irritable%20bowel%20syndrome
IRRITABLE BOWEL SYNDROME
Irritable bowel syndrome is a common chronic gastrointestinal condition characterized by abdominal pain and bloating with altered bowel habits.
There are no identifiable physical, radiologic or lab abnormalities indicative of organic disease.
Symptoms may be exacerbated by stress, alcohol or food.

Lifestyle Modification

Dietary Monitoring
  • It may be helpful to have patients keep a diary of food intake, symptoms including severity and possible exacerbating factors (eg emotional issues) for 2-3 weeks
  • Physician may then be able to make lifestyle or diet modification suggestions based on the above
Recommended Dietary Modifications for IBS Patients:
  • If IBS is complicated by fructose malabsorption, reduce all short-chain carbohydrates from diet (ie fructose, polyols)
  • A short-term diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is recommended to reduce IBS symptoms
  • Probiotics may be considered to improve symptoms such as bloating and flatulence
  • If lactose intolerance is suspected, a trial period of low-lactose diet may be advised; if confirmed via a positive lactose hydrogen breath test, low lactose diet is highly recommended
  • Supplementation with soluble and poorly fermentable fiber is recommended for overall symptom improvement
    • Psyllium but not wheat bran is recommended for overall symptom improvement
  • Elimination/empirical diet is recommended for 2-4 weeks when specific foods are suspected of causing IBS symptoms; if no improvement after 4 weeks, consider other factors or refer to specialist
  • Other general dietary modifications include drinking at least 2000 mL of fluid daily, reducing intake of alcohol, caffeinated drinks or softdrinks, restricting fresh fruit intake to 3 portions daily, avoiding sorbitol if patient has diarrhea
IBS with Constipation
  • A 3-month trial with ground linseeds is recommended for IBS-C patients with abdominal pain and bloating
  • May suggest to patient to increase dietary intake of fiber to 20-30 g/day
  • Dietary fiber assists with constipation but does not seem to improve abdominal pain
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