify the role of probiotics and which one or ones are most helpful. In the meantime, if you wants to try probiotics, you should keep to the same brand of probiotic containing product for at least four weeks to monitor the effect. Perhaps try a different probiotic for at least a further four weeks if the first one made no difference.

Other lifestyle factors

Regular exercise may also help to ease symptoms. Stress and other emotional factors may trigger symptoms in some people. So, anything that can reduce your level of stress or emotional upset may help.

It may help to keep a food and lifestyle diary for 2-4 weeks to monitor symptoms and activities. Note everything that you eat and drink, times that you were stressed, and when you took any formal exercise. This may identify triggers, such as a food, alcohol, or emotional stresses, and may show if exercise helps to ease or prevent symptoms.

Quick links

• Terms and conditions
• Privacy policy
• Disclaimer
• Advertise with us

© copyright goodtoknow.co.uk 2009