IBS : How to manage your gut.
I am a person who has been struggling with irregular bowel habits or constipation issues since my childhood.
At that age I was not aware what constipation really was and was totally oblivious of such a thing called IBS. As I grew up I got to know that I might have IBS and certain foods aggravates my condition, as well as certain lifestyle aggravates that too.
So, I have searched a bit about this topic and will write some stuff about this topic to explain it as well as tell my experience as to how I am able to manage this now.
Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder that affects the large intestine, causing symptoms like stomach cramps, bloating, diarrhea, constipation, and fluctuating bowel habits. It is called syndrome because it is a group of symptoms that appear altogether. The condition is categorized into different types based on the dominant symptom, and dietary management is crucial for alleviating symptoms.
IBS is not a disease, It is a functional disorder, which means that the bowel doesn’t work as it should.
In IBS, the muscles and nerves of the bowel becomes extra sensitive. For example, muscles may contract too much when you eat. These contractions can cause cramping or diarhhea during or shortly after having a meal. Or, nerves can become overly sensitive and strech like during gas. This can be painful.
Main Symptoms:
- Crampy pain in the abdomen.
- Painful diarhhea/constipation.
Common Symptoms:
- Mucus in stool
- Swollen or bloated abdomen.
- The feeling of fullness or the feeling of not having a complete bowel movement and you thinking that I might have to go again soon or there is some pressure in my rectal region due to partial peristaltic activity of the intestines.
Major Question: Does stress cause IBS?
As per many research papers it is evident that stress do affect the intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation(In conditions like IBS, the immune system might react to normal gut bacteria or food particles, causing inflammation and discomfort.), alterations in central nervous system, peripheral neurons and gastrointestinal microbiota.
You can read in depth about it here:
Types of IBS:
- IBS with Diarrhea (IBS-D): Predominantly diarrhea as the main symptom.
- IBS with Constipation (IBS-C): Predominantly constipation as the main symptom.
- IBS Mixed (IBS-M): A combination of both diarrhea and constipation.
- IBS Unclassified (IBS-U): Symptoms don't fit clearly into IBS-D or IBS-C but still cause discomfort.
I have some samples of diet chart that you can follow to ease up your IBS flare ups and live a healthy and active lifestyle.
Before starting this, you must know what is FODMAP Diet.
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are short-chain carbohydrates (sugars) that the small intestine poorly absorbs. When they reach the large intestine, they are fermented by bacteria, which can cause bloating, gas, pain, and changes in bowel movements, especially in people with digestive disorders like Irritable Bowel Syndrome (IBS).
The Low-FODMAP Diet is designed to reduce the intake of these fermentable carbohydrates to help manage IBS symptoms and other gut-related issues. Below is a detailed breakdown of what FODMAPs are, their effects, and how the Low-FODMAP Diet works.
What Are FODMAPs?
FODMAPs are a group of five types of short-chain carbohydrates that include:
- Oligosaccharides : These are sugars made up of 3-10 simple sugars.Examples: Fructans (found in wheat, onions, garlic) and Galacto-oligosaccharides (GOS) (found in beans, lentils, and some vegetables like cabbage).Effect: Can cause fermentation in the large intestine, leading to gas, bloating, and diarrhea or constipation.
- Disaccharides : A type of sugar that contains two simple sugars. Example: Lactose (found in milk, yogurt, and soft cheese).Effect: Many people have difficulty digesting lactose due to insufficient lactase enzyme production, leading to bloating, gas, and diarrhea.
- Monosaccharides : Simple sugars that contain only one sugar molecule. Example: Fructose (found in apples, honey, high-fructose corn syrup).Effect: Excess fructose may be poorly absorbed by the small intestine, leading to fermentation in the large intestine and causing digestive discomfort.
- Polyols : Sugar alcohols that are poorly absorbed in the gut. Examples: Sorbitol, mannitol, xylitol (found in stone fruits like cherries, mushrooms, and many sugar-free products).Effect: These can draw water into the intestines and ferment in the gut, causing bloating, gas, and diarrhea.
Symptoms Associated with High FODMAP Foods
When FODMAPs are consumed, they can cause several gastrointestinal symptoms, especially in people with IBS, including:
- Bloating
- Gas and flatulence
- Stomach cramps and discomfort
- Diarrhea
- Constipation
- Urgency to go to the bathroom
- Nausea
For individuals with IBS or other gut-related disorders, consuming high-FODMAP foods can exacerbate these symptoms, leading to discomfort.
Low-FODMAP Diet
The Low-FODMAP Diet involves eliminating high-FODMAP foods from the diet for a period (usually 4-6 weeks) and then systematically reintroducing them to see how the body reacts. The diet has three main phases:
- Elimination Phase (4-6 weeks) : All high-FODMAP foods are avoided to allow the gut to calm down and symptoms to subside. During this phase, foods such as garlic, onions, certain dairy products, and fruits high in fructose (like apples and pears) are eliminated. Focus on consuming low-FODMAP alternatives like gluten-free grains, lactose-free dairy, and non-cruciferous vegetables (e.g., spinach, carrots).
- Reintroduction Phase (8-12 weeks) : Gradually reintroduce high-FODMAP foods one at a time to determine which types of FODMAPs are problematic. This phase helps identify specific triggers so that the diet can be personalized for better symptom management.
- Personalization Phase (Ongoing) : Based on the results of the reintroduction phase, a long-term eating plan is created. The goal is to incorporate as many foods as possible while avoiding only the specific FODMAPs that cause symptoms.
Foods to Avoid on a Low-FODMAP Diet
High FODMAP Foods to Avoid:
- Fruits: Apples, pears, cherries, watermelon, mango, stone fruits (e.g., peaches, plums), and dried fruits.
- Vegetables: Onions, garlic, cauliflower, broccoli, asparagus, artichokes, mushrooms, snow peas.
- Dairy: Cow's milk, soft cheese, yogurt, ice cream (due to lactose).
- Grains: Wheat (in large amounts), rye (in large amounts).
- Legumes and Pulses: Lentils, chickpeas, kidney beans, black beans.
- Sweeteners: Honey, high-fructose corn syrup, sorbitol, mannitol, xylitol.
Foods to Include on a Low-FODMAP Diet
Low FODMAP Foods:
- Fruits: Bananas, strawberries, blueberries, oranges, kiwi, pineapple.
- Vegetables: Spinach, zucchini, carrots, potatoes, bell peppers, cucumbers.
- Dairy: Lactose-free milk, hard cheeses (cheddar, parmesan), lactose-free yogurt.
- Grains: Rice, oats, quinoa, gluten-free bread and pasta.
- Proteins: Chicken, turkey, eggs, fish, tofu, and certain types of beans (like lentils in small portions).
- Nuts and Seeds: Almonds (in small amounts), walnuts, chia seeds, flaxseeds.
Benefits of the Low-FODMAP Diet
- Reduction of IBS Symptoms: Many people with IBS experience significant symptom relief, including reduced bloating, gas, and diarrhea/constipation, by following the Low-FODMAP Diet.
- Personalization of Diet: By identifying specific food triggers, individuals can better understand their digestive health and make lasting dietary adjustments.
- Improved Gut Health: Lowering the intake of FODMAPs helps reduce irritation and inflammation in the gut, improving overall digestive function.
Challenges of the Low-FODMAP Diet
- Restrictiveness: The elimination phase can be quite restrictive, especially for those who enjoy a wide variety of foods. It can also be difficult to maintain for long periods.
- Nutritional Balance: Some high-FODMAP foods (like fruits and vegetables) are rich in vitamins and fiber, and eliminating them may lead to nutritional deficiencies if not carefully managed.
- Need for Professional Guidance: Because the diet is complex, it’s often recommended to undertake the Low-FODMAP Diet under the guidance of a healthcare professional, such as a dietitian, to ensure it’s done correctly and safely.
FODMAP Testing and Resources
There are tools and apps available to help individuals with IBS manage the Low-FODMAP Diet:
- Monash University FODMAP Diet App: Monash University, the institution that developed the Low-FODMAP Diet, offers an app that lists foods according to their FODMAP content, making it easier to plan meals.
- FODMAP-friendly Certification: Some food products carry a "FODMAP Friendly" certification, indicating they are safe for those on the diet.
Global Diet Chart
1. IBS with Diarrhea (IBS-D)
People with IBS-D often experience frequent loose stools, urgency, and cramping. A diet for IBS-D should aim to reduce gut irritation and slow bowel movements.
Diet Chart for IBS-D:
1. Breakfast:
- Oatmeal with almond milk and a sprinkle of chia seeds (soluble fiber)
- A banana (low-FODMAP and easy on the stomach)
2. Mid-Morning Snack:
- Rice cakes with peanut butter (plain)
- A small portion of lactose-free yogurt
3. Lunch:
- Grilled chicken breast with sautéed spinach (low-FODMAP)
- Quinoa or rice (easy to digest)
- A small serving of carrots (steamed)
4. Afternoon Snack:
- A small handful of almonds (unsalted)
- Cucumber slices
5. Dinner:
- Baked salmon with a side of mashed potatoes (made without butter, using olive oil)
- A side of roasted zucchini and pumpkin
6. Evening Snack:
- Herbal tea (peppermint, ginger, or chamomile)
- A small portion of lactose-free yogurt
Key Tips for IBS-D:
- Avoid high-FODMAP foods like onions, garlic, and apples that can exacerbate bloating and diarrhea.
- Limit caffeine and alcohol, as they can increase bowel movement frequency.
- Eat small, frequent meals to avoid overloading the digestive system.
- Stay hydrated, as diarrhea can lead to dehydration.
2. IBS with Constipation (IBS-C)
IBS-C involves difficulty passing stools, constipation, bloating, and abdominal discomfort. A diet for IBS-C should focus on increasing fiber intake and promoting regular bowel movements.
Diet Chart for IBS-C:
1. Breakfast:
- Whole grain toast with avocado and a poached egg (fiber-rich and healthy fats)
- A small serving of papaya or kiwi (both help digestion)
2. Mid-Morning Snack:
- A handful of pumpkin seeds or sunflower seeds
- A small portion of figs or prunes (natural laxative effect)
3. Lunch:
- Lentil soup (for soluble fiber)
- A mixed salad with leafy greens, cucumber, and carrots (ensure low-FODMAP vegetables like spinach and arugula)
- A small portion of brown rice or quinoa
4. Afternoon Snack:
- Apple slices (with the skin for fiber) and almond butter
- Herbal tea like fennel or ginger to help with bloating
5. Dinner:
- Grilled chicken or turkey with roasted sweet potatoes and steamed broccoli (fiber-rich vegetables)
- A side of quinoa or whole wheat couscous
6. Evening Snack:
- A small portion of chia pudding (made with almond milk)
- A cup of warm herbal tea (peppermint, chamomile)
Key Tips for IBS-C:
- Increase fiber intake, focusing on soluble fiber (e.g., oats, carrots, lentils) to help soften stools.
- Drink plenty of water to help fiber move through the digestive system.
- Exercise regularly, as physical activity can help stimulate bowel movements.
- Avoid high-fat, greasy foods that can slow digestion.
3. IBS Mixed (IBS-M)
IBS-M involves alternating periods of diarrhea and constipation, making it a more complex case to manage. A balanced diet that addresses both symptoms is essential.
Diet Chart for IBS-M:
1. Breakfast:
- Oatmeal with ground flaxseed and blueberries (fiber + anti-inflammatory)
- A hard-boiled egg for protein
2. Mid-Morning Snack:
- Rice cakes with a small amount of almond butter
- A few carrot sticks
3. Lunch:
- Grilled chicken or tofu with quinoa and a salad with mixed greens, cucumber, and avocado
- A side of baked sweet potatoes
4. Afternoon Snack:
- A handful of mixed nuts (unsalted, including walnuts and almonds)
- A small portion of papaya or banana
5. Dinner:
- Baked cod or salmon with roasted carrots and parsnips
- A side of steamed broccoli or spinach
6. Evening Snack:
- A small portion of lactose-free yogurt or kefir
- Herbal tea like ginger or peppermint
Key Tips for IBS-M:
- Stay balanced with a mix of fiber sources (both soluble and insoluble) to avoid worsening either diarrhea or constipation.
- Avoid trigger foods and keep a food journal to track reactions to specific meals.
- Stay consistent with meal timing to help regulate bowel movements.
4. IBS Unclassified (IBS-U)
For IBS-U, symptoms don't fit neatly into either diarrhea or constipation, and can include a mix of symptoms, making diet management more individualized.
Diet Chart for IBS-U:
1. Breakfast:
- Whole-grain toast with almond butter and a poached egg
- A small serving of berries (strawberries or blueberries)
2. Mid-Morning Snack:
- A handful of almonds or walnuts
- A small portion of coconut yogurt
3. Lunch:
- Grilled fish (like salmon) with quinoa and a side of steamed spinach or zucchini
- A small serving of mixed vegetables (carrots, green beans)
4. Afternoon Snack:
- A small portion of avocado with cucumber slices
- A boiled egg
5. Dinner:
- Chicken breast with baked sweet potatoes and steamed broccoli
- A small serving of quinoa or brown rice
6. Evening Snack:
- A cup of chamomile or peppermint tea
- A few whole grain crackers with a small serving of hummus
Key Tips for IBS-U:
- Experiment with fiber levels based on personal tolerance, focusing on foods that don’t trigger symptoms.
- Stay hydrated to maintain bowel regularity.
- Reduce fatty and spicy foods to avoid triggering discomfort.
- Limit dairy products if lactose is a problem.
General IBS Dietary Guidelines:
- Avoid high-FODMAP foods (such as garlic, onions, and certain fruits) that can cause gas, bloating, and discomfort.
- Incorporate soluble fiber (oats, bananas, carrots) for better digestion and stool formation.
- Stay mindful of food intolerances, as certain foods can worsen symptoms depending on the individual (like lactose or gluten).
- Drink plenty of fluids throughout the day, especially water and herbal teas.
- Eat smaller, more frequent meals to prevent overloading the digestive system and reducing symptoms.
It’s always advisable for people with IBS to consult a healthcare provider or nutritionist before making drastic dietary changes to tailor these recommendations to their specific needs and symptoms.
Diet Chart for Indians:
1. IBS with Diarrhea (IBS-D)
IBS-D involves frequent diarrhea, urgency, and cramping. The focus is on foods that help slow down bowel movements, reduce irritation, and keep hydration levels optimal.
Diet Chart for IBS-D (Indian Diet)
1. Breakfast:
- Poha (made with minimal oil, without onions or garlic) with coriander leaves, carrots, and peanuts for protein and fiber.
- Banana (unripe or semi-ripe, as they are low-FODMAP).
- Herbal Tea (like ginger or chamomile, which can help soothe the stomach).
2. Mid-Morning Snack:
- Rice Cakes or Multigrain Crackers with a small serving of peanut butter (unsweetened).
- Coconut water (for hydration and electrolytes).
3. Lunch:
- Plain Rice with moong dal (yellow split lentils) (cooked with turmeric and cumin, as both are gut-friendly).
- Steamed vegetables like carrots, pumpkin, zucchini, and spinach (low-FODMAP vegetables).
- Cucumber raita (made with lactose-free yogurt).
4. Afternoon Snack:
- Rice or millet porridge (without onions, garlic, or spicy seasonings).
- Herbal Tea (Peppermint or ginger tea).
5. Dinner:
- Grilled chicken or baked fish (mildly seasoned with salt, turmeric, and cumin).
- Steamed rice or quinoa with a side of stir-fried bell peppers and spinach (both low-FODMAP).
- Lactose-free yogurt (can be added to the meal or consumed separately).
6. Evening Snack:
- Carrot sticks with hummus (make sure it's without garlic).
- Plain water or herbal tea.
Key Tips for IBS-D:
- Avoid high-FODMAP foods like garlic, onions, and high-sugar fruits (like mangoes and grapes).
- Limit spicy foods and foods that may increase acid production, such as tomatoes or citrus.
- Eat smaller meals throughout the day to avoid overloading the digestive system.
2. IBS with Constipation (IBS-C)
IBS-C is characterized by difficulty passing stools, constipation, and bloating. The goal is to increase fiber intake, promote regular bowel movements, and reduce gut discomfort.
Diet Chart for IBS-C (Indian Diet)
1. Breakfast:
- Oats porridge made with lactose-free milk (or water) and topped with flaxseeds or chia seeds for added fiber.
- Papaya or kiwi (both aid digestion and are high in fiber).
2. Mid-Morning Snack:
- Figs or prunes (both act as natural laxatives).
- A handful of unsalted almonds.
3. Lunch:
- Whole wheat chapati (1-2) with moong dal (yellow split lentils) or toor dal (pigeon pea).
- Steamed vegetables like carrot, beans, pumpkin, or sweet potato.
- A small serving of cucumber and tomato salad with lemon and olive oil dressing.
4. Afternoon Snack:
- Roasted chana (unsalted) or a small serving of baked sweet potato (rich in fiber and helps digestion).
- Warm herbal tea (peppermint or ginger).
5. Dinner:
- Chapati or paratha made with whole wheat or millets like ragi or jowar (helps with fiber intake).
- Dal soup (made with toor dal, yellow moong dal, or masoor dal).
- Steamed or roasted vegetables like carrots, spinach, bottle gourd, and zucchini.
- A small serving of lactose-free yogurt.
6. Evening Snack:
- Poppy seed and flaxseed mix (soaked in water overnight and consumed).
- Warm herbal tea (fennel or ginger).
Key Tips for IBS-C:
- Increase fiber intake with whole grains, fruits, and vegetables.
- Stay hydrated by drinking plenty of water throughout the day.
- Avoid high-fat, greasy foods which can slow digestion.
- Exercise regularly to stimulate bowel movements.
3. IBS Mixed (IBS-M)
IBS-M involves a combination of both diarrhea and constipation. The focus is on a balanced diet that includes both soluble and insoluble fiber and avoids common IBS triggers.
Diet Chart for IBS-M (Indian Diet)
1. Breakfast:
- Vegetable upma made with semolina (rava), with vegetables like carrots, beans, and spinach (steamed).
- Banana (unripe, low in FODMAP) or kiwi.
2. Mid-Morning Snack:
- Chia seed pudding with lactose-free yogurt or coconut milk.
- Watermelon or pineapple (small portion for hydration).
3. Lunch:
- Brown rice or quinoa with moong dal (seasoned with cumin, ginger, and turmeric).
- Steamed or sautéed vegetables (e.g., zucchini, carrots, bell peppers).
- A small portion of cucumber raita (lactose-free yogurt).
4. Afternoon Snack:
- Rice cakes with a small amount of coconut chutney (without garlic or onions).
- Herbal tea (like ginger or peppermint).
5. Dinner:
- Grilled chicken or baked fish with steamed sweet potatoes or millet-based khichdi (a mixture of rice, lentils, and turmeric).
- Steamed broccoli, pumpkin, or spinach.
6. Evening Snack:
- Papaya or a small serving of melon.
- Peppermint tea to soothe digestion.
Key Tips for IBS-M:
- Avoid high-FODMAP foods like onions, garlic, and high-fructose fruits.
- Balance fiber intake to prevent both constipation and diarrhea.
- Monitor portion sizes and avoid overeating to reduce digestive stress.
4. IBS Unclassified (IBS-U)
IBS-U has symptoms that don't fit neatly into IBS-D or IBS-C. A flexible approach is needed to identify triggers and manage symptoms effectively.
Diet Chart for IBS-U (Indian Diet)
1. Breakfast:
- Vegetable paratha made with whole wheat or millets like ragi (without onions or garlic).
- Coconut water for hydration.
2. Mid-Morning Snack:
- Papaya or a small serving of steamed apple (sliced with a pinch of cinnamon).
- A handful of unsalted walnuts or almonds.
3. Lunch:
- Moong dal khichdi (moong dal with rice) with carrots, spinach, and a small amount of ghee (clarified butter).
- Cucumber and tomato salad with olive oil and lemon.
4. Afternoon Snack:
- Roasted fox nuts (makhana) or buttermilk (made from lactose-free yogurt).
- Herbal tea (ginger or chamomile).
5. Dinner:
- Grilled fish or tofu with a side of mashed sweet potatoes and steamed vegetables (e.g., carrots, bottle gourd, and zucchini).
- A small serving of moong dal soup.
6. Evening Snack:
- Chia seed pudding (made with almond milk).
- Herbal tea (peppermint or fennel).
Key Tips for IBS-U:
- Track food triggers to identify specific FODMAPs or foods that may cause discomfort.
- Stay hydrated and incorporate fiber-rich foods that don't cause irritation.
- Consume smaller meals to prevent bloating and discomfort.
General IBS Diet Guidelines for Indian Diet:
- Avoid high-FODMAP foods such as onions, garlic, cauliflower, and certain fruits (apples, pears, etc.).
- Include soluble fiber from sources like oats, psyllium husk, and well-cooked vegetables.
- Consume lactose-free dairy if dairy causes digestive issues.
- Stay hydrated by drinking water, coconut water, and herbal teas.
- Avoid processed and greasy foods as they can worsen symptoms.
By adjusting the diet based on the type of IBS, individuals can manage symptoms effectively and improve their quality of life while still enjoying a wide range of traditional Indian foods.
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