IBS is a condition that affects mainly the bowel, the part of the digestive system that makes and stores stool. It can cause a range of symptoms, from cramping and bloating to gas, diarrhea, and constipation, and it can be very painful. And because IBS varies from person to person, so does therapy. “It’s treated in many different ways,” says Brigid Boland, MD, assistant professor of medicine in the Inflammatory Bowel Disease Center at the University of California in San Diego. “For people who have constipation, there are medications for that. For people who alternate between constipation and diarrhea, they may try something different. There’s not one medication that works for everyone.” In fact, Dr. Boland says that people with mild to moderate IBS tend to find the most success by changing the way they eat. “Dietary modifications end up being the mainstay for a lot of people with IBS,” she explains. Some people find success controlling IBS with an elimination diet or by following a specific dietary regimen. Other lifestyle measures can help treat the condition, including stress reduction techniques and ensuring that you get adequate exercise. Find out more about how diet and other lifestyle factors can play a role in IBS management. RELATED: Can Cognitive Behavioral Therapy Help Relieve IBS Symptoms?
Fiber Packs a Punch Against Constipation and Diarrhea
One way to potentially lessen the symptoms of IBS is by introducing fiber into your diet. For some people, fiber reduces IBS symptoms — such as constipation and diarrhea — because it can make stool softer and easier to pass (good for constipation) or bulkier and more regular (good for diarrhea). Fiber isn’t the answer for everyone with IBS, however. “A lot of people don’t respond to it, and it can cause bloating for others,” Boland says. If you want to try adding foods with fiber to your diet, start slowly. Adding a little at a time allows your body to get used to high-fiber foods. Too much fiber all at once might cause gas. Here are some examples of fiber-rich foods:
Fruits Apples, peaches, pears, bananas, and berriesVegetables Broccoli (raw), cabbage, carrots (raw), peas, and spinachGrains Whole-grain breads, whole-grain cereals, oatmeal, and branBeans Kidney beans, lima beans, black beans, and lentils
You may want to consult a dietitian about adding fiber to your diet, and your doctor may also recommend taking an over-the-counter supplement to get more fiber. If you continue to have problems with IBS, consult your physician about other dietary modifications you can make.
Dietary Changes Might Be Just What the Doctor Ordered
In recent years, one dietary approach designed by Australian researchers has become more widely accepted as beneficial for people with IBS — the Low FODMAP diet. A review published in January 2017 in Gastroenterology and Hepatology found that 50 to 86 percent of people with IBS showed improvement in their symptoms on a low-FODMAP diet. According to the IFFGD, FODMAPs (or “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols”) are carbohydrates that tend to cause problems for people with IBS. Restricting them — not cutting them out completely — has been shown to improve IBS symptoms. Foods that are considered high FODMAP include soft cheeses, cow’s milk, yogurt, vegetables such as asparagus and artichokes, fruits such as plums and apples, cashews and pistachios, and rye and wheat breads. “The Low FODMAP diet has seen a fair amount of success,” Boland says. “But it can be challenging to follow completely. I tell my patients that they don’t need to follow it to a tee, but it can help them identify trigger foods that they didn’t expect.” RELATED: The Business of a Diet
Look for Ways to Manage Stress
Food isn’t the only factor impacting your IBS symptoms. Stress may also play a role. “I hear so many of my patients saying ‘I’m stressed out right now, so my symptoms are worse,’” Boland says. Feeling mentally or emotionally tense, troubled, angry, or overwhelmed can stimulate colon spasms in people with IBS. The colon has a vast supply of nerves that connect it to the brain. These nerves control the normal rhythmic contractions of the colon and can cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. But with IBS, the colon can be overly responsive to even slight conflict or stress. “Trying to have some sort of game plan to help yourself through the stressful time can be beneficial,” Boland says. If stress plays a major role in your life, try these tips to find relief:
Practice relaxation. Do relaxation training, such as meditation or yoga, at least once a day.Dial back. “If things are escalating, try to simplify them,” Boland suggests. “For example, go back to a very simple, bland diet that you know is going to be okay.”Take a time-out. Time-outs aren’t just for athletes or unruly children. In fact, all of us occasionally need time on the sidelines to clear our heads and gain new perspectives. Call it a time-out, call it meditating, call it whatever you want — just take some “me time” and give yourself a break every once in a while.Pamper yourself. What do you get when you combine candlelight, a warm bath, and soothing music? Instant relaxation! Next time stress has you in a stranglehold, loosen up with this tried-and-true home remedy.Get a massage. Apart from feeling great, massage is a wonderful way to relieve tension and stress throughout your whole body.Walk it off. “Exercise can be a stress reliever and help IBS,” Boland says. For starters, try working a 10-minute walk into your daily routine. Your body and your mind will thank you.Have a good laugh. Sounds silly? Well, it is — and that’s the point. Not only is laughter a scientifically proven tension reliever, it’s also free, so use it at will. If your funny bone needs some prodding, rent a comedy or recall amusing stories from the past with a friend.Get adequate sleep. “Good sleep plays into general overall health,” Boland says. Most healthy adults should aim for between seven and nine hours of shut-eye per night, according to the National Sleep Foundation.
Try an Alternative Technique, Like Hypnotherapy
One approach that has been shown to help relieve IBS symptoms is hypnotherapy, a type of therapy that promotes relaxation and subconscious change. In fact, a study published in the American Journal of Gastroenterology reported that gut-directed hypnotherapy improved IBS symptoms in participants after three months and for up to a year. A review published in April 2014 in the Journal of Neurogastroenterology and Motility found that hypnotherapy may be particularly beneficial in alleviating abdominal pain in the short-term and can also help improve overall quality of life for IBS patients. The practice of hypnosis is not restricted by law in most places in the United States, which means that anybody can become a hypnotherapist without any qualifications or quality assurance. When choosing a hypnotherapist, keep the following in mind:
A clinical hypnotherapist should have seven to nine years of university coursework plus additional supervised training in internships and residency programs.The hypnotherapist should be licensed (not certified) in his field by the state.If the person’s degree is in hypnosis or hypnotherapy, rather than a state-recognized healthcare profession, the person is a lay hypnotist and is not qualified to treat your medical problem.Hypnotherapists qualified to treat IBS should have membership in the American Society of Clinical Hypnosis (ASCH) or the Society for Clinical and Experimental Hypnosis (SCEH). Also check for membership in the American Medical Association, the American Dental Association, the American Psychological Association, and other professional organizations.
Writing Out Symptoms and Tracking Food Can Help Identify Triggers
Some people with IBS find it beneficial to keep a journal to track their symptoms and how they’re feeling. And whenever you feel like you need emotional clarity or a good de-stressor, writing can help. If you’re new to journaling, start by buying a notebook. Then start writing for a few minutes every day — don’t worry about spelling, grammar, or punctuation. Make note of any strong feelings that arise during the day. When pressed for time, try using one adjective that sums up your day and a second to describe how you want tomorrow to be. Don’t give up if you haven’t written for a few days. Reading previous journal entries may put your current health problems in perspective. For example, you could determine that a week-long bout of diarrhea was just the result of bad dietary choices, not a flare up of your condition.
Try Exercise to Regulate Bowel Function
Adding exercise to your management plan can provide significant IBS relief and improve your general health — plus, when done right, it has few side effects (except maybe a blister or two). On the physical level, exercise regulates bowel functioning. It stimulates the digestive process, triggering peristalsis, which can be particularly helpful if constipation is your main symptom. In one study in the American Journal of Gastroenterology, researchers reported that study participants who were physically active had noticeably improved GI symptoms compared with the participants who did not exercise. The researchers then followed up with study participants a few years later. The results, published in January 2015 in the World Journal of Gastroenterology, found that those who had continued exercising experienced positive long-term effects on their IBS symptoms. A 2018 study published in the journal PLoS One yielded similar results. Researchers surveyed more than 4,700 adults on their gastrointestinal disorders, including IBS, and physical activity levels. The study concluded that less active people were more likely to have IBS than those who exercised. In addition, exercise can reduce stress and generate a sense of well-being. Yoga in particular may be helpful with this. A study published in December 2015 in the European Journal of Integrative Medicine found that doing yoga for one hour three times a week for 12 weeks improved symptoms and overall quality of life for IBS patients. Adding physical activity into your day doesn’t mean you have to go to extremes with exhaustive workouts, five times a week. It’s actually important to gradually increase exercise, making it part of your daily routine. Begin with low-impact physical activity, such as a 20-minute walk three days a week. Some higher impact activities, such as running, can lead to diarrhea — so the gradual approach is particularly important for individuals with diarrhea-predominant symptoms. Whatever you choose to do, always remember to consult your physician for advice about what is safe and effective for you.
