Irritable Bowel Syndrome: Is a Stressed-Out Gut Stressing You Out?

Image by Anastasia Gepp from Pixabay¹

What Causes Irritable Bowel Syndrome?

Irritable bowel syndrome is cluster of symptoms including bloating, gas, abdominal cramps, constipation and/or diarrhea that can be triggered by multiple things including stress and different foods. Between 7 and 15% of the population are affected by IBS symptoms. There is not one clear cause of IBS, but many people who suffer from IBS are sensitive to lactose, fructose, and sorbitol/fodmaps. Gluten, dairy, alcohol, caffeine, etc. can all contribute to IBS flares, depending on what specific foods are triggering for an individual.² Changes in the gut microbiome, the good bacteria that live in the gut, are seen in IBS.³

There is also a link between serotonin and IBS which can help explain why IBS and mood issues like anxiety and depression are so closely tied together. Both production and use of serotonin are altered in people with IBS, thought it is not fully understood why. 95% of serotonin is in the gut and only 5% is in the brain. This can help explain why medications that regulate serotonin can be beneficial for IBS symptoms.⁴

Beyond the serotonin connection, constant concern about severe and embarrassing digestive symptoms triggered by eating different foods can cause more stress which can make the gut more sensitive leading to a vicious circle that needs to be addressed with both dietary and stress management to be successfully alleviate symptoms.⁵

Food Plan and Therapeutic Foods

A low FODMaP diet can be useful for symptom resolution and identifying trigger foods for people suffering from IBS. FODMaPs are highly Fermenatable Oligo-, Di-, and Mono- saccharides and Polyls that are known to contribute to bloating, gas, and other IBS symptoms in a significant number of people with IBS.² The low FODMaP diet is best used for a short time as it can negatively impact the gut microbiota and lead to more digestive issues later.⁶

The Low FODMaP diet includes foods that are lower in fructose like bananas, berries, melons, and maple syrup. Lactose free milk products or rice milk and hard cheeses, vegetables lower in fructans and galectins like carrots, celery, green beans, corn, tomato, and gluten free grains. Sweeteners that end in “-ose” may be included, sweeteners that end in “-ol” are to be avoided. Some foods like beans, legumes, excess wheat and rye, and some fruits and vegetables are to be avoided during the first phase of the diet. This allows the gut to calm down and the identification of which specific foods trigger symptoms when they are introduced back into the diet. The Low FODMaP diet can be used during IBS flares to calm the system then return to a more normal eating pattern and only avoid foods that you know are problematic for you.⁵ A helpful list of foods to include and to limit is available here: https://www.ibsdiets.org/fodmap-diet/fodmap-food-list/⁸

Ginger is helpful for reducing nausea and can settle the intestines by reducing spasms and improving muscle tone. One way to prepare ginger is by making tea using 250-500mg of powdered root or a piece of fresh ginger about the size of the pinkie in 150ml of boiling water for 5-10 and drinking before meals.⁵

Supplements

Probiotics can be helpful in treating IBS symptoms as they help to maintain the good bacteria in the gut. They are also important when using a low FODMaP diet because this eating plan can cause negative shifts in the balance of bacteria in the gut. Bifidobacterium infantis and Lactobaccillus plantarum, are two strains that have been studied and shown to help IBS. People who are immunocompromised or have severe pancreatic disease should be cautioned in the use of probiotics.⁵

Peppermint oil has been shown to improve IBS symptoms. In a randomized control trial, those using enteric-coated sustained release peppermint oil had a 40% reduction in their IBS symptom score with improvements in both individual symptoms and symptom severity.⁷ Using peppermint oil that is not enteric coated can irritate the stomach and cause heartburn.⁵

Conclusion

IBS is a challenging set of symptoms that reduce quality of life and there are no simple solutions, but there are many steps that you can take including identifying food triggers, being able to use a low FODMaP diet to tame symptoms. using ginger, probiotics, and peppermint oil as well as managing stress that can all help you get back in control of your life.

Ready to get started with personalized nutrition care? Click here to book your first session. It may even be covered by your insurance!

References

1. Image by <a href=”https://pixabay.com/users/nastya_gepp-3773230/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=4392164″>Anastasia Gepp</a> from <a href=”https://pixabay.com/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=4392164″>Pixabay</a&gt;
2. Altobelli E, Del Negro V, Angeletti PM, Latella G. Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis. Nutrients. 2017;9(9):940. Published 2017 Aug 26. doi:10.3390/nu9090940
3. Luo M, Zhuang X, Tian Z, Xiong L. Alterations in short-chain fatty acids and serotonin in irritable bowel syndrome: a systematic review and meta-analysis. BMC Gastroenterol. 2021;21(1):14. Published 2021 Jan 6. doi:10.1186/s12876-020-01577-5
4. Arbab Sikander; Satya Vati Rana; Kaushal Kishor Prasad (2009). Role of serotonin in gastrointestinal motility and irritable bowel syndrome. , 403(1-2), 0–55. doi:10.1016/j.cca.2009.01.028
5. Rakel, D. Integrative Medicine 4^th ed. Elsevier; 2018.
6. Dimidi E, Whelan K. Food supplements and diet as treatment options in irritable bowel syndrome. Neurogastroenterol Motil. 2020;32(8):e13951. doi:10.1111/nmo.13951
7. Alammar N, Wang L, Saberi B, et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019;19(1):21. Published 2019 Jan 17. doi:10.1186/s12906-018-2409-0
8. IBS Diets. FODMAP Food List. Updated 2021. Accessed November 19, 2021. https://www.ibsdiets.org/fodmap-diet/fodmap-food-list/