Irritable Bowel Syndrome

IBS is a chronic condition that affects millions of Americans. More and more research shows it's closely linked to stress, diet and other lifestyle factors that can be successfully managed with the right lifestyle changes and medical support. Discover the foods and lifestyle habits scientifically proven to help below.

Cases per year

Affects between 25 and 45 million people in the United States 1.

General frequency

10-15% of US adults suffer with IBS symptoms.

Risk

IBS can have profound effects on a person's quality of life, causes problems at work, and is associated with depression and anxiety.

Manage irritable bowel syndrome with lifestyle interventions and a plant-based diet

By eating more plants and fiber and less processed foods, meat and dairy, patients with IBS often see significant improvement in their gut microbiome and their symptoms.

Our PA Christina Lascano has seen the power of a plant-based diet help many of her patients

Podcasts

Here are some top scientific studies that support the results our clinicians have seen first-hand:

A unhealthy diet and gut microbiome related to severe IBS

Diet and gut microbiome interactions of relevance for symptoms in irritable bowel syndrome

This study of 201 participants found that individuals with severe IBS tended to have a higher intake of poorer quality food during their main meals. The researchers also looked at the participants gut microbiota and found that IBS severity was associated with altered gut microbiomes, and suggested that nutritional interventions should support the health of the gut microbiome 2. Plant based diets are consistently associated with healthy gut microbiomes.

Exercise therapy relieves symptoms of IBS 

Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials

Combined data from ​​a total of 683 patients with IBS testing a range of exercise interventions including yoga, walking/aerobic physical activity, Tai Ji, mountaineering, and Baduanjin qigong activity. The researchers found that exercise had significant benefits on gastrointestinal symptoms, quality of life, depression, and anxiety in patients with IBS 3.

Stress is a potent factor in the development of IBS 

Impact of psychological stress on irritable bowel syndrome - PMC

This review of the scientific literature identifies stress as a key factor in cases of irritable bowel syndrome. Evidence from clinical and experimental studies showed that psychological stresses increase intestinal sensitivity and permeability, and that stress management is an important avenue for IBS management 4.

Information about IBS and management with lifestyle interventions

What is IBS?

IBS is a chronic condition made up of a group of intestinal symptoms that typically occur together, and affect the large intestine. 

What causes IBS?

Currently, the exact cause of irritable bowel syndrome in unclear, but there is some understanding of the mechanisms involved in the condition. 

Two of the biggest factors in IBS are gut dysbiosis, and stress and anxiety. The bowel is connected to the brain via a network of nerves, called the gut-brain axis5. At the root of IBS is a problem in the interactions between the gut, brain, and nervous system, with more and more clinical evidence showing that IBS is a “combination of irritable bowel and irritable brain” 4. Because of this, people with IBS have a bowel that is more sensitive to changes in food and mood compared to people without IBS. Disturbances to the immune and hormonal systems are also likely to be involved in the development of IBS 4

Stress and other psychological triggers may send signals to the intestines to squeeze more than needed, as well as activating certain nerves and chemical releases in the gut which causes a disturbance in the contracting muscles, leading to the symptoms seen in IBS.

Additionally, due to the hypersensitive nerves seen in IBS patients they may experience more pain than people without IBS. This can cause normal things like a meal, passage of stools, or even gas to cause pain and cramps 6

A diagram showing abnormal bowel contractions in someone with IBS
Abnormal contractions of the bowel cause pain and bloating for people with IBS

Symptoms 

Irritable bowel syndrome occurs as a group of intestinal symptoms. They vary in severity and duration between individuals and include: 

  • Pain and cramping in your abdomen 
  • Changes in your bowel movements, which could be diarrhea, or constipation, or both
  • Bloating 
  • Gas 
  • Straining, urgency, or a feeling of incomplete evacuation.

These symptoms occur without any visible damage to the digestive tract. 

Diagnosis 

Because symptoms occur without visible damage to the digestive tract, diagnosis does not involve testing such as blood tests, X-rays, or endoscopy. Instead, to diagnosis irritable bowel syndrome, your healthcare provider will likely use:

  • The well-accepted set Rome criteria that includes stomach pain and discomfort averaging at least one day a week in the last three months. This pain should occur with at least 2 other symptoms out of: pain and discomfort related to defecation, a change in the frequency of defecation, or a change in stool consistency.
  • Medical history 
  • Family medical history 

Your healthcare provider may also carry out tests to help rule out other conditions with overlapping symptoms, such as coeliac disease. 

Treatment 

The best way to manage the symptoms of IBS are through the right diet and lifestyle changes. Two of the biggest factors in IBS, gut dysbiosis and stress and anxiety, can be directly addressed with the pillars of lifestyle medicine (whole foods, plant based diet, physical activity, restorative sleep, stress management, substance control, and social connections). 

The lifestyle interventions suggested to patients with IBS include: 

  • Participating in regular physical activity
  • Managing stress 
  • Taking probiotics and eating other gut-friendly foods 
  • Cutting back on caffeine intake 
  • Eating smaller meals 

An imbalance between the good and bad bacteria in the gut has been linked to irritable bowel syndrome. Fiber is the key ingredient in restoring a healthy gut microbiome, as it provides food for the good bacteria in our gut to feed on. It’s so important that fiber is considered a first-line therapy in treatment recommendations for patients with IBS, according to the 2021 American College of Gastroenterology clinical guidelines. A plant-based diet is rich in fiber and other gut-friendly foods that support gut health, and studies show that people who have a diet high in plant foods also have healthier, more diverse gut microbiomes than those eating animal-based diets 7 8.

It’s important to go slow when making dietary changes with IBS, and slowly increase fiber into the diet. Guidance from a dedicated lifestyle-medicine physician and medical team can provide the needed support to make these changes. 

Our knowledgeable and empathetic physicians can help you make changes that best suit your unique circumstances, to test different foods, and support the addition of whole plant foods and stress management techniques into your routine. 

Useful links

Success stories

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References 

1. IBS Facts and Statistics - About IBS. https://aboutibs.org/what-is-ibs/facts-about-ibs/ (2021).

2. Tap, J. et al. Diet and gut microbiome interactions of relevance for symptoms in irritable bowel syndrome. Microbiome 9, 74 (2021).

3. Zhou, C., Zhao, E., Li, Y., Jia, Y. & Li, F. Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials. Neurogastroenterol. Motil. 31, e13461 (2019).

4. Qin, H.-Y. Impact of psychological stress on irritable bowel syndrome. World J. Gastroenterol. 20, 14126 (2014).

5. Carabotti, M., Scirocco, A., Maselli, M. A. & Severi, C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann. Gastroenterol. 28, 203–209 (2015).

6. Delvaux, M. Role of visceral sensitivity in the pathophysiology of irritable bowel syndrome. Gut 51, i67–i71 (2002).

7. McDonald, D. et al. American Gut: an Open Platform for Citizen Science Microbiome Research. mSystems 3, e00031-18 (2018).

8. David, L. A. et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature 505, 559–563 (2014).

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