General Treatment and Diet for Irritable Bowel Syndrome (IBS)

Diet and stress are the most common triggering factors for IBS. Modification in these two areas can be beneficial in the management of IBS:

Diet

1. Avoid food triggers:

Avoiding the food that triggers the symptoms is very useful for the management of the disease. The food that triggers the symptoms of IBS varies largely from person to person. However, the common triggers include

a. Fatty foods b. Caffeine: coffee, tea, chocolate, and cola drinks c. Gas-producing vegetables such as beans and broccoli, cabbage, coleslaw, beans d. Milk, cheese, and dairy products that cannot digest milk sugar lactose (Because dairy products are an important source of calcium and other nutrients that your body needs, be sure to get adequate nutrients in the foods that you substitute). e. Alcohol and alcoholic beverages, including beer, wine, and "mixed" drinks. f. Smoking

2. Avoid large meals:

Large meals can cause cramping and diarrhea in people with IBS. Symptoms may be eased if you eat smaller meals more often or just eat smaller portions. This should help, especially if your meals are low in fat and high in carbohydrates, such as pasta, rice, whole-grain bread and cereals, fruits, and vegetables.

3. Addition of fiber:

Dietary fiber may lessen IBS symptoms in many cases. Whole-grain bread and cereals, beans, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help to prevent spasms from developing. Some forms of fiber also keep water in the stools, thereby preventing hard stools that are difficult to pass.

4. Judicious water intake in patients who predominantly experience constipation is recommended.

5. Stress:

Psychological therapies can also help teach people ways to cope with the stress that can trigger bouts of IBS.

Psychological treatments should be considered symptoms are severe and are associated with psychological distress. Some of the treatments that have been used successfully include but are not limited to cognitive-behavioral therapy, biofeedback therapy, relaxation therapy, and hypnotherapy.

The core of cognitive-behavioral therapy is the way a person thinks about their bowel symptoms. For example, thoughts or cognitions such as "there must be more stool in my rectum to evacuate" can lead to anxiety or attention, which, in turn, can lead to increased IBS symptoms such as sensations of incomplete evacuation. During cognitive-behavioral therapy, patients learn exercises and strategies to control their symptoms. Therefore, cognitive-behavioral therapy retrains patients' cognitions about their illness beliefs as it pertains to their gastrointestinal symptoms. Several studies have found cognitive-behavioral therapy to be superior to control treatment.

Biofeedback and relaxation training for IBS is designed to increase awareness and control of physical and emotional responses and is particularly useful in helping patients control the physiological consequences of stress. Typical techniques used in biofeedback and relaxation therapy include breathing and muscle relaxation, hypnosis or imagery techniques, or a combination of these.

Hypnotherapy uses techniques aimed at increasing suggestibility in patients.

Proper rest and exercise can help reduce stress levels and help control IBS.

Written & Approved by-

Dr. Rajesh Shah

M.D. (Hom.)