Q: My doctor says I have IBS. Another doctor told me that IBS is a "nonsense" diagnosis. Either way, my digestion isn't right. Help! -Greta Y., Santa Barbara, Calif.
A:Irritable bowel syndrome (IBS) has been in the medical news a lot lately because-guess what-it's real, and increasingly common. Contrary to popular opinion, IBS does not cause colon or other cancers, but it can make your life uncomfortable, and if you have irregular and uncomfortable bowel movements, you should be evaluated for the possibility of a more serious disease.
IBS is distinct from inflammatory bowel disease (IBD), which is a more serious category of gastrointestinal disorders such as Crohn's disease (ulcers in the small intestine) or ulcerative colitis (bleeding from large intestine). IBS typically presents as chronic loose and urgent stools, often with cramping, and it's not always easy to sort out the cause. This is partly because there is often an additional emotional component to IBS.
First, ask yourself if there is something you need to "purge" in your life-a bad relationship, a bad boss, a bad memory that may require ceremonial closure (funerals are an example of ceremonial closure). The gut is your "second brain" and can react to emotions to a profound degree.
Did You Know?
The gut is your "second brain" and can react to emotions to a profound degree.
Foods to Avoid with IBS
The "big 9" food irritants are:
However, fructose-induced diarrhea is not uncommon, and should be a consideration, especially if you eat more than 2-3 servings of fruit daily.
To figure out if a certain food is causing your symptoms, you need to completely avoid the potentially offending food for 2-3 weeks, then reintroduce it into your diet and watch for symptoms. IBS can also present with heartburn, fatigue, headache, back or abdominal pain, and even palpitations. If after 3 days of reintroduction there are no undesirable changes to your gut function, skin, mood, joint stiffness, or other symptoms, that food is likely fine.
This takes careful organization of your diet, and it really helps to work with a licensed naturopathic physician or well-trained nutritionist (not dietician). Some chiropractors also have additional nutrition training, but most MDs have very little training in nutrition, since they are experts in pharmaceutical medicine.
Always be sure to cook your food thoroughly. Well-cooked foods are much easier to digest than raw foods.
Natural Solutions for IBS
During the acute phase of IBS (lots of watery stools and cramping), try a hypo-allergenic diet (see sidebar). As improvement occurs, eggs and yogurt (preferably made from goat's milk) can be added if they don't worsen the symptoms. Supplements that often help heal and soothe the gut include liquid chlorophyll (1 Tbs. daily), alfalfa tabs, calming herbal teas (Melissa, chamomile, fennel, peppermint, and ginger), and my favorite GI repair agent: glutamine, about 2 grams daily.
As your symptoms stabilize, you can slowly add the cruciferous vegetables back into your diet. These provide many important nutrients, but can be hard to digest, so are best cooked with digestion-aiding herbs such as fennel, caraway, cumin, anise, and dill. Nuts and seeds, grape skins, and red meat are also all difficult to digest, but may not be the causes of your GI distress.
Carrageenan is a common additive used to make ice cream and other confections "smooth," but is very irritating to the gut. Avoid this additive when possible, which is used in a lab setting to make mice guts bleed. Very spicy and very sweet foods are also GI irritants, as are fried foods, alcohol, and caffeine.
Keep in mind that we're exposed to more chemical additives than ever in our food and drink, so read labels and try to stick to food that is as close to the way it grew as possible when you eat it. And cook your food thoroughly. Well-cooked foods are much easier to digest than raw foods.
With acute crampy pain, heat to the abdomen (hot water bottle or heating pad) can be very soothing. Regular exercise helps everything, including being a highly effective stress-reliever.
Hypoallergenic Diet for IBS
- Breakfast: whole brown rice cereal (3-4 Tbs. rice in 2 cups water, stirring constantly over medium heat) with 2 tsp. virgin olive or flax oil stirred in when cooked.
- Morning snack: baked apple or blueberries/sliced banana topped with unsweetened cocoa powder.
- Lunch: vegetable soup from massaged kale, parsley, zucchini, pumpkin, carrots, and squash, with millet or barley, and 2 tsp. olive or flax oil.
- Afternoon snack: baked apple or berries or orange.
- Dinner: same as lunch, or add a little fresh fish or free-range chicken.
Some of my colleagues have noted that the low FODMAP diet can help IBS. This basically means avoiding fermented foods (kombucha, pickles, yogurt); short-chain (simpler) carbs such as those found in high fructose corn syrup; honey; inulin; wheat; soy; garlic; onions; beans/peas; celery; mushrooms; most fruits; many condiments, dips, and sauces; beer; wine; coconut water; fruit juice; and all dairy.
What's left to eat? Most squashes, sprouts, pumpkin, potato, chard, kale, fennel, zucchini, yam, blueberries, banana, clementines, oranges, lemon, lime, papaya, pineapple, carrots, cucumber, ginger, radish, clean beef, chicken, lamb, pork, turkey, tuna, salmon, cod, most fresh fish and crustaceans, bone marrow, oats, quinoa, rice, seeds (chia, pumpkin, sunflower, etc.), maple syrup, mustard, eggs, and cocoa powder.
A low FODMAP diet may work better if you have confirmed SIBO (small intestinal bacterial overgrowth).