It is important to understand right up front that IBS treatment is something of a trial-and-error process. This is not shooting in the dark, but is instead taking treatments that have been successful for some IBS patients, and seeing if they will work for you.
IBS (Irritable Bowel Syndrome) is a complicated collection of signs and symptoms. It is a syndrome and not specifically a disease because it can involve many causal and contributory factors, which, frankly, are not thoroughly understood by the medical and research communities. IBS can involve diarrhea, constipation (sometimes both), abdominal pain, bloating, gas and sometimes other things. Often the types of foods eaten will impact IBS, whether the sufferer realizes it or not.
Nutrition science is relatively young and incredibly complicated. It is very difficult to create experiments that directly get to the heart of even rather simple nutritional questions — let alone complicated issues like IBS. At this point, evidence-based practitioners must piece together information from existing IBS research and clinical experience to tease out potentially effective solutions. In most cases, suggested courses of action for IBS amount to implementing a given suggestion (that has been helpful for some others) and seeing how effective it is for you.
IBS probably involves several related factors:
- Gut microbiome (the collection of bacteria that lives in your intestines)
- Permeability of the cells that line the intestinal wall
- Immune system
- Dietary choices
A dietetic approach to IBS treatment is likely to involve and certainly impact all these factors sooner or later. How these are addressed and in what order depends on client preferences, budget, and often most importantly, how determined the client is to control the types of foods consumed. Those most successful in controlling their IBS and normalizing their results are often those who are willing to take a personal hand in preparing their own food and thereby adhering to dietary recommendations. It is often difficult to eat for IBS control if one relies on restaurants for a significant percentage of their meals.
Generally physicians will attempt to treat IBS sufferers with standard lifestyle recommendations and various medications. If these are not effective, both the physician and patient can be frustrated. There are other options to explore in some dietetic offices (such as mine, in which a certified LEAP therapist practices) that are not available from other medical or dietetic practitioners.
Dietetic IBS treatments can begin with either tests to assess immune reaction (the mediator-release test) or with dietetic suggestions to try first. Medications to treat IBS have likely been explored with your physician, but these will certainly be discussed as part of the client-provider discourse.