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PrintIrritable Bowel Syndrome
One of the most common complaints I hear in my gastroenterology practice is that of the gurgling gut — the sensation of food running through you, or feeling pregnant or bloated. In most situations, these symptoms can be attributed to Irritable Bowel Syndrome, or IBS. This is not to be confused with IBD, which stands for “inflammatory bowel disease” and is a completely different ball-game.
Most common symptoms
Most IBS patients report excessive gas and abdominal cramping. Patients with IBS will also often have either diarrhea or constipation, or both in an alternating fashion.
Treatments
Unfortunately, there is no magic pill for gas and most of the Gas-X or Mylanta type medications don’t work well. Dietary adjustment is critical here. The first recommendation is usually to get more fiber in your diet, but that has not been proven effective in treatment of overall IBS symptoms and I certainly never recommend it in patients with the bloating problems.
Instead, first look at your dairy intake. About one in three patients are lactose intolerant and this usually increases with age. Remember — cheese, chocolate, and ice cream are concentrated forms of milk (and are all high in fat).
I usually suggest a complete removal of dairy products for three weeks to see if that does the trick.
Activities such as gum chewing, drinking carbonated beverages, smoking, and rapid consumption of food also cause excess air ingestion and hence bloating and gas.
Other foods that aggravate the symptoms of IBS are caffeine, alcohol, fruits (especially apples, citrus, and tomatoes), red or processed meats, spices, diet drinks/foods, fast food, chinese food (MSG), fried and fatty foods, whole or multigrain breads, commercial salad dressings, certain veggies like cabbage, broccoli, corn and cauliflower, beans (and other legumes), preservatives, artificial flavoring and coloring, insoluble fiber and baked products.
Uffda! That’s a long list and many patients ask: “What the heck am I supposed to eat?” That is certainly a legitimate question! Foods that tend to be well tolerated are water… ha-ha — got ya! You can certainly eat more than that. Try steamed rice, plain pasta, sweet potatoes, plain breads, fish, chicken, turkey, non-smoked ham, eggs, natural cereals, soy products, salads with natural oil/vinegar, cooked vegetables, crackers, fruits like melons or peaches, and finally peanut butter. Slowly, some foods on the “bad list” can be added in to see how well you tolerate them. We now have plenty to eat!
Natural remedies
A recent study has shown the benefits of peppermint oil. There are also anecdotal reports of impressive response to the acai berry, which has high antioxidant properties. Chamomile tea, evening primrose oil, fennel seeds, wormwood oil and comfrey are commonly believed to be beneficial in IBS but have no published studies in their support.
Also, exercise! It has been shown to improve intestinal function and in many other studies treat depression and stress.
The bottom line: Recognize the symptoms, eat well, and exercise. Leave the pills for last but certainly use them if necessary.
Dr. Aga Bednarz is a gastroenterologist at St. Luke’s.
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