Managing IBS, a Migraine of the Gut

UW Health Digestive Health experts offer tips for managing IBS through dietMadison, Wisconsin – For the 1 in 6 Americans who experience Irritable Bowel Syndrome (IBS), food may sometimes feel like an enemy. Eating too much at a meal, spicy foods, milk – it's hard to pinpoint what might trigger symptoms. But the reality is that diet is really the cornerstone to managing the condition.


During a recent educational session at UW Health's Digestive Health Center, Mark Reichelderfer, MD, gastroenterologist and specialist at the Inflammatory Bowel Disease Clinic, along with UW Health dietitian Makayla Schuchardt, RD, shared what dietary factors could benefit those experiencing IBS.


"No one really knows what exactly causes IBS," explained Reichelderfer. "There is some evidence that the problem occurs in the wiring between the brain and the gut. It's essentially a migraine of the gut."


While IBS generally responds well to treatment, the challenge is that each patient who has IBS experiences different triggers that bring on symptoms. Schuchardt explained that the key is to identify those triggers.


"Keep a food diary to track what you're eating," she said. "And try eliminating the known triggers."


Common food triggers include

  • Milk and dairy
  • Beans and legumes
  • Raw or cruciferous vegetables
  • Coffee or caffeinated beverages
  • Wheat
  • Sweeteners
  • Alcohol
  • Chocolate

Schuchardt also recommends paying attention to how you eat and lifestyle habits.


"Eating smaller, more frequent meals, chewing slowly, exercise and stress management are other key changes that can help," she explained.


The Importance of Fiber


Another dietary change that can benefit IBS patients is the addition of fiber. But that can present some challenges as well.


There are five different classes of fiber, all of which have different effects on gastrointestinal function. Over-the-counter supplements, like the powders stirred into beverages, are one way to add fiber to a diet. Another is cereal.


"When choosing a cereal, you need to compare labels," explained Schuchardt. "Look for at least 3 grams of fiber per serving."


For the average person, adequate fiber intake is approximately 20-35 grams of total fiber per day. Average Americans, however, typically consume 16 grams per day.


While supplements can help, Schuchardt was careful to point out that the majority of fiber should come from your diet.


"Food first. If you eat a variety of fruits, vegetables and whole grains, you'll get a good mix," she said. "Include one cup of fruit or vegetables with each meal and you're well on your way."


Making simple swaps can also go a long way. Whole wheat instead of white bread, whole grains like quinoa or millet instead of white rice are a few examples.


When increasing fiber intake, Schuchardt offered a few reminders:

  • Add fiber slowly
  • Increase fluid consumption to help prevent constipation
  • Choose foods that naturally contain fiber
  • More fiber isn't always better. If you experience digestive problems, reduce your intake

The Role of Probiotics


IBS sufferers, and those simply looking to maintain good digestive health, may benefit from the addition of probiotics, or bacteria.


The digestive system is home to more than 500 different types of bacteria.


"There are ten times as many bacteria in our intestines as cells in our body," explained Reichelderfer. "The bacteria are metabolically active breaking down and making important substances in our bodies, and they are immunologically active helping to regulate our immune systems."


The addition of probiotics, whether through supplements or food, has been shown to help those suffering from diarrhea and IBS. There's some evidence that probiotics also help maintain a strong immune system. But cautions Reichelderfer, "Not all probiotics are the same, so you have to experiment."


Yogurt is a popular way to increase probiotic intake. When choosing a yogurt, it's important to look for the phrase, "Contains live active cultures" and ensure it has low sugar.


Another source of probiotics gaining in popularity is fermented foods like miso, tempeh, sauerkraut and drinks like kefir and Kombucha. But there are some cautions.


"Fermented foods that have not been pasteurized can contain harmful bacteria and be dangerous to children, pregnant women, the elderly and those with compromised immune systems," said Schuchardt. The catch is that the pasteurization process kills the probiotics, so look to see that the products have had the probiotics added after the process. And be cautious of miraculous claims.


When you're looking to make significant dietary changes, it's important to work with a registered dietitian. UW Health's Digestive Health Center has registered dietitians available to provide nutritional counseling for patients. For appointments, call (608) 890-5000.


IBS or IBD? Understand the Difference


Irritable bowel syndrome can be confused with the more severe, chronic inflammatory bowel disease (IBD). The two disorders may share symptoms but are not the same. To learn more, including when to see a physician, visit


Date Published: 05/19/2014

News tag(s):  digestive health

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