Diet for IBS pain in irritable bowel syndrome
Diet does not help all people suffering with IBS pain – however, when it is playing a role its effect can be profound. People report it helping with a variety of uncomfortable symptoms including stomach pain after eating, gurgling stomach, bloating, wind, cramping bowel pain, constipation symptoms, looseness and colon pain. It can help where symptoms look like lactose intolerance symptoms in IBS. Because the IBS diet it is not the same for every diet-affected person, and because diet does not help everyone, some doctors may say diet has no role in IBS. In addition, sometimes people report that they are sure of a food reaction on one occasion but it does not happen every time they eat that food. But dietitians research at RPAH in Sydney and my own clinical work has shown that IBS symptoms improve on the diet and return when suspect foods are re-introduced. Indeed, so central is IBS to food intolerance and sensitivity, that it can be a diagnostic aid. That is, if a family (including grandparents, parents, aunts, uncles, and children) has members which have headaches, IBS and eczema, then there is a strong likelihood that members of the family are food sensitive, and thus that use of the Diet Detective Method for diet investigation will improve the problem.
There are many conditions which have specific diets. We are all familiar with the gluten free diet for coeliacs, the lactose intolerance diet, diets for weight control, and for coronary heart disease. Diet management for food intolerance and sensitivity symptoms is different. It is more like allergy where everyone has their own allergies. Unfortunately however, there are no helpful tests which show that a person is food intolerant or sensitive! Diet therapy begins with the exclusion of all the foods that you already suspect. In addition there is a need to consider what I call “the layer underneath”. These are foods known to cause reactions from clinical research but are much less likely to be a problem on their own. Small amounts of these foods add up so the likelihood of a reaction when the usual suspect foods are eaten is much greater. You can use the diet detective method to design your own Family Elimination Diet. It considers only the additives, food chemicals and foods that are known to be suspect from the research and adds that to those foods considered suspect from the Family sensitivity history. Additionally you can decide how strict you want it to be: easy to manage or stricter to get good results, or very careful. Then you do challenges to show if diet symptoms do return with food reintroduction. If symptoms return you then test individual foods and additives to develop your own diet made up of all the foods you do not react to and occasional ones you have only mild reactions to. This allows you to manage in the real world where you want to eat with others as normally as possible and have outings.
Some foods are particularly associated with causing reactions in IBS. Spice may be an obvious culprit for certain people, and rich foods eaten out are reported as suspect in others – though often the reaction may not be until 2 am the next morning or even the next day. The relationship between IBS and diet is often sufficiently evident to IBS-sufferers that they have previously performed their own diet investigation – sometimes trialling exclusion of sugar, yeast, milk, wheat and fructose. They often find some initial improvement, but it usually does not last over time. This is why systematic diet investigation through the diet detective process is so important – it identifies all the suspect foods that can be playing a role, and allows the food-sensitive person to be aware of how they can add together to cause the symptom.
In babies food caused tummy problems are called colic, in children they are called tummy aches, in the teens they are often called abdominal migraine, or spastic colon, and in adults irritable bowel syndrome. They rarely happen continuously. Babies may grow out of colic. Tummy aches or abdominal migraine may gradually fade out, and IBS often does not begin until well into adulthood. The name may change but where food intolerance or sensitivity is present diet will have a role in all of them. It is interesting to note that adults with IBS report that the many symptoms that form their particular IBS may all change in varying amounts. These include gut pain, bloating, wind, gut urgency [sometimes with faintness], need to recover after toileting, diarrhoea or constipation, explosive motions, strong smelling wind or motions, and reflux.
Diet is a natural cure for IBS pain. Because diet is a natural IBS treatment, it does not have any side effects and does not interfere or interact adversely with any other medication you need to have.
Each patient has their own particular cluster of symptoms – often IBS will be accompanied by other food-sensitivity symptoms like headaches, eczema and moodiness. A bonus of this diet detective work is that people regularly report improvements in other symptoms. They report their mood as calmer, no longer waking as often, or after having bad dreams, and decreased body odour, and less fuzzy thinking.
One interesting fact about food sensitive people with IBS pain is that they often have a very good sense of smell, particularly of stale food in the refrigerator. I remember one patient remarking “When I can smell milk that is “off” to me and I give it to my mother, she just can’t smell it!” While they can be seen as “fussy” by relatives or work mates, this sensory sensitivity is in fact very useful. When present, it means that you can detect changes that mean particular amines are increasing in the food. For non-food-sensitive people, some amine changes are not a problem – they may enjoy the “aged” or “matured” taste in wines or cheeses. But food-sensitive people should trust their noses, and not eat any food that smells “strong” or “off” to them. For more details of this interesting phenomenon, see the article on “Supertasters” and “Supersmellers” in the chapter on understanding food sensitivity in Are You Food Sensitive?
Joan Breakey Specialist Food Sensitivity Dietitian www.FoodIntolerancePro.com