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Claire Turnbull: Managing an irritiable bowel - 12 April

Managing an Irritable Bowel

Do you wake up in the morning with a flat stomach, only to be so bloated by the end of the day that you look like you're several months pregnant? These symptoms could very well be due to an undiagnosed food intolerance. New Australian research shows there could be more people than previously thought who suffer from intolerances to common foods such as fruit, vegetables, artificial sweeteners and dairy foods - resulting in bloating, cramping and other symptoms of Irritable Bowel Syndrome (IBS).

1. What is IBS or Irritable bowel and how common is it?

Irritable bowel syndrome (IBS) is the most common of the digestive disorders, and many of our HFG readers tell us it's a problem for them. Generally IBS affects women more than men: in Britain and the United States it has been estimated that IBS affects between 14-24% of women and between 5-19% of men.

IBS often diagnosed when someone is struggling with some form of bloating, stomach pain or change in bowel habits when all problems have been eliminated. People often have x rays, cameras to look into the bowel and if there are no abnormalities with those, the conclusion is often IBS.

2. What are the symptoms of IBS?

IBS occurs when the bowel's normal rhythmical waves go into spasms; it is sometimes called irritable or spastic colon. Symptoms of IBS can include bloating, excess wind, constipation, diarrhea, cramping and abdominal pain.

It is important never to self-diagnose: if you think you may have IBS, see your GP in the first instance so that other disorders can be eliminated.

You may then be referred to a dietitian for assistance with managing your diet and eating patterns. It's a good idea to keep a diary for at least a week before you see the dietitian.

3. What cause IBS

Stress: Anxiety can affect the speed with which food is processed in the gut. For people with IBS their digestive tract is hypersensitive to stress, so learning to manage stress and anxiety is an important part of relieving the symptoms. Reduce stress in your life by ensuring you get regular exercise and adequate sleep; learn relaxation techniques like deep breathing, visualisation, self-hypnosis or muscle relaxation exercises.

Physical activity: For some people, 'bouncy' activities like aerobics or jogging can exacerbate symptoms. Try 'gentler' ways to exercise like walking, swimming, yoga, Pilates or even weights. For some people, gentle exercises also help with pain management, even if it's only a diversion.

Hormonal changes: For some women, symptoms are worse around their periods due to the hormonal changes.

BY FAR one of the largest factors is however: Diet
Although it is believed that IBS is not caused by particular foods, some foods may exacerbate its symptoms.

4. SO looking at your diet, what are the Foods affect IBS?

Responses to specific foods are highly variable. Many of the common foods we eat contain a variety of small, naturally occurring carbohydrate molecules. These molecules don't cause any problems for most people, but some of us don't digest them well - leading to symptoms like bloating. Collectively, these molecules are known as FODMAPs - Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Common examples include:

High fructose foods: Apples, pears, mangos, tinned fruit in natural juice, watermelon (have props). Also HONEY, and things with high fructose corn syrup, dried fruit

Lactose: Milk, yogurt, ice-cream, cheese (soft) - have props

Fructans: Vegetables: Beetroot, brussel sprouts, cabbage, garlic, leeks, onions (refer to lastest HFG). Cereals: wheat and rye in large amounts, pasta, couscous, crackers

Galactans: legumes - chickpeas, baked beans

Polyols: partially - sugar free gum/sweets - sorbitol, manitol, xylitol

5. Where do I start?

Unlikely to be all of these things, so need to do a Record: when and what you eat and drink and the amounts; physical activity; as well as symptoms you have. This will be a good starting point for the dietitian to discuss what's going on and suggest changes that may help.