Irritable Bowel Syndrome (IBS) comes with several uncomfortable digestive symptoms, which can be terribly disruptive to a busy life. Several of my patients complain of bloating, gas, abdominal pain or discomfort, and most commonly, irregular bowel movements. Stool symptoms can range from constipation to diarrhea and everything in between. Not fun.
A common complaint I hear from patients struggling with this syndrome is the unpredictable nature of the symptoms, and a lack of ability to discern which foods aggravate their symptoms. Another frequently experienced complaint: “I look and feel 9 months pregnant when I’m bloated”. If this sounds like you or someone you love, read on.
The typical contributing factors to IBS are food sensitivities, stress and anxiety, and in women, hormonal changes.
Let’s talk about food.
Food sensitivities or intolerances are classified as “allergies”, however to avoid confusion with anaphylactic or acute allergies, I will continue to refer to them as “sensitivities”. Note that these sensitivities or intolerances are considered allergies because they do cause activation of the immune system, however the effect is delayed, not immediate as in the cases of an anaphylactic allergy or hives. Common triggers of immediate allergies are to drugs, foods (peanuts, shellfish), environmental triggers, and insect stings, and most people are aware of these from a young age.
The food sensitivities that impact IBS are classified as delayed hypersensitivities, meaning that they can present with digestive symptoms directly after consuming the food, or up to 72 hours later. This means that you can consume your favourite cupcake on Monday morning and it can impact your digestive system on Tuesday evening or even Wednesday. This extended delay is rare for digestive symptoms and typically reserved for food sensitivities that affect the skin (for example, with eczema or acne due to a food intolerance).
The most common food triggers for patients struggling with IBS are the following (in no particular order):
- Refined sugar
- Fructose (found in many fruits)
- Legumes (lentils, chickpeas, beans)
- Citrus fruits
The Low-FODMAP diet, which removes several of the above foods, has also been studied to help patients who have IBS and other digestive symptoms.
If you are suffering with IBS-like symptoms or have been diagnosed with this condition, try removing the above foods or adhering to the Low-FODMAP diet for a trial period of 2 weeks. This is generally enough time to improve the impact of these foods on your digestive system and will help provide some relief to your symptoms. If you notice improvement, continue the avoidance for up to 8 weeks for extended benefit to your gut. While removing these bothersome foods, it is important to see an ND or other functional medical provider to support digestive health with specific nutrients, herbs, and/or probiotics. This allows for the digestive tract to improve resilience to food triggers and reduce inflammation, which leads to the digestive symptoms that cause suffering in IBS patients.
Food Sensitivity Testing
Another option if you have difficulty adhering to a restrictive diet, or if the above dietary changes have not worked for you, is to pursue food sensitivity testing. Note that food sensitivity tests are not the first-line recommendation – I do suggest the dietary approach first, as it has a greater accuracy in determining true food triggers when done correctly. However, food sensitivity testing can be a more efficient approach for those who have already tried making changes to their diet, with not enough certainty or success.
We offer food sensitivity testing at our clinic, allowing patients to objectively see the foods that their bodies are reacting to. I typically advise removing offending foods for 4-8 weeks depending on the severity of symptoms, while addressing digestive health with key supplements that support gut function. During this period, we expect to notice a significant improvement in digestive symptoms, however patients may also experience improvement in other symptoms. Food sensitivity testing simply tells us about the foods your body is reactive to, however reactions may not be specific to the digestive tract. This means that you may discover food triggers for other bodily symptoms, such as headaches, fatigue, acne, brain fog, or weight gain. One of the greatest benefits of food sensitivity testing is that knowledge and subsequent avoidance of your food triggers allows for you to experience improved functioning of your health across several systems in the body.
After the removal of foods for 4-8 weeks, accompanied by a gut healing protocol, I recommend re-introducing certain foods back into the diet one-by-one to assess the type of reaction your body is having to each of the offending foods. This allows for you to individualize your results even further, and understand how your body responds to specific foods. Ultimately this empowers you with unique knowledge about your body and informs the decisions you make regarding food. So when you reach for that gluten-filled cupcake (knowing you have a gluten sensitivity), and you know it will likely cause bloating (based on your re-introduction results), you can decide which one wins out: cupcake vs. bloating. PS – I am a firm believer in choosing the cupcake every now and then!
If you are interested in finding out about your unique food sensitivities, for IBS symptoms or other health concerns, book in with one of our naturopathic doctors at CCH, Dr. Elaine Lewis ND or Dr. Amber Moore ND.