Irritable bowel syndrome (IBS) is a common condition. It often has a significant impact on quality of life. The main symptoms of IBS are abdominal pain with some change in bowel habit. Either constipation or diarrhoea, or alternating between the two.
There is probably more than one cause of IBS. Or a combination of triggers. There are certainly a number theories. These include an over sensitive gut, abnormal movement of the gut and changes in the composition of the gut bacteria. We do know that IBS is what we describe as a functional disorder. Meaning there is no structural change to the gut but there is a change in how the gut functions. So approaching IBS from a functional medicine perspective can help.
A functional medicine approach aims to restore proper function, improve health and eliminate symptoms. Functional medicine interventions might comprise solely of dietary changes. But additional options include herbal remedies, lifestyle changes and stress management techniques.
A functional medicine approach for IBS follows a number of steps. The first step is identification and removal of whatever is considered to be in excess. This could be something the person eats or drinks. Or lifestyle factors such as stress, or even pathogenic bacteria in the gut. Or it could involve aspects of all the above.
Most people diagnosed with IBS relate their symptoms of pain and bloating with eating certain foods. And eating wheat is identified by many to trigger or exacerbate symptoms. But in studies many people reported that certain vegetables and fruits also caused problems for them.
This lead to the development of the low FODMAP diet for IBS. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. FODMAPS are short chain carbohydrates that instead of being digested, are fermented by the gut microbiota. The products of the fermentation cause painful gas and bloating of the intestines.
The low FODMAP diet is an elimination diet. It excludes the foods that are high in the short chain carbohydrates. These tend to occur in foods that are otherwise considered healthy such as vegetables and fruits. Restricting the high FODMAP containing foods usually relieves many of the IBS symptoms. And, even in people that said gluten was a trigger for their symptoms. The low FODMAP diet provided greater relief than a gluten-free diet.
The low FODMAP diet for irritable bowel syndrome was developed by Monash University and there is more information on their website here.
In many cases of IBS following the low FODMAP diet will significantly reduce symptoms. However, the low FODMAP diet should not be considered a long term solution. The researchers that developed the diet suggested it should be used for up to 6 weeks. Then eliminated foods should be gradually re-introduced. One very important reason is because reducing FODMAPs reduces the numbers of beneficial gut microbes.
If you have a diagnosis of IBS and have tried a low FODMAP diet without complete success then additional interventions may be necessary and you may need to talk to a functional medicine practitioner.