Grumpy guts

It is estimated that IBS affects somewhere between 9% and 23% of the world’s population. It’s hard to be any more precise as many people just suffer in silence not realising that they have a medically recognised problem that can be treated, although not cured.

If you have been experiencing diarrhoea, constipation, wind, abdominal pain or any combination of these symptoms over a prolonged period of time you may have IBS. The first thing to say though is that these symptoms are associated with a number conditions and so it is really important to visit your GP and get your symptoms properly investigated. IBS is not a life threatening condition but other conditions with the same symptoms can be, so please get checked out.

In my experience many people who get diagnosed with IBS leave the doctor’s surgery with either a sense that it’s just something you can’t do much about or, with a bewildering diet sheet that seems to suggest being permanently tied down to a miserably restrictive diet. So if you find yourself down in the dumps about your grumpy guts here are some tips to help you find a happier place.

There is no “one size fits all” diet for IBS. In most cases it’s best to start with some really simple changes as these often result in significant improvement without the need for anything more complicated.

I ask my clients to start keeping a symptom diary as soon as they make an appointment and I give the following basic advice over the phone. Some people are already doing these things but if not it’s good to create a baseline from which we can work.

Simple changes can really help improve symptoms:

• Have regular meals, avoid missing meals and take time to eat.
• Drink at least eight cups of fluid per day, especially water or other non‑caffeinated drinks, for example herbal teas.
• Restrict tea and coffee to three cups per day.
• Make sure you are sticking to the guidelines for alcohol – no more than 14 units per week and try to have a couple of alcohol free days.
• Keep fizzy drinks to a minimum.

When I meet a client with IBS I look at their symptom diary and have a chat about whether any particular symptoms dominate like say diarrhoea or wind/bloating. The advice I give will vary depending on each person’s unique situation. I will then look at the person's fibre intake and the different sources of fibre and proportions of these in their diet. For most people I suggest a few simple changes based on this information and ask them to keep recording their symptoms for a few weeks.

After all this if people still feel that they have not experienced a significant improvement then I will discuss the strangely named FODMAP diet. FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) are types of carbohydrate found in a number of foods that we commonly eat. Science has shown that by experimenting with the FODMAP content of their diets people with irritable bowel syndrome can get relief from the gas, bloating and discomfort that they experience. It is essentially a diagnostic tool that enables people firstly to find out if reducing FODMAPs will help them and after this to work out which high FODMAP foods they tolerate and in what quantities. It’s not simply a case of cutting out a few foods and getting relief, you need patience.

So if you suffer from grumpy guts the main message is don’t suffer in silence, get your symptoms checked out and get specialist advice from a dietitian.