Irritable bowel syndrome isn't a standard conversation starter at holiday celebrations. But with one in five Americans prone to IBS, chances are it affects you or someone you know. For IBS sufferers, party time can quickly turn into bathroom time.
“No one is sure of the cause of IBS,” says Debra Brammer, ND, associate professor of naturopathic medicine at Bastyr University in Kenmore, Washington. Theories abound, however. Some experts think stress leads to the onset of IBS. Others attribute the condition to an imbalance in the body's digestive enzymes. Health care practitioners diagnose IBS through a process of elimination, after ruling out inflammatory bowel diseases, such as celiac disease, ulcerative colitis, and Crohn's disease.
The first step in alleviating symptoms — which include bloating, abdominal pain, cramping, gas, diarrhea, and constipation — is often an elimination diet, during which common culprits are avoided for a time, then reintroduced to observe their effects (see “How to Do an Elimination Diet,” below). “Sixty percent to 70 percent of people who do this will find that a certain food is contributing to their IBS,” says Benjamin Kligler, MD, MPH, research director for the Continuum Center for Health and Healing in New York. Because the holidays can be a tough time to accomplish such a feat, we offer four effective tactics to find relief during the month ahead.
Take beneficial bacteria
IBS may strike because “good” gut flora become imbalanced with the “bad” — which can be the unfortunate result of taking antibiotics or corticosteroids. Antibiotics are meant to kill off disease-causing bacteria, but they don't discriminate: Beneficial gut microbes that support digestion, fight infection, and reduce inflammation get destroyed, too. Even if you haven't taken antibiotics recently, ramping up your probiotics can help prevent flare-ups and soothe IBS-linked digestive disturbances, especially abdominal cramps and bloating, says Brammer.
To maintain beneficial bacteria and support a healthy digestive system, eat cultured foods daily, or at least several times a week. Good probiotic-rich foods include unsweetened kefir and yogurt, sauerkraut, and miso. After a course of antibiotics, Brammer suggests adding probiotic supplements to your daily regimen: Take a mixture of probiotic strains, in at least 4-5 billion colony-forming units, twice a day for one to two months. The mix of probiotic bacteria helps alleviate a variety of symptoms. Plus, you may respond to some probiotic strains better than others.
Carminative herbs such as peppermint relieve IBS-related cramps, gas, and bloating. “Peppermint normalizes the flow of minerals, such as potassium and sodium, in the smooth muscles of the intestines so they contract and release in a normal way, not spasmodically,” says Brammer.
To prevent cramping after a meal, drink a strong cup of peppermint tea. If you tend to get heartburn, tread lightly — peppermint can worsen acid reflux. Instead, take 0.2-0.4 ml of peppermint oil in enteric-coated capsules three times daily. The coating prevents peppermint from releasing until it reaches the small intestines, where IBS sufferers need it most.
See a hypnotherapist
In IBS sufferers, the signals that tell the gastrointestinal tract how to perform have somehow been derailed — perhaps because of stress. Yoga, meditation, journaling, and creating art all can help the nervous system function more smoothly. Hypnosis, another stress-reduction trick, has shown excellent results for helping the digestive system get back on track. “The therapeutic visual suggestions help you relax. As a result, the gastrointestinal tract settles down and becomes more efficient,” says Kligler. He recommends finding a hypnotherapist who works one-on-one or in small groups.
To locate a therapist in your area, ask your health care practitioner for recommendations or contact the American Society of Clinical Hypnosis (asch.net) or The American Board of Medical Hypnosis (abmedhyp.net). Between hypnotherapy sessions, get extra help from guided-imagery CDs, such as the IBS Audio Program 100 (ibsaudioprogram.com), or listen to a personalized audio CD recorded for you by your hypnotherapist.
Get moving again
If you suffer from IBS-related constipation, exercise may be nature's best laxative, particularly after meals. A post-dinner walk, for example, works like a pump on the intestines: You lift and lower your legs, contracting and releasing your pelvic-area muscles. Food moves more easily through your digestive system, and stools progress unhindered through the colon. More frequent bowel movements mean less cramps, spasms, and gas, too.
If walking doesn't suit you, swim, cycle, mow the lawn, or dance — whatever aerobic fitness routine inspires you. Or try Brammer's suggestion for a less-intense exercise that still moves things along in the body: yogic breathing. Relax your upper chest and use the lower belly muscles to push and pull air rapidly in and out through the nose for two to three sets of 10 to 20 breaths. “This ‘Breath of Fire’ gets circulation going and actually compresses and releases muscles around the intestines, for a mild pumping action,” says Brammer.
How to do an elimination diet
For two to four weeks, stop eating the most common irritation culprits: soy, dairy, citrus, wheat, and nuts. You can also try eliminating other foods that you eat frequently or tend to crave. These may cause IBS symptoms, too, according to Benjamin Kligler, MD, MPH.
If symptoms don't improve during the elimination period, you may not have a dietary IBS trigger. If you find relief, challenge yourself by reintroducing one food at a time for three to four days, noting how your body reacts. If you suffer a bout of IBS, take the food back out. If you feel fine, leave the food in your diet. Then progress to the next test food.
Assessing all five ingredients takes about two months, and by the end, you will likely have identified food categories you're better off avoiding. “It's not a cure,” says Kligler, “but it can give you a greater degree of control over your symptoms. If dairy is a big trigger, it doesn't mean you can't ever eat it. But you know that if you eat cheese fondue, you're going to experience symptoms for the next few days.”
For more about how probiotics can aid digestion, read Get Cultured.