Posted May 12, 2011

My sister calls to tell me she has been diagnosed with IBS (Irritable Bowel Syndrome). “How is IBS different from IBD (Inflammatory Bowel Disease)? she asks.

GQ (Good question) and not so simple in terms of diet treatment.

IBD is an inflammatory disease that damages the lining of the GI (gastrointestinal) tract. The two primary inflammatory bowel disorders are UC (Ulcerative Colitis) which affects the lining of the large intestine (colon) and Crohn’s disease, which can cause inflammation in any part of the intestines. The cause of IBD is largely UNK (unknown).

Unlike IBD, IBS (Irritable Bowel Syndrome) AKA (also known as) “spastic colon” does not involve damage to the intestines. And it is often more difficult to diagnose since it may not show up on lab results or other diagnostic tests. Symptoms of IBS include stomach pain, bloating, constipation and/or diarrhea. Interestingly, most IBS sufferers are women.

IBS can be stress induced, say experts. When nerves are in overdrive, muscles in the intestines may be stimulated to contract more and cause symptoms. Infections and other nutritional factors may trigger symptoms of IBS as well.

MNT (Medical Nutrition Therapy) for IBS is therefore NSE (not so easy). So what is the recommended COA (Course of Action)? Here are some places to start:

Avoid foods that aggravate symptoms. Stimulants like caffeinated beverages, tea, or sodas may not be tolerated. RD’s (registered dietitians) often recommend avoiding CAPS (caffeine, alcohol, pepper and other spices).

Eat a DAT (Diet as Tolerated). Gas-forming foods like cabbage and onions might be OOC (out of commission) for some IBS sufferers. Ditto with foods that contain lactose (milk sugar) and sugar alcohols like sorbitol or mannitol if these contribute to loose stools.

Some people with IBS are also intolerant to fructose–a simple sugar found in fruit, juices, and honey. But unfortunately there is no SSE (solid scientific evidence) that one dietary treatment works well for all sufferers.

Even the role of fiber is controversial, according to the most recent position paper by the ADA (American Dietetic Association). Dietary fiber (especially soluble fiber) tends to normalize problems people have with constipation or diarrhea. But not always …

At the risk of giving TMI (too much information), the goal of nutrition therapy for those who suffer with IBS is to improve QOL (quality of life). This involves LOVE (lots of voluntary effort) on the part of the patient.

And BTW (by the way), you can find more information on this topic at NDDIC (National Digestive Diseases Information Clearinghouse), a service of the NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases)

http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/

(Barbara Quinn is a registered dietitian and certified diabetes educator at the Community Hospital of the Monterey Peninsula. Email her at bquinn@chomp.org.)

Editor’s note: Mediator Release Testing (MRT) and the LEAP eating protocol can help uncover foods and food chemicals that trigger symptoms in IBS.

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