The medical community characterizes Irritable Bowel Syndrome (IBS) as a gastrointestinal condition involving intestinal motility dysfunction. This condition affects 12-14% of the adult population in the United States, appearing almost 50% more in women than in men (Anastasi, 2013; Smeltzer, Bare, Hinkle, & Cheever, 2010). According to Anastasi (2013), health care practitioners can diagnose IBS six months after appearance of symptoms with the use of the Rome III Diagnostic Criteria.
The Rome III criteria allow an IBS diagnosis if the patient has two of the following three conditions on at least three days of three consecutive months: pain relieved by defecation, change in the frequency of bowel movements, or a change in stool appearance (Anastasi, 2013). Smeltzer et al. (2010), indicate that bowel pattern is a hallmark symptom of IBS, and people who suffer with the syndrome can experience rapid abdominal and stool changes. Meanwhile, feelings of bloating, pain, and distention often accompanies fluctuations in bowel pattern (Smeltzer et al. , 2010).
Additional factors that can contribute and exacerbate IBS include poor lifestyle choices, such as a high fat diet coupled with little exercise, ineffective stress management practices, resulting in a decreased impact on quality of life (Anastasi, 2013; Smeltzer et al. , 2010). Presently, health care practitioners agree that the IBS treatment strategy includes controlling pain, minimizing bowel changes, and addressing the psychosocial aspects of the disease (Smeltzer et al. , 2010). Anastasi (2013) maintains that changes in diet and lifestyle, along with pharmacologic and nonpharmacologic therapies, are important in the treatment of IBS.
In fact, a study performed by Judy Moore (2013), found that as much as sixty percent of patients who suffer from IBS often find a successful resolution of symptoms by transforming dietary habits and avoiding foods that trigger symptoms. Diet First line of treatment. Phillips (2012) attests that the first goal of dietary treatment in persons with IBS should be to adopt a healthy, well balanced diet which includes regular meals and mealtimes in which a person sits down to eat, along with adequate fluid intake. Moreover, to avoid abdominal distention, Smeltzer et al. , (2010), suggests drinking fluids independent of meal consumption.
Abstain from bad eating habits such as chewing quickly, eating on the road, and skipping meals (Phillips, 2012). In some cases of IBD, a prescription for a high-fiber diet by the physician helps to regulate the symptoms of diarrhea and constipation (Smeltzer et al. , 2010). Smeltzer et al. , (2010) also adds that exercise combined with a high-fiber diet increase gastrointestinal motility. Consequently, studies have shown that while the effects of fiber are beneficial for patients with constipation, it could potentially cause adverse symptoms such as bloating, distention, flatulence, and diarrhea (Anastasi, 2013; Phillips, 2012).
However, Phillips (2012) recommends that if dietary fiber increases in patients with IBS, this increase should take place gradually over a period of time to hedge off any adverse effects (Phillips, 2012). Other important foods to cut out of the diet include caffeine, coffee (caffeinated and decaffeinated); dairy or sources of foods high in lactose content, alcohol, and foods that include use artificial sweeteners containing the ingredient sorbitol or xylitol as many patients report symptom exacerbation with these foods (Anastasi, 2013).
With this in mind, the health care professional may then recommend a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; otherwise known as a low FODMaP diet (Anastasi, 2013; Phillips 2012). FODMaPs, what are they? In short, FODMaPs consists of short-chained carbohydrates, fructose, specifically, lactose, fructans, galactans, and polyols (Moore, 2013). Additionally, research suggests a link between these carbohydrates and adverse effects on IBS suffers because of active osmolality, rapid fermentation, or poor absorption in the small intestine (Moore, 2013; Phillips 2012).
Examples of FODMaP classified foods are stone fruits such as apricots and mangoes, apples, pears, beans, onions, garlic, chickpeas, lentils, and cabbage (Moore, 2013; Phillips 2012). These foods actively trigger IBS symptoms; avoidance of these foods is important to avoid the onset of IBS symptoms (Phillips, 2012). FODMaP diet, what is it? Patients suffering from IBS, and for whom a regular well-balanced diet is insufficient to control symptoms, often transition to a low FODMaP diet.
Studies show that foods high in these short-chained carbohydrates often perpetuate symptoms that can produce gastrointestinal upset in IBS patients (Phillips, 2012). It is important to realize that the FODMaP diet is a complex dietary structure in which requires a patient to work one on one with a registered dietician and is not easily followed (Phillips, 2012). Studies show the diet’s success, however, shows amazing potential in the patients who do stick with the regimen. Phillips (2012) alleges that a low FODMaPs diet is successful for approximately seventy-five percent of patients in reducing symptoms of IBS.
Moore (2013), a nurse practitioner, declares a sixty percent success rate in the resolution of IBS symptoms in patients attending her clinics over a five-year period. Subsequently, after six weeks of successful treatment, in which little to no IBS symptoms originated on the low FODMaP diet, patients reintroduce high-risk foods slowly into the diet (Moore 2013). This reintroduction of FODMaP foods, allows the patients to determine which foods bring the onset of symptoms (Moore, 2013). By the time this process concludes, patients are more able to control their symptoms by virtue of diet, therefore, increasing quality of life (Moore 2013).
