Monday, April 21, 2014

IBS Awareness Month - Guest Blogger: Patsy Catsos, MS, RD, LD

Irritable Bowel Syndrome now More
Treatable with Diet than Ever Before

Is it just me, or are more people talking about irritable bowel syndrome these days? Could it be that IBS is coming out of the (water) closet? It’s always been a difficult subject to talk about, due to its “indelicate” nature. Although very common, affecting up to 20% of Americans, IBS will probably never make great dinner party conversation. Nor does it make for pleasant gossip around the water cooler, though it is the second leading cause of absenteeism in the workplace after the common cold. Some people even hesitate to discuss their symptoms with their health care providers; after all, there has never been much you could do about IBS—it’s one of those things you just have to learn to live with, isn’t it?

Not anymore! If you’ve been suffering from gastrointestinal symptoms that interfere with your work, exercise or social life, discuss them with your primary care provider; many new treatment approaches have become available in the past few years.

People with IBS have digestive systems that don’t function properly, though nothing seems to be medically wrong. IBS symptoms can include excess gas, bloating, abdominal pain, diarrhea and or constipation. Some people with IBS experience alternating diarrhea and constipation.

It’s important not to self-diagnose, because the symptoms are not specific to IBS. Your doctor might be able to make a diagnosis simply by running some basic blood work and comparing the pattern of your symptoms and history to established diagnostic criteria. Make a list of your symptoms and bring it to your appointment. When did they start? What seems to bring them on? If you have any so-called alarm symptoms, your doctor may refer you to a specialist such as a gynecologist or a gastroenterologist to rule out other conditions before settling on a diagnosis of IBS. Alarm symptoms might include passing blood; fever; unexplained weight loss; onset of symptoms after age 50; poor growth or failure to thrive (in children); incontinence; or family history of Crohn’s disease, ulcerative colitis, celiac disease, ovarian or colon cancer.

If you are diagnosed with IBS, you and your doctor might discuss various treatment options. There are a variety of pharmaceuticals that can be prescribed (anti-spasmodics, anti-diarrheals, anti-depressants, and laxatives). Several new drugs have come on the market in the past year or two to help people who suffer from constipation. However, many people are interested in managing things more naturally, with lifestyle and diet. Most people with IBS are advised to start with the basics: regular meals, adequate fluids, better food choices including lots of high-fiber foods, and regular physical activity. High fiber diets and fiber supplements have been the mainstay of dietary advice for many, many years. Unfortunately, many people with IBS find that eating more fruits, vegetables, whole grains and fiber-fortified foods doesn’t help, or makes their symptoms worse.

That’s where the latest research on nutrition and IBS comes in. Rather than following one-size-fits-all diet advice for IBS, patients today are being encouraged to experiment with their diets. The FODMAP approach, in particular, can help up to 75% of patients with IBS learn to manage their symptoms, and is particularly effective with the guidance of a registered dietitian nutritionist. FODMAPs are certain sugars and certain fibers in the diet that are capable of causing symptoms because they are rapidly fermentable by the normal bacteria that live in the gut, which causes the IBS sufferer to have excess gas and painful bloating. FODMAPs can also pull extra fluid into the gut, causing bouts of diarrhea. During a FODMAP-elimination diet, FODMAP-containing foods are first eliminated, then reintroduced in a carefully planned way to identify which FODMAPs are tolerated and which are not. This evidence-based dietary approach was developed by researchers at Monash University, in Australia, and is now in use world-wide. Other types of adverse reactions to food are also possible. IBS symptoms for some individuals might be triggered by the way their immune systems react to particular foods, natural food chemicals or food additives.

While diet is unlikely to the cause or the cure of IBS, appropriate food choices can certainly help most people manage their symptoms. If you have IBS, I think you’ll agree that’s important. Don’t settle for learning to live with your symptoms. You deserve a chance to find the diet that’s right for you.

Patsy Catsos, MS, RD, LD is a medical nutrition therapist, and author of IBS—Free at Last! and the Flavor without FODMAPs Cookbook. For further information about Patsy Catsos, MS, RDN, LD you can find her at the following links:


Patsy’s book links on

Other resources:
1. International Foundation for Functional Gastrointestinal Disorders, Inc.
2. The Rome Foundation,

3. FODMAPs: Profound Help for Symptoms of IBS (video)

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