Irritable Bowel Syndrome or IBS is a chronic relapsing and often lifelong disorder involving a collection of symptoms, which vary from person to person but generally include:
- Abdominal pain or discomfort
- Bloating or distension
- Wind or flatulence
- Change in bowel habit (Diarrhoea and /or constipation)
I like to think of what happens in our gut as a continuum from ‘normal’ function to severe problems and we all find ourselves somewhere on that line.
Who does IBS affect?
肠易激综合征最常影响20至30岁的人群，女性的发病率是男性的两倍。在英国，约有17%的人患有肠易激综合征，更多人可能有一些症状，但从未去看医生。最近，它也被发现存在于老年人中。
If your symptoms bother you often enough to disrupt your life, then you may have IBS.
What are the symptoms?
The symptoms can be catastrophic for many people and you may feel that you are not being taken seriously or that you are in so much pain that there must be something really wrong…you go back and forth to the doctor but nothing seems to work?
Also, the symptoms you experience may differ from day to day and not be the same as the next person with IBS, which makes it so difficult to diagnose.
Your first point of call should be your GP, as there is a set protocol for the GP to follow, which may require taking blood, or bowel sample to rule out other things, as some people with other gut disorders such as inflammatory bowel disease or coeliac disease have similar symptoms.
For this reason it is also difficult to perform research into the best diet for IBS.
However most people reportalcohol, caffeineandfatty foodsas their triggers. More recently research has shown that some carbohydrates may contribute to IBS symptoms These carbohydrates are call Fermentable Oligo- saccharides, Di-saccharides Mono-saccharides and Polyols and a Low FODMAP diet to restrict them has grabbed media attention.
However rather than starting with a restrictive diet, some small changes may be all you need to control your symptoms and reduced the amount of medicines that you take. It is not advisable to commence a low FODMAP diet without the help of a registered dietitian – restricting your diet may mean that you avoid many foods and therefore miss out on some important nutrients which may lead to deficiencies. Also a healthy gut needs a variety of foods to keep the bacteria in balance.
Here are some things that anyone can try
- First find your triggers – Keep a food diary!
- 经常吃
- Drink enough fluid (8-10 cups of caffeine free drinks, non fizzy drinks or water)
- Chew your food well, and take time when eating.
- Reduce caffeine and alcohol.
- Try to reduce stress.
Keeping a Food and Symptom Diary
So keeping a food diary is a good way of helping you to notice the foods, which may upset you – it is important to carry the phone or paper you are using to note down with you rather than try and remember as it is easy to forget what you ate that day.
Below is an example of what to record, by reflecting on this and making small changes, you will find that over time your symptoms improve.
| Meal | Food eaten | Symptom |
| Breakfast 8am | White toast with butter -2 slices | – |
| Snack 11 am | Tea and 2 rich tea biscuits | – |
| Lunch | Nothing except water | – |
| – | – | 6.00pm pain and grumbling stomach |
| Evening meal | Curry with Friends | – |
| – | Chicken Tikka Starter, salad and dips | – |
| – | Dahl and Rice | 9.30pm Pain and wind, bloated – unable to sleep |
| All day -Coffee from machine at work | 5 or 6 cups | 11.30pm diarrhoea |
IBS Food Diary
[BBC:064]Food Diary
Keeping a food diary is a good way of noting which foods may upset you if you think you have IBS. This chart will help you keep a record of what you ate and when to identify triggers.
Eating Regularly
有时我们因为赶时间或疼痛而错过了吃饭，不知道吃什么最好。提前计划可以帮助你——如果你已经知道什么不太可能给你带来麻烦，围绕这些食物来计划你的饮食，在前一天晚上给自己做一个三明治，或者留一部分昨晚的食物作为第二天的午餐。
Fluids
Sometimes drinking more is just about reminding yourself – find something that you like to drink. Still water is best, so carry a bottle with you – aim to drink the whole bottle before you leave work or college or before say 6pm if you are at home that day.
Stress
Many people ask me “does stress really affect my gut?”
答案是肯定的!
Think about people who get a bout of diarrhoea before an exam or interview…. this is part of our ‘Fight or Flight’ response, an innate system which prepares our body to face threat, such as a wild scary animal.
当我们感到压力时，我们的荷尔蒙会让我们的身体做好战斗或逃跑的准备，这包括加快我们的心率和脉搏，排空我们的肠道……这在面对面试而不是面对老虎时是非常有用的!
However we can deal with this stress and help ourselves to relax. Try meditation, deep breathing techniques or using an app such as Calm or Headspace to talk you through a relaxation exercise. Physical Exercise also helps alleviate stress and improve mood, so try a walk, a swim, yoga or Pilates.
Cutting Down on Caffeine and Alcohol
Hopefully your food diary will have indicated how often you drinkcaffeinateddrinks, How often do these appear?
- Cola, Diet Cola, Iron Brew
- Energy Drinks: Monster, Red Bull
- Tea
- Coffee – instant or freshly brewed
这些饮料中很多都有脱咖啡因的版本，所以把普通咖啡换成脱咖啡因的咖啡很容易，而且不会对味道造成太大影响。大多数咖啡店也会有脱咖啡因的咖啡，你只需要在点咖啡的时候问一下。一些餐馆会提供不含咖啡因的饮料，如薄荷茶或其他草药饮料。
Most people find cutting down onalcohol有点棘手。但这是可以做到的!试着把你的饮料换成单杯而不是双份，或者换成低酒精的啤酒或葡萄酒。试着把它们和柠檬水或苏打水混合在一起，做成奶昔或汽水。或者，每第二轮喝一杯不含酒精的饮料，或者试着放慢速度，这样你在同一时间内就不会喝那么多了。如果你很渴，可以尝试不含酒精的饮料，记住每周不要超过14个单位。
Fatty Foods and Fibre
Fatty foods are not great for anyone and therefore should be limited as part of a healthy diet. They also have been shown to aggravate some IBS symptoms such as diarrhoea.
高脂肪食品包括油炸食品、许多外卖食品、糕点、薯片、蛋糕和饼干;所以尽量限制这些食物的摄入量，或者选择低脂肪的食物。
我经常说纤维是你唯一可以多吃的东西!然而，这需要小心，因为纤维既可以改善肠易激综合征症状，也可以使其恶化。
Fibre is found in bread, rice pasta, fruit and vegetables, whole nuts and seeds. Try making small changes such as changing to wholemeal bread or white bread with added fibre. Wholemeal pasta and brown rice contain more fibre than the white varieties and wheat bisks, bran flakes and oats contain more fibre than cornflakes and rice krispies. You may wish to swap some of these, but don’t make too many changes at once as you won’t know what works and what doesn’t – I suggest starting with the thing you find easiest and leaving a week between changes.
Above all, it’s important to think about what you eat and listen to your body. Notice and record any changes to your symptoms as you make adjustments so that you learn what suits you. If you can follow the initial steps to drink plenty of water, eat regularly and avoid your triggers, you’ll then be able to take some additional steps towards a healthier and happier lifestyle. Reducing stress is never easy, but once you find something that works for you and your schedule, your belly will thank you for it!
Sarah Monk
Registered Dietitian
Hi I’m Sarah, a registered dietitian who currently works in a leadership role for the NHS. I became a dietitian because I love food, cooking and eating it… so what better job to do than talk about food all day!
我热衷于用食物让人们感觉更好;我真的相信“吃什么就是什么”。然而，改变我们的饮食并不像吞下一片药片那么简单，而是需要反复试验才能找到适合自己的方法。