Living with Irritable Bowel Syndrome (IBS) and the FODMAP Diet
What is Irritable Bowel Syndrome (IBS)?
Living with irritable bowel syndrome (IBS) can range from a mild annoyance to complete debilitation. As a sufferer of this syndrome myself, I understand the largest frustration is often due to the fact that the cause is unknown. Until recently, many physicians believed that IBS was all in your head. Since no physical evidence of disease is found, it’s difficult to determine the cause of symptoms and the best course of treatment. And while there is certainly a brain-gut connection with IBS, the syndrome is not just all in your head – these symptoms are very real.
A diagnosis of irritable bowel syndrome can be very frustrating. “Nothing’s wrong,” they say. “Colon looks good!” they say. But you know something’s not right. You might be prescribed a medication or two to help ease your symptoms, but if you’re like me, what you want is to get to the root cause. A word of caution: be careful what you wish for. The path toward finding the root cause of your symptoms is typically frustrating, emotional, and will definitely test your patience. But I can also tell you first-hand that once you figure it out, the journey is worth it!
Various IBS Diets
If you do an internet search for IBS diet you will likely find a number of websites and articles claiming they’ve discovered the Holy Grail. Chances are one or more of these diets will work for you, at least to some extent. They tend to have something in common: they typically restrict certain types of carbohydrates that tend to be problematic. Most likely, they will advise you to give up either gluten or dairy (or both). You don’t have to have celiac disease to be sensitive to gluten, but many individuals find that it’s actually the wheat (the carbohydrate part) which is causing the problem. It’s impossible to know until you give it a try. I recommend eliminating one component of your diet at a time rather than multiple components at once. This will help you control the variables of your dietary experiment. And remember, if this whole process overwhelms you, meeting with a registered dietitian with experience in treating food sensitivities can make a world of difference.
For the purposes of this blog, let’s assume FODMAPs are your issue. FODMAP stands for many long words that have to do with the nutritional molecules in food. Following a diet low in one or multiple FODMAPs is not easy. Many of my patients are more frustrated by the social aspect of following this diet than anything else – it’s not fair that they can’t eat “normally.” They feel exposed. They hate asking the server to add or eliminate certain ingredients. They wish they could just eat any kind of food and feel fine. My response: you can’t change the cards you’re dealt. Based on my experience, here are some more words of wisdom.
Tips on How to Follow Diets for IBS
1. You have to decide that it’s worth it.
No one’s forcing you to follow a special diet. It’s entirely up to you how much misery you can tolerate. Some people make minimal changes with massive results (the lucky ones), while others have to make lots of changes, monitor every morsel, and turn their lives upside-down. Chances are you are somewhere in between. No matter where you fall in this spectrum, the benefit of changing your diet has to weigh heavier than the burden of doing so.
2. You have to think ahead.
Imagine how you’ll feel an hour or two after eating a meal while staying on track – pants fit, plenty of energy for the rest of the day, not worrying about locating the nearest restroom, etc. Then imagine how you’ll feel an hour or two after multiple dietary indiscretions – probably pretty miserable. You know this because you’ve been here before and it’s not pretty. Bloating. Gas. Discomfort. No energy. Possibly needing to run to the restroom at a moment’s notice. When you remind yourself of this reality, you’re more likely to stick to your plan.
3. You have to practice telling people what you need.
Start with your immediate family – hopefully, they are your greatest supporters. Don’t assume they know what you can and can’t eat. Give them tools to help you by letting them know what you need. Advice? Ideas? Support? Some specialty item from the grocery store? People can’t read your mind, and they can’t do it for you. But they can provide support and encouragement if you let them.
4. You have to give it time.
Practice doesn’t make perfect – practice makes permanent. Practice your new diet in every situation you can imagine. Take notes on how you feel. Keep a food diary. Eventually, you will develop a routine and what was once your “new diet” will become simply the way you eat. Once you reach that new normal, you’ll be so glad that you spent the time putting in the work to feel your best.
Original post date: March, 2015. Revised: Feb. 2019.
These blogs are written by members of the CHI Health Nutrition Services team.