About Our Group and IBS*
Welcome to IBS Support Canada. If you have been diagnosed with Irritable Bowel Syndrome (IBS), you will find this group invaluable for information and support.
What is IBS?
IBS (also referred to as spastic colon and sometimes incorrectly as spastic colitis) is a devastating, potentially debilitating, condition that affects up to 20 per cent of the world’s population.
It’s not a disease. It's a functional disorder, which means the bowel simply does not work as it should.
The main symptoms of IBS are continuous or recurring lower abdominal pain or cramping (from mild to excruciating), along with bloating, gas, diarrhea (IBS-D), constipation (IBS-C) or alternating diarrhea and constipation (IBS-A).
IBS is usually first triggered by an “assault” to the digestive system such as a stomach flu, food poisoning, travellers' diarrhea or sometimes even diet pills. Once a person has developed IBS, it becomes a lifelong condition of which there is no effective medication or cure.
But don't panic! IBS can be controlled through diet and lifestyle.
It’s believed IBS is caused by a “brain-gut dysfunction”. This means IBS symptoms result from a hypersensitivity of the gut’s nervous system, along with misinterpretations of the nervous system messages from the gut by the central nervous system and the brain.
Basically, this circuit (from gut-to-brain and brain-to-gut) appears to be abnormal in IBS sufferers although the precise abnormalities are unclear.
For some reason, IBS affects three times as many women as it does men. This is mostly likely because IBS is affected by hormonal fluctuations. In fact, many women find their IBS worsens around their menstrual period when their body is undergoing many hormonal fluctuations.
Diagnosis of IBS is generally done through a process of exclusion. In other words, once a doctor has ruled out other possible illnesses, he or she may diagnose the person as having IBS. Illnesses that need to be ruled out before IBS can be diagnosed, include:
- Colon and carcinoid cancer
- Inflammatory bowel diseases (Crohn's and Ulcerative Colitis)
- Bowel obstructions
- Diverticulosis / Diverticulitis
- Food allergies, intolerances, and malabsorptions (fructose, lactose, etc.)
- Celiac (a genetic, autoimmune disorder resulting in gluten intolerance)
- Bacterial infections and small intestine bacterial overgrowth (SIBO)
- Intestinal parasites
- Ovarian cancer
Many people are bewildered about what to eat and what not to eat when they're diagnosed with IBS. A number of diets claim to help IBS, but the truth is many of them will make your IBS worse rather than better.
The best diet in the world for controlling IBS symptoms is one developed by Heather Van Vorous, an American woman who suffers from IBS herself. Heather outlines her diet on her website at http://www.eatingforibs.com and in two published books:
- Eating For IBS
- The First Year IBS (Irritable Bowel Syndrome): An Essential Guide For the Newly Diagnosed.
Foods that are most likely to trigger an IBS attack are as follows:
- Red Meat (beef, pork, lamb, etc.): high in fat and difficult to digest
- Poultry (dark meat and skin): high in fat and difficult to digest. Skinless white poultry meat is fine.
- All Dairy Products (milk, cheese, butter, ice cream, yoghurt): high in fat and difficult to digest. Be careful about substituting margarine for butter because most margarine contains milk products!
- Egg Yolks: high in fat and difficult to digest
- Fried Foods: high in fat and difficult to digest
- Coconut milk: high in fat and difficult to digest
- Oils, shortening, fats, butter, margarine: All high in fat and potential IBS triggers
- Solid chocolate: high fat content
- Coffee, regular and decaffeinated: all coffee contains caffeine which is an IBS trigger
- Alcohol: a powerful irritant to both the digestive tract and major organs
- Carbonated beverages: carbonation can cause bloating and cramps
- Artificial sweeteners: all can cause cramps. Sorbitol is the worst
Soluble Versus Insoluble Fibre
IBS sufferers need to avoid foods that over-stimulate the colon while eating ones that soothe and regulate it. This is best achieved by limiting your intake of fat, eating soluble fibre and restricting your intake of insoluble fibre.
Soluble fibre contains substances that can be easily dissolved in water and are, therefore, easily digested.
Insoluble fibre contains substances that are rough and do not dissolve and passes intact through the intestines.
Examples of insoluble fibre that can pose serious challenges for IBS sufferers are:
- raw fruits
- raw vegetables, greens, raw sprouts
- whole wheat and whole bran
- whole nuts
- brown rice
- onions, leaks
- broccoli, cauliflower, cabbage and Brussels spouts (also high in sulfur compounds which pose problems)
You may also need to avoid:
- fresh fruit juices
- citrus juice and cooked tomatoes
- rhubarb, prunes, figs, licorice
Examples of foods that are high in soluble fibre include:
- oatmeal (rolled oats are the best)
- white flour pasta
- white rice
- potatoes (skin removed)
- yams (skin removed)
- white, French or sourdough bread
What Can I Eat?
An IBS diet is not as simple as avoiding trigger foods and sticking to safer foods.
In fact, it involves a number of important factors. These factors can be bewildering for someone new to the diet. They include such issues as your food supply, how to prepare food, frequency of meals, portion sizes, what combination of foods to eat and what to look for when buying prepared foods.
The ideal way to eat for IBS is to prepare your own food from scratch. When you prepare your own food, you have the best control over the ingredients
Buying prepared foods can be a risky business because you don't have any control over ingredients and it can be difficult to ascertain what triggered an attack if you get sick. Sometimes it may be just one ingredient that didn't agree with you. IBS can be very finicky when it comes to ingredients -- even the smallest of ingredients can trigger an attack.
It should be noted that food sensitivities can vary from person to person. So, while trigger foods are universal, some of the lesser triggers (such as whole wheat), if taken in smaller quantities, may not bother some people while some “safe” foods may pose problems.
For example, Belinda (founder and organizer of IBS Info and Support Toronto) can tolerate some lemon juice if she eats it with other food. Normally an IBS sufferer would have great difficulty tolerating lemon juice. On the other hand, Belinda has problems with most varieties of white rice, which would generally be safe for an IBS person.
So, you may need to try out some foods to determine what you can and cannot tolerate.
However, if you do, please keep in mind the following:
- Testing new foods is not recommended if your IBS is unstable
- The following major trigger foods -- red meat, dark skin poultry, fried foods, coconut milk, oils, solid chocolate, coffee and caffeine, alcohol, carbonated beverages, artificial sweeteners and glucose-fructose – should be avoided under all circumstances
- Your ability to tolerate other foods may depend in part on the severity of your condition and your body's own particular chemistry.
In the beginning, Belinda was skeptical about organic food. So she decided to do an experiment. She went to the supermarket and bought eight conventional vegetables. She took them home and cooked them. She ate a small portion and began to feel nauseated. Her nausea went on for hours.
The next day Belinda went to a health food store and purchased the same eight vegetables, but this time she bought all organic. She took the vegetables home and cooked them exactly the same way she had cooked the conventional vegetables the day before. She ate the same small portion … and waited … and waited … and waited. Nothing happened! She felt absolutely fine! This experience convinced her there must be something to organics and she began to eat mainly organic.
In fact, when you think about it, it makes good sense that eating organic is better for IBS people because organics contain no chemical pesticides, herbicides and fertilizers, antibiotics or hormones. They also haven’t been genetically modified, meaning they haven’t been cross bred with other species of plants. Normally older species of plants are used in organic farming.
Since IBS attacks can be triggered by even minute amounts of chemicals or antibiotics, etc. in food, it is best to eliminate these triggers if possible.
In particular, certain foods like eggs and chicken contain high amounts of these contaminants so it is recommended IBS people buy organic eggs and chicken that is either organic, naturally raised or kosher.
Eating organic is also recommended because IBS people probably don't get as much nutrition as non-IBS people because they must eat a restricted diet. In such cases, every vitamin counts!
Organically-grown produce is packed with vitamins because it is cultivated from older species of fruit and vegetables. Conventional produce, on the other hand, is not cultivated to necessarily have high vitamin content. Rather, it is cultivated to not bruise easily, look appealing to grocery shoppers and to have a long shelf life. These factors are aimed at ensuring good profits as opposed to ensuring good nutritional values.
How To Prepare Food
You will need to peel, remove seeds and cook most vegetables. Some exceptions to this would include lettuce and tomatoes.
Lettuce is safest when eaten with soluble fibre (such as in a sandwich) or at the end of a meal. Tomatoes are safest when peeled, seeds removed and eaten raw with soluble fibre (again, such as in a sandwich).
The safest vegetables to eat are root vegetables such as carrots, turnips, beets and parsnip.
Generally boiling or baking vegetables is best. Frying vegetables is not safe.
The two safest fruits for you to eat are bananas (peeled and eaten raw) and apples (peeled, cored and boiled into a sauce or baked until soft). Apples should be eaten with soluble fibre (such as on white, French or sour dough toast).
If you don’t have time to cook vegetables or fruit, you can try buying baby food because it is usually cooked and pureed.
Certain cooked vegetables are difficult for IBS people to tolerate. These include any in the cabbage family (including cabbage, broccoli, cauliflower, Brussels sprouts) and in the garlic and onion family. However, cooked cauliflower may sometimes be quite tolerable in small quantities. Garlic and onion may be tolerable in small amounts in powdered form (as in cooking spices).
Certain fruits are difficult to tolerate too even if they are cooked. These include pears, peaches, nectarines, plums, prunes, pineapple and citrus fruits. Many IBS people react to melon too although Belinda can tolerate small amounts of watermelon, honeydew and cantaloupe.
For fish and poultry, it's best to bake, boil or barbecue the meat or use any method that doesn’t involving a fatty cooking process such as frying.
Belinda uses her own steam-bake method for poultry and fish. She puts the meat in a large Corningware baking dish, fills it up with water, covers it and bakes it in the oven. When it’s ready, she removes all the skin and fat in the broth before eating it.
Meal Frequency and Portion Sizes
With IBS (and many other conditions too), it's best to eat small meals and often. It's also important to NOT miss any meals because that can make your IBS worse.
The goal should be to keep your digestive system running evenly and as smoothly as possible. The way to do this is to have something to eat every few hours.
For example, you can make sandwiches and, if you're at work, eat a half-sandwich every couple of hours. You can also have other snacks as well.
It's also best to carry food with you wherever you go because it can be difficult to find IBS-safe food sometimes. So, for example, if you're going to the mall, bring along something to munch on so you don't put your digestive out of whack.
The key thing is to never allow yourself to go hungry. Your goal should be to eat something at regular intervals.
Foods that are less IBS-safe to eat can be made safer by eating them in combination with soluble fibre. As a result, it's recommended you include soluble fibre such as white rice (organic white Basmati rice is the best for IBS!), skinless potatoes or white bread, French bread with anything you eat.
Your meal will be even more soothing if you include peppermint tea as your beverage.
UNDER CONSTRUCTION ... MORE TO COME!!!
Please note: Much of the above information came from Heather Van Vorous’s website http://www.eatingforibs.com and her two published books, Eating For IBS and The First Year IBS (Irritable Bowel Syndrome): An Essential Guide For the Newly Diagnosed.