Managing Diet & Nutrition for Treating IBS Symptoms
A“gut-brain mis-interaction”—that’s howgastroenterologist Michelle Cohen, MD,refers to irritable bowel syndrome (IBS), a condition experienced by five to15% of the global population, and much of her own medical practice.
“Weevaluatethe different sub-types of IBS—dhea, constipation, and mixed pattern—and try to look at it in terms of whether a patient is experiencing the condition mildly, moderately, or severely,and how much it impacts their quality of life,” explainsDr. Cohen,Assistant Professor of Clinical Medicine in the Division of Gastroenterology and Hepatology at ֭Ƶ (WCM).
Based on a detailed medical historyand limited test workup, gastroenterologists can diagnose the condition and help patients manage itby creating an individualized treatment approach.
Treating Symptoms of IBS
Medication can be of limited use for some IBS patients, so diet is an effective way to start addressing IBS.
“The response rate for medications for IBS is not crazy high and can sometimes cause only a modest improvement in symptoms,” Dr. Cohen says. “That tells us we need to look at other thingsatplay.”
For patients with less severe cases of IBS, diet can sometimes be enough to improve symptoms. But even dietary changes have to be customized based on the patient.
“The puzzle pictureof IBSis the samefrom one patient to the next, but everyone’s puzzlepiecesare different,” Dr. Cohen says. “But we know there is some response to diet—it can be a key player in managing symptoms for patients with amild caseof IBS.”
Maintaining a Low FODMAP Diet
One of the go-to diets for patients with IBS-D (diarrhea) is called the, which can be used to help patients identify which foods trigger their symptoms.The diet is an attempt to limit foods thatmaycause gas and bloating, namely,fructose,lactose,fructans,galactans, andpolyols.
“Certain foods definitely promote diarrhea, and some patients have food intolerances that get tied into IBS symptoms,” Dr. Cohen says.
Constipated patients, she adds, may see results by balancingthe different fibers the ingestandmaking modifications to the low FODMAP diet.
“Other dietary tweaks like lowering fat and caffeine intake can be helpful,” Dr. Cohen says.
WCM dietitians and nutritionistscanbe an importantresource for IBS patients.
“We know some patients need a lot of dietary help, and it’s useful to find their specific triggers,”Dr. Cohen says.“They sit with patients and go through their dietsto talk about what works and what doesn’t work.”
It’s also aneffectiveway to individualize care.
“Adjusting a patient’s diet is not a one-size fits-all approach,” Dr. Cohen adds. “Sometimesadjusting dietis enough for a patient to experience relief, and sometimes it’sjustoneway to helptreat the overall condition.”