What triggers IBS symptoms?
Triggers tend to be very individual, but centre around lifestyle factors such as stress levels, and dietary factors that include not just troublesome foods but also careless eating habits.
IBS symptoms are as individual as the triggers themselves. Symptoms of a flare up may include abdominal pain, diarrhoea, bloating, flatulence, constipation and nausea. These are all due to underpowered digestion, resulting in a weak digestive response.
- Fewer digestive enzymes are produced. When fewer enzymes are produced, food is not properly broken down in the stomach. Then when it passes further along the digestive tract it can cause bloating and wind, any may irritate the gut lining triggering loose stools or diarrhoea.
- Stomach acid levels are low. Stomach acid is essential for effective digestion. When stomach acid levels are low, proteins are not properly broken down and minerals can’t be efficiently absorbed. Food is more likely to sit in the stomach, causing discomfort and belching.
- Bile is not moved into the small intestine. Bile aids digestion by helping to break down and absorb fats, as well as assisting in getting rid of waste products. If fat can’t be absorbed it passes into the colon, where it can act as an irritant.
- Transit may be slower. Transit time is the duration between when food enters the mouth and when waste is released as a stool. If transmit time is slow, excess water is drawn from the stool and can make it harder to pass, thus leading to constipation. On the other hand, if transit time is fast less water is absorbed back into the body and the stool will be watery, resulting in loose bowel movements or even diarrhoea.
So, it’s clear that having a strong digestive response is important in order to avoid triggering IBS symptoms.
IBS and stress
The body's response to stress, whether physical or emotional, includes the release of adrenalin. One of adrenalin's first actions is to shut down the digestive system, diverting energy to areas such as the circulatory system in order to maximise the ability to fight or run. Stress is therefore a key factor in reducing the digestive response.
Try this: Sitting down and relaxing over a meal rather than eating on the run; chewing well rather than rushing to get finished; these simple actions ensure a better digestive response. Many people with IBS find themselves able to digest without any trouble when they are relaxed and focused happily on their food.
Even if you are stressed, taking care around how you eat will counter some of the adverse effects.
General food tips for IBS
Here are some easy tips to promote better digestion, even when stressed.
- Try not to skip meals. This can cause your body to release more adrenalin in order to push up your blood sugar; and this then hinders effective digestion.
- Try to eat meals at regular times, as your body will then naturally switch into digestion mode at the appointed times. The human body likes routine!
- Don't rush your meals! Chew your food properly! When food is chewed thoroughly you release a lot of saliva, which contains digestive enzymes. The chewing action also alerts the stomach to the imminent arrival of food, so it prepares itself with the production of more enzymes and stomach acid. As previously mentioned, a lack of digestive enzymes will contribute to bloating, wind and other digestive mayhem.
- Aim to drink at least 1.5 litres of still, plain water each day. However, try to avoid drinking whilst eating as too much liquid will dilute digestive enzymes.
- Eat bitter foods regularly. Bitter foods such as rocket, radicchio lettuce, artichokes and chicory are all helpful in switching on proper digestive processes. If you're not keen on bitter foods, take a short cut with some herbal bitters.
Herbal bitters and IBS
Herbal bitters can act as a digestive aid for your gut! Herbal bitters can support the digestive system by gently stimulating the production of digestive enzymes as well as ensuring the correct balance of stomach acid. This allows you to break down protein properly and absorb minerals effectively. This can often help to ward off symptoms such as bloating, constipation and diarrhoea. As well as this, herbal bitters help to fend off bad bacteria like Helicobacter pylori, which can undermine the health of your stomach. Finally, herbal bitters can help increase the production of bile, thereby countering constipation in many cases.
What else? Bitters can work very quickly! They should be taken before a meal in a little water, and can also be taken after a meal if necessary. Remember to chew your food properly as well!
Food Factors
There are some food and drinks that are generally harder to digest, requiring more digestive energy, and these are therefore more likely to cause problems. These inlude:
- Caffeine
- Alcohol
- Spices and herbs
- Wheat
Caffeine and IBS
Regular caffeine consumption is associated with a range of digestive problems and can trigger an IBS flare up. Caffeine can increase gastric secretions, which can irritate the lining of the stomach and cause pain.
In addition to this, caffeine can also increase peristalsis (the contraction of the muscles in the intestines, which moves wastes through the large intestine). Increased peristalsis encourages a bowel movement, but overstimulation of peristalsis decreases the amount of time that the colon has to absorb water from a stool, thereby contributing to looseness or diarrhoea.
Furthermore, caffeine can increase your urinary output, which could lead to dehydration if you do not make up for lost fluids. Dehydration can have a negative effect on the intestines which can make your stools dry and hard to pass, possibly leading to constipation. It is therefore helpful to check your water intake and consider minimising your coffee consumption!
Alcohol and IBS
Regular alcohol intake is directly associated with a range of digestive problems, and research has shown that it can worsen IBS symptoms. (1) Alcohol prevents the absorption of minerals by damaging the cells lining the intestines. As well as this, alcohol also hinders the secretion of digestive enzymes. As we have seen, low levels of enzymes and stomach acid means food passing into the intestines in a poorly broken down condition, leading to bloating, wind and a raft of other IBS symptoms.
Also, alcohol can both increase and decrease the speed of peristalsis. Chronic alcohol consumption can increase peristalsis and cause diarrhoea. On the other hand, alcohol can also decrease the speed of peristalsis and have the opposite effect – constipation. It's a lose; lose situation.
Additionally, excessive consumption of alcohol may lead to gastritis. This is a condition that occurs when the lining of the stomach becomes inflamed. During inflammation your stomach lining changes and some of the stomach's protective cells are lost. Gastritis often causes digestion problems such as abdominal pain, bloating and nausea.
Finally, regular consumption of alcohol can lead to alcohol hepatitis, an inflammation of the liver caused by exposure to substances such as alcohol and other drugs. Alcohol hepatitis can permanently damage the liver, leading to cirrhosis – irreversible scarring of the tissue. Symptoms often include digestive problems such as abdominal pain.
A little tip - Water is a recommended drink for those who suffer from IBS, as water helps to replace the fluids that are lost through diarrhoea. I know that some people find water is a little on the plain side, so why not switch it up a little and add some fruit and herbs such as a few slices of cucumber and a sprig of mint.
Spices/herbs and IBS
Spices have negative impact on the body as they can irritate the stomach lining and trigger an IBS flare up. However, some spices and herbs have also been associated with helping to manage IBS symptoms.
Capsaicin is an ingredient in red chilli that produces a burning sensation. This may cause abdominal pain and diarrhoea in some IBS patients.
Garlic has been known to trigger IBS symptom such as diarrhoea as it contains fructans. Fructans are oligosaccharides that are made up of fructose and glucose molecules. Unfortunately, these are tricky to metabolise in the small intestine (2) and may result in watery stools and possibly diarrhoea.
Garlic also contains sulphur – the compound that causes wind to smell. Wind can be experienced in the form of burps or flatulence. Eating foods that contain sulphur can lead to excessive, smelly wind. Also, garlic is a high FODMAP food which may not be properly digested in some people, causing bloating.
Ginger – Ginger has anti-inflammatory properties and is warming. Also, it helps digestion by speeding up the gastric emptying process. Delayed gastric emptying has been associated with IBS. Research has shown that ginger can be beneficial to IBS patients. (3)
Turmeric – Turmeric contains curcumin. Research has shown that curcumin has anti-inflammatory and anti-oxidant properties. A recent study found that these can potentially be beneficial to managing IBS symptoms. (4) However, be careful how much turmeric you use!
If you're a spice lover but suffer from IBS it may be worth swapping chilli spices for some turmeric or ginger. However, if you don't fancy any of these spices you can use mild herbs such as basil, parsley, thyme and rosemary, which also appear to have a beneficial effect on IBS symptoms.
Wheat and IBS
Wheat contains gluten, an indigestible protein that is increasingly understood to cause intolerance. Some people are allergic to gluten, suffering from coeliac disease. This is an autoimmune disorder in which gluten damages the lining of the small intestine, causing poor absorption of nutrients and often a great deal of pain. Gluten intolerance is a milder problem, but will still have a negative impact on your digestive system. Many people with IBS also suffer from gluten intolerance. (5) Recent research has found that following a gluten-free diet can help decrease IBS symptoms of abdominal pain and wind. (6)
As well as gluten, wheat also contains fructans. As previously mentioned, fructans are not easy to digest and may cause bloating and diarrhoea. This is backed up by a study which found that fructans are likely to induce symptoms of IBS. (7)
So what can you take away from this blog?
- IBS symptoms can flare up seemingly randomly, due to a combination of stress and demanding foods.
- Digestive power plays a huge role in IBS: a weak digestive response is very likely to cause IBS symptoms.
- Minimise IBS symptoms by improving how you eat, and reducing intake of foods and drinks that are hard to digest. Small changes can make an encouragingly speedy difference to your digestion, so start implementing a few changes as soon as you can!
What you said
We recently ran a poll to find out what is your most frequent IBS symptom. We've crunched the numbers and here are the results.
Results: What is your most frequent IBS symptom?
Abdominal pain is a common symptom of IBS, so its no wonder that the majority of you agreed that this is your most frequent symptom.
