Three words: Irritable Bowel Syndrome. Aka, an angry, overly sensitive gut. IBS is a common gut condition affecting a whopping 25-45 million people in the US and 10-15% of people worldwide. In fact, it is the most common diagnosis by GI doctors (gastroenterologists). While there are many root causes behind IBS, it is not easy to treat. IBS is often referred to as a functional disorder, meaning that it’s a condition based more on symptoms rather than physical (or “structural”) changes. Meaning, an x-ray, endoscopy, or blood test cannot detect it. Though a recent blood test called IBS-Smart was developed at Cedars Sinai, most doctors don’t use it, leaving IBS a common “umbrella term” for a variety of symptoms. With all of this said and done, April is the national IBS Awareness month, and today I wanted to bring you tips on how to manage IBS. Just as a reminder, none of these are meant to substitute medical advice or treatment. Always try to get to the root of your IBS, since it’s often the result- and not the cause- of a larger issue at hand (like SIBO). So, without any more delay, let’s jump into those tips! [1] [2] [3]

Know Your Trigger Foods

There’s no rhyme or reason as to why certain foods trigger IBS. For instance, while certain problematic foods like beans and raw cruciferous vegetables increase gas and bloating, that doesn’t guarantee it’s going to aggravate every person with IBS. Many people that follow the short-term FODMAP diet find that despite restricting a ton of foods, there are some they can get away with or have a higher tolerance for. So, it helps to know your trigger foods. I recommend keeping track of your typical diet with a food journal and highlighting the ones that cause the most reactions. Don’t be surprised if anything from beef to garlic shows up. After you’ve identified your trigger foods, avoid them for a few weeks before reintroducing one at a time and checking for any negative side effects. If they continue to cause problems, then it’s safe to say they’re a no-go for your body.

(Side note: if you were able to eat most foods without any problems and all of a sudden develop intolerances, then please get checked by a doctor for things like IBD- irritable bowel disease-, inflammation, SIBO- small intestinal bacterial overgrowth-, yeast infections, and autoimmune disease.)

Simple Meals

Start simplifying your diet. I hate to break it to you, but you’re going to have to ease up on complicated, exotic meals. Think superfood-based smoothies with over ten ingredients or huge salads jammed with as many different veggies as you can find. These can be overwhelming to break down for your gut. Instead, simplify them. With smoothies, keep them as basic as possible. You can’t beat a simple combination of spinach, banana, and almond milk. Or cooked salmon with asparagus and sweet potatoes. Not only are you making it easier for your digestion, but you’ll also have a stronger understanding of what works (and doesn’t) for your body. Plus, it takes the stress out of preparing complex meals.

Increase Digestion

With gut-issues like IBS, digestion is already as hard as it is. Luckily, there are many ways you can increase your digestive strength! These include:

• Limiting raw, cold foods and opting for warmer ones. This is based on Eastern medicine, where cold foods are said to dampen digestion. While I’m not saying you should never eat a salad, smoothie, or fruit again, it would help to increase more cooked foods into your diet. Speaking of which-
  
• Cook your vegetables. This one is based on fact. Cooking is a form of pre-digestion, softening the cellulose (fibers) that often are difficult to digest for already sensitive, weak stomachs. Bonus: some foods, like carrots and tomatoes, are more nutritious when cooked; their antioxidants and nutrients start to increase, and we get more bang for our buck. [4] 
• Soak nuts, seeds, legumes, and grains. If you eat a plant-based diet or allow these foods into your diet, be sure to soak them overnight. This reduces phytic acid, which not only binds to potential impurities and minerals in the food but also possibly irritates sensitive stomachs. [5] 
• Sour, bitter, and spice. These three textures are often lost in modern diets. However, for traditional cultures, they’re not only common, but they’re also good for supporting digestion. All three activate receptors in the liver, stimulating the production and release of digestive enzymes and bile. Here’s how to get each of them. With sour, add lemons, limes, or grapefruits to salads, veggies, and animal foods (they even help to tenderize meat). As for bitter, there’s raw apple cider vinegar (which could arguably be sour), dandelion greens, radicchio, and arugula, which can be eaten either as a pre or post-dinner “digestive stimulator” to get those juices flowing. Bonus, you can also buy herbal digestive bitters, which are an old folk remedy for increasing digestion and relieving indigestion, bloating, and gas. Finally, with spice, look no further than cayenne pepper, chili flakes, black pepper, wasabi, or ginger. Their kick brings flavor and lights up your digestion! (Although people with reflux should be cautious.) [6] 
• Use natural probiotics and digestive enzymes. Before spending a ton of money every month on supplements, start with food. With probiotics, you can easily obtain them in fermented foods like sauerkraut, kimchi, pickles, kefir (water or milk), low sugar kombucha, and miso. A ¼ cup to a “shot” before or after meals is an excellent place to start. As for enzymes, you’ll be surprised to find out that certain fruits contain them, such as pineapple (bromelain), papaya (papain), mango (amylase), avocado (lipase), and kiwi (actinidain). [7]

Whole Foods to the Rescue

Want to know another reason why whole foods like meat, vegetables, fruits, nuts, seeds, and (optional) grains work for a vast majority of people? It’s because they come from nature. And in doing so, they don’t come with problematic ingredients that can potentially upset your stomach. These include emulsifiers and thickeners (gums), preservatives, and fermentable sugars (sorbitol, xylitol) that can either aggravate your gut or increase gas and bloating. Initially, I was going to tell you guys to read the labels of your food. While I still recommend you do so, a much simpler approach is to stick with whole foods. Foods like eggs, lemons, and broccoli oil don’t normally come in a box or have a paragraph of ingredients. You only have one ingredient, which is the food itself. If you follow this approach, you’re least likely to be exposed to common gut irritants. [8] [9]

Gut Instinct

It’s all about using your intuition. For some people, managing their IBS is all about managing stress and avoiding problematic foods like dairy and gluten. For others, slowing down, chewing their food properly, and eating a specific diet like Whole30 or paleo works. Whatever you do, tap into your better judgment. Taking care of IBS isn’t an exact science, but many things can be done to give your body a fighting chance. But I’d like to hear from you- what do you do with your IBS? Got any tips? Let me know in the comments below!

Sources:

[1] https://www.aboutibs.org/facts-about-ibs.html
[2] https://www.aboutibs.org/facts-about-ibs/statistics.html
[3] https://www.ibssmart.com/?gclid=Cj0KCQiAxfzvBRCZARIsAGA7YMwYSCUpAcJhoVr7VqsYJmY0sPIv5XYe9suMh2t2ZKer_LXCn02eUw4aAhqnEALw_wcB
[4] https://www.scientificamerican.com/article/raw-veggies-are-healthier/
[5] https://foodandnutrition.org/blogs/stone-soup/case-soaking-grains/
[6] https://www.healthline.com/health/food-nutrition/how-to-use-bitters
[7] https://www.healthline.com/nutrition/natural-digestive-enzymes#section11
[8] https://www.sciencealert.com/two-common-food-additives-linked-to-obesity-and-gut-inflammation
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4944381/