GUT HEALTH / Gut Flora

Do you have IBS? – it’s one of the world’s most prevalent diseases

IBS is one of the world’s most prevalent diseases. Approximately 10% of Swedish adults are affected, more women than men. Why people get IBS is still unclear, but things such as lifestyle, diet and how you take care of your intestinal flora affect its development. So how would you know if you have IBS and what can you do to relieve its symptoms?

Symptoms of & relief from IBS

Examples of IBS symptoms

– Stomach pain (often worse after eating and can be lessened after going to the toilet)

– Bloated stomach and/or wind

– Irregular stools

These symptoms would affect you on an ongoing basis for several months.

The symptoms can vary greatly, the most common being a stomach ache. But pain, swollenness, constipation, or diarrhoea are also common. IBS stands for Irritable Bowel Syndrome, and basically means an over-sensitive bowel. It quite often takes a long time to diagnose as other diseases need to be ruled out first, and therefore it can take a lot of visits to the doctor before the diagnosis can be made.

Often you can also have other conditions such as sensitivity to gluten or lactose. In recent years, a link between the ability to digest fibre and having IBS has been identified. At that point, a long list of foods you should avoid – called FODMAPs – was compiled. It consists of foods with difficult-to-digest carbohydrates. And has been used as an accepted form of treatment. Unfortunately, it doesn’t provide relief for everyone, and there may be easier treatments.

Foods with high FODMAP values

– Fructose: Apples, pears, peaches, mangoes, watermelons, canned fruit, dried fruit, honey, juices.

– Fructans and/or galactans: Wheat and rye in larger quantities (bread, pasta, biscuits). Broccoli, Brussels sprouts, cabbage, onions, garlic, peas, legumes.

– Polyols (sugar alcohols): Apples, apricots, cherries, nectarines, plums, avocados, mushrooms, cauliflower. Sweeteners e.g.: sorbitol, mannitol, xylitol.

– Lactose: Milk, yoghurt, cream cheese.

A Swedish study, which is the largest so far conducted on diet versus IBS, shows that a diet with a low intake of carbohydrates can work just as well against IBS as the FODMAP diet. The diet in the study limited carbohydrates such as rice, bread and pasta and contained more protein-rich foods, natural fats and vegetables. The subjects also continued to receive other FODMAP-rich foods. They found this diet to be unexpectedly effective as it was previously believed that IBS could be worsened by a high fat intake. The diet also gave relatively quick results, which can increase motivation. A FODMAP diet can be complicated which often makes persistence and keeping the diet consistent challenging. Many of the foods in FODMAPs are also very good and healthy for us – which unfortunately becomes a problem when you cannot eat them and have a healthy, pain-free stomach.

Intestinal flora and IBS

The intestinal flora consists of millions of bacteria that contribute to digestion, nutrient absorption, and immune defence. It has been shown that the nerves in the intestine have increased sensitivity in people with IBS, which negatively affects the function of the intestine and makes it more easily irritated. In addition, several studies have discovered differences between the intestinal flora of patients with IBS and healthy people.

In connection with IBS, stress is also mentioned as a factor. However, we do not know exactly whether it is the symptoms from the gut that cause the stress or vice versa. What we do know is that the gut and the brain communicate via the gut-brain axis. If you suffer from IBS, it’s therefore extra important to manage the amount of stress you’re exposed to, and especially around the times you eat.

Anti-inflammatory diet as relief against IBS

It’s important to get to the root of the problem of why IBS has developed, and then it will often be your lifestyle that you’re encouraged to review. Diet, exercise and stress management are all factors that can have an effect. Just adjusting your diet is, as mentioned previously, standard advice for IBS, and we recommend eating an anti-inflammatory diet.

Diet is an important part in alleviating the symptoms, as well as keeping our intestinal flora healthy. An anti-inflammatory diet and supplementing lactic acid bacteria and fibre is therefore important. Adding probiotics and prebiotics via dietary supplements (such as Synbiotic) is good as it contains several of the bacterial strains that can help the body break down fibre.

The anti-inflammatory diet also avoids foods that people with IBS are often sensitive to, such as gluten and lactose. And many find that the symptoms of IBS become milder or reduced with this diet. Anti-inflammatory foods are very healthy overall and are largely in line with the national dietary recommendations given. Since the anti-inflammatory diet mainly consists of different types of plant food, it’s also rich in fibre, vitamins and antioxidants.

In practice, eating anti-inflammatory food means eating foods that have a reductive effect on inflammation in the body, and it’s mainly food from the plant kingdom. Fibre, for example, is very important for your intestinal flora. An anti-inflammatory diet is also about avoiding inflammation-causing food, such as gluten, flour products, sugar, trans fats and unnecessary additives.

Tips for anti-inflammatory eating

– Let the majority of your diet be made up of raw vegetables.

– Avoid heating your food above 100 degrees.

– Follow the 80-10-10 rule – 80 percent fresh/frozen fruits and vegetables, 10 percent vegetable fat (avocado, coconut, nuts, etc.), 10 percent protein (legumes, wild-caught fish).

– Reduce meat intake (max 300 grams per week).

Good anti-inflammatory foods

– Green leafy vegetables (e.g. spinach and kale).

– Fruits and berries (strawberries, blueberries, cherries, oranges).

– Nuts and seeds (e.g. almonds, walnuts).

– Gluten-free grains (amaranth, sorghum, teff and quinoa).

– Legumes (various types of beans, peas, and lentils).

– Fermented foods such as kimchi and sauerkraut.

– Anti-inflammatory spices (e.g. turmeric, cayenne pepper, cloves).

– Wild-caught fish (e.g. mackerel, cod, and pollock).

3 steps to relieve IBS

– Eat an anti-inflammatory diet – As mentioned, dietary adjustment is the most common tool for treating IBS. A lot of people experience fewer symptoms with the help of an anti-inflammatory diet. Read more about the anti-inflammatory diet here.

– Add good bacteria and fibre – Take care of your intestinal flora by adding good bacteria and fibre. You can do this both by eating more plant fibres and by adding dietary supplements such as pre- and probiotics.

– Manage your stress – Stress is not good for a stomach with IBS. Try to find ways to minimise stress.