Ever been camped out in the bathroom for days? Left clutching your stomach in bed when you should have been at happy hour? Literally: The. Worst.
For the 10 to 15 percent of Americans that, according to the American College of Gastroenterology, suffer from irritable bowel syndrome (IBS), these feelings of discomfort and pain aren’t an occasional thing—and avoiding them isn’t as easy as swearing off Mexican food.
Since there’s no cure for IBS (experts are still trying to nail down what, exactly, causes it), the best course of action is to find IBS treatments that alleviate your particular set of symptoms—whether that’s abdominal pain, bloating, gas, constipation, diarrhea, or all of the above—and, hopefully, give your gut health a boost in the process, says Dr. Will Bulsiewicz, a board-certified gastroenterologist in Mount Pleasant, South Carolina.
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But since finding IBS treatments that are the cheese to your macaroni can be a tricky business, here, experts share their go-to strategies for IBS relief. Behold:
1/ Try The Low FODMAP Diet
Created by Monash University in Australia, the low FODMAP diet is designed to treat IBS symptoms. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (phew!), which are short-chain carbs that aren’t properly absorbed in the gut. “These can trigger symptoms in people with IBS, including gas, bloating, diarrhoea, and constipation,” says Chicago-based registered dietitian Rachelle LaCroix Mallik, FODMAPs are found in a variety of foods, including wheat, garlic, onions, honey, apples, milk, and cashews.
The goal of the FODMAP diet is to determine what your individual dietary triggers are—first, by eliminating high-FODMAP foods, then by reintroducing one FODMAP group at a time (while limiting the rest) and tracking how you respond to each group. “Once FODMAP triggers have been identified, the idea is to slowly re-introduce one food back into your diet every two to four weeks at small, but increasing amounts, to see how much you can handle of that food without symptoms,” says Dr Neilanjan Nandi, gastroenterologist and assistant professor at Drexel College of Medicine in Philadelphia.
It can be a tricky diet to follow on your own, so working with a registered dietitian who’s familiar with the diet can make it easier to follow and identify your triggers—plus, they can help you develop a healthy, individualized (and IBS-friendly) eating plan, says Mallik.
2/ Master Stress Management
While stress alone doesn’t cause IBS, it can certainly aggravate symptoms if you already have it, creating a vicious cycle: An uptick in anxiety can lead to more flare-ups, and those flare-ups can stress you out even more, says Dr. Daniel Motola, a gastroenterologist and clinical assistant professor of medicine at NYU Langone Medical Center.
That’s because, when you experience stress, your body goes into fight or flight mode, which means non-essential activities (like digestion) shut down, explains Dr. Samantha Nazareth, board-certified gastroenterologist in New York City. Too much stress can also mess with sleep quality, and any disruptions in circadian rhythms can affect gut health. Meditation, yoga, and keeping your circadian rhythm in check—by sleeping and waking at a consistent time—all act as stress reducers and can help break the cycle, says Nazareth.
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3/ Ask About Antidepressants
Most of your body’s serotonin, the happy hormone, is produced in the gut. Besides affecting mood, serotonin influences the flow of traffic in your intestinal tract and how sensitive we are to pain, says Bulsiewicz. This is why anxiety and depression can make an already finicky stomach that much crankier, and why doctors often prescribe selective serotonin reuptake inhibitors (SSRIs) as both a treatment for anxiety and depression, as well as IBS.
SSRIs can help keep things moving for people with IBS with constipation and can help with pain. Meanwhile, tricyclic antidepressants (TCAs), can be beneficial if you have IBS with diarrhoea—they work by slowing down the time it takes for poop to travel through you, and also contain pain-relieving properties, says Nazareth.
The medications are used at doses lower than those used to treat depression, says Motola, and typically work within a few months. “Patients need to see specialists if they’re interested in trying these medications, and should be monitored—particularly, with respect to side effects and drug to drug interactions,” he adds.
4/ Get Tested For Vitamin D Deficiency
A recent study published in the European Journal of Clinical Nutrition not only found a high prevalence of vitamin D deficiency in IBS patients (which is an essential vitamin for both immune function and gut health), but that study participants who took vitamin D supplements experienced an improvement in symptoms—including bloating, constipation, and diarrhea.
While the exact reason for this isn’t yet clear, researchers theorize that since vitamin D receptors are found in the gut, the vitamin may help promote intestinal function and guard against bad bacteria. Nandi recommends scheduling a vitamin D screening from your doc. Once you figure out your totals, your doctor will be able to let you know exactly how much more D (if any) you need.
5/ Balance Out Bacterial Overgrowth
The microorganisms in your gut (known as gut flora) play a starring role in digestion and immune function—so when the bacteria in your gut is out-of-whack and pathogenic (bad) bacteria starts calling the shots, the imbalance can lead to an increase in IBS symptoms.
Antibiotics are often to blame for this gut disruption, but there’s one antibiotic that might actually ease IBS symptoms. “Rifaximin, a narrow spectrum antibiotic, focuses its attention on specific types of bacteria responsible for creating some of the bloating and diarrhea that many IBS patients suffer from,” says Nandi, who recommends chatting with your doc to see if testing for bacterial overgrowth—or taking a round of this antibiotic for a spin—may improve your symptoms.
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6/ Exercise On The Regular
Along with relieving symptom-inducing stress, sweat sessions can stimulate normal contractions of your intestines (peace out, constipation!). A recent study from the University of Illinois also found that exercise can increase the good bacteria in your gut, independent of diet. Post-exercise, most study participants had larger concentrations of short-chain fatty acids in their intestines, which may help alleviate gut inflammation, and in turn, symptoms related to faulty wiring in the digestive tract (though more research needs to be done on this), say researchers.
For symptom relief, Motola recommends exercising for 20 to 60 minutes three to five times per week—aerobic exercises, such as running or cycling, as well as workouts that incorporate relaxation, such as yoga, can be effective (and fun!) IBS treatments.
7/ Pop Peppermint Oil Capsules
A 2014 meta-analysis published in the Journal of Clinical Gastroenterology found that peppermint oil can improve IBS symptoms and reduce abdominal pain. Coated peppermint oil relaxes the muscles of the intestines, says Nazareth, and popping it in capsule form helps the oil travel further down into the intestinal tract to relieve IBS symptoms, such as gas and bloating.
Even though peppermint oil capsules are available OTC, it’s best to check in with your doc to fine tune a dosage that’s right for you.
8/ Steer Clear Of Artificial Sweeteners
Artificial sweeteners are poorly absorbed and become fermented by bacteria in the colon, which can cause gas, bloating and diarrhea, says Motola. The production of gas causes pain by stretching or distending the intestinal walls (gah), and people with IBS may have a heightened response to the pain compared to those without IBS.
Hence why it’s super-important to break up with foods and beverages that contain sugar substitutes. The best way to scope them out? Get into the habit of reading food labels. “It helps to know some of the terminology the food industry uses for artificial sweeteners,” says Nazareth. “Common ones are aspartame, isomaltose, saccharin, and sucralose.” Sugar alcohols are another class of sweeteners that are used as sneaky sugar substitutes, and these typically end in “ol”—mannitol, sorbitol, glycerol, and xylitol, to name a few.
9/ Increase Your Fibre Intake
The American Heart Association recommends consuming 25 grams of fibre per day. However, most Americans are only getting around 15 grams, says Nazareth. “Fibre in the form of plants (indigestible fibres) act as prebiotics, which feed the good organisms in your gut and promote a healthy gut microbiome,” she says. It can also level out constipation and diarrhoea for more consistent poops.
When using fibre as one of your IBS treatments, go slowly with increasing your intake—say, an extra serving of fruits or veggies (or teaspoon if taking a supplement) every few days—and check in with yourself to see if you’re bloated, crampy, or gassy, says Nazareth. If not, continue adding additional servings until you reach your fibre goal, making sure to drink one to two eight-ounce glasses of water with the extra fibre for safer travels through your digestive tract. (And if your stomach does give you ‘tude, try waiting longer between increases.)
This article was originally published on www.womenshealthmag.com
