KEEPING YOUR INSIDES CALM
Doctors still aren’t sure what causes irritable bowel syndrome (IBS), a miserable intestinal problem that often causes cramps, gas, diarrhea, and constipation. What they do know is that by eating a healthy diet—getting more of some foods and less of others—you can control IBS instead of having it control you.
Perhaps the trickiest part of managing IBS is knowing which foods are most likely to trigger attacks. Since this varies from person to person, it takes time to learn which foods are safe and which aren’t. “A lot of it is trial and error,” says David E. Beck, MD, chairman of the department of colon and rectal surgery at the Ochsner Clinic in New Orleans.
Even though everyone with IBS reacts to foods differently, there are a few common denominators. Dairy foods, for example, are often a problem. Although children can usually enjoy milk and cheese to their hearts’ content, up to 70 percent of adults worldwide produce insufficient amounts of the enzyme (lactase) needed to digest the sugar (lactose) found in dairy foods. For people with IBS, having dairy foods can be especially uncomfortable, Dr. Beck says.
You don’t necessarily have to give up milk and cheese entirely, he adds. But you’ll certainly want to try cutting back to see if your symptoms improve. Over time, you’ll get a good idea of how much of a dairy food you can enjoy without having problems.
Eating beans often causes problems for people with IBS. Again, you don’t have to rule them out entirely, Dr. Beck says. You may find that some kinds of beans bother you more than others, and some may not bother you at all.
Another food that’s hard to digest is the sugar (fructose) found in soft drinks and apple and pear juices, says Samuel Meyers, MD, clinical professor of medicine at Mount Sinai School of Medicine in New York City. In addition, sweeteners like sorbitol, which are found in diet candy and chewing gum, can also be a problem. For many people with IBS, cutting back on juices and candies may be all it takes to ease the discomfort, he says.
Just as the right foods can help calm an irritable bowel, there are also a number of herbs that will help keep the problem under control, says Daniel B. Mowrey, PhD, director of the American Phytotherapy Research Laboratory in Salt Lake City, and author of Herbal Tonic Recipes. Here’s what he recommends:
Licorice root. This sweet-tasting herb, which you can use to make tea, is a natural anti-inflammatory that can help relieve irritation in the bowel, he says.
Peppermint. In one study, people with IBS who took peppermint capsules were able to eliminate all or most of their symptoms, Dr. Mowrey says. Peppermint tea is also effective, he adds.
Psyllium. The main ingredient in a number of over-the-counter laxatives, psyllium seeds, which are very high in fiber, have been shown to help relieve the pain of IBS as well as the diarrhea and constipation that may accompany it.
A common cause of IBS flare-ups is fat. This is because the bowel normally contracts following a high-fat meal. For people with IBS, these normal contractions can be extremely painful, Dr. Meyers explains. Getting no more (and preferably less) than 30 percent of your total calories from fat will go a long way toward calming an irritable bowel, he says.
A sure way to eat less fat is to cook your own meals rather than eat out, says Paul Millea, MD, assistant professor of family and community medicine at the Medical College of Wisconsin in Milwaukee. Restaurants prepare food with their own benefit in mind, not yours. As a result, the food you eat at restaurants is loaded with fat and low in nutrients.
At the same time, high-fat food means low fiber, and fiber is key to avoiding IBS flare-ups for several reasons. Fiber makes stools larger, so the intestine doesn’t have to squeeze as much to move them along, Dr. Beck says. In addition, the larger stools help sweep potential irritants from the bowel before they cause cramping, gas, or other symptoms. Getting more dietary fiber also will help relieve both diarrhea and constipation, which often occur in people with IBS, Dr. Beck says.
The Daily Value (DV) for fiber is 25 grams. As a starting point, Dr. Millea tells his patients to add a bowl of bran cereal to their diet every day and build up from there. “Most people will be surprised at how it affects their gastrointestinal system,” he says. Although at first, the extra fiber may cause some bloating, give it time, and your body will adjust. (Avoid cereals made from corn, however, since corn tends to aggravate IBS in 20 percent of people with the problem.)
Because fiber has a healing effect on the bowel while fat causes the bowel to contract painfully, make the effort to eat healthier meals at home, says Paul Millea, MD, of the Medical College of Wisconsin in Milwaukee. Start with a bowl of bran cereal a day and build up to eating whole-wheat bread, whole grains such as wholewheat pasta and brown rice, and plenty of fruits and vegetables.
“If all Americans ate low-fat, high-fiber diets, irritable bowels would be very uncommon,” Dr. Meyers says.
IBS is hardly ever seen in people who are retired because its symptoms are commonly brought on by stress, says Dr. Millea. When we’re under stress, we typically grab for foods that exacerbate IBS, such as coffee, soft drinks, chocolate, and fast food. That’s like throwing gasoline onto the fire for most people with IBS.
“I hate to tell people to avoid stress because that essentially comes across as ‘Don’t live your life,’” Dr. Millea says. But it is important to be aware of the choices you make when you’re under stress. Avoid stimulants such as caffeine and alcohol, add as much fiber to your diet as you can, avoid eating out, and be sure to get enough sleep and exercise.
If giving up coffee sounds impossible, try drinking less. Because both regular and decaf coffee make the bowel more sensitive, Dr. Beck recommends limiting yourself to a cup or two each day.
Finally, it’s helpful to eat smaller meals. The more food you put into your body at one time, the harder the intestines have to work, and that can cause problems for people with IBS. Having several small meals is usually easier for the body to handle than having two or three big meals, says Douglas A. Drossman, MD, professor of medicine and psychiatry at the University of North Carolina at Chapel Hill School of Medicine.