Many diets claim that they are good for promoting gut health and therefore improving IBS symptoms. Is the Paleo diet helpful in controlling IBS?
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What Is IBS?
Irritable Bowel Syndrome (IBS) is a medical disorder characterised by a wide range of digestive symptoms including bloating, diarrhea, constipation, gas and general abdominal discomfort. It is estimated that around 15 – 20% of the western population suffer from IBS and related disorders at some point in their lives. IBS is twice as common in women as it is in men and can occur at any age, but most often occurs before the age of 40.
Three sub-types of IBS have been classified as follows:
- IBS-D describes IBS which causes increased or frequent diarrhea
- IBS-C describes IBS which causes increased or frequent constipation
- IBS-M describes a mixed type of IBS which includes both symptoms
There is no known exact cause of IBS and no single reliable test for it. Diagnosis is difficult as the symptoms aren’t caused by any obvious physical or metabolic abnormality. As the symptoms are also common to other bowel conditions, it is mostly diagnosed after testing for other digestive disorders proves negative.
The first thing to identify is what is causing the IBS in the first place, which can be extremely frustrating as the symptoms often have no one easy to identify cause, and there is no magic pill to cure all cases.
After discussing with your medical practitioner, you can try cutting out all the foods, medicines, and products that might be contributing to gut symptoms. Eliminate foods such as grains, legumes, dairy, nightshades and seed oils from your diet as these can be harmful and inflammatory. Some medications can contribute to IBS. Antibiotics can destroy your good gut bacteria and general intestinal health. Many over-the-counter painkillers such as NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) cause digestive issues in even those not experiencing any signs of IBS.
What Are the Causes of IBS?
Gut Dysbiosis: This is the scientific name for an imbalance of gut bacteria. Studies have shown that up to 70% of IBS patients have gut dysbiosis. This is to usually decreased levels of good bacteria and increased levels of bad bacteria. Prebiotics and probiotics are often prescribed to help alleviate IBS symptoms and their success in treating this is further evidence that this may be a cause.
Gut Permeability: Commonly referred to as “leaky gut”, this is a condition where cracks or holes develop in the lining of the intestine. This allows bacteria and toxins to enter the bloodstream, causing widespread inflammation and may trigger a reaction from the immune system.
SIBO: Small intestinal bacterial overgrowth is a condition where the small intestine has an abnormally high number of bacteria. SIBO is found in up to 80% of IBS patients. The treatment of SIBO with antibiotics can also be effective for treating IBS, however the use of antibiotics can kill off the helpful gut flora needed for normal bowel health.
Food intolerances and sensitivities: Sensitivities to foods such as gluten, dairy, legumes, eggs and yeast can cause the same symptoms as IBS.
Stress: There is a strong link between IBS and stress. Recent research shows that the nervous system controls the gut as well as responding to psychological stress. The link between IBS and stress goes both ways. Feeling stressed can worsen or even be the trigger for IBS symptoms, and the physical symptoms of IBS can cause psychological distress.
What Is the FODMAP diet?
FODMAPs are the chemical names of a collection of carbohydrates (sugars) that aren’t properly absorbed in the small intestine. FODMAPs are found naturally in many foods and can trigger symptoms in people with IBS.
FODMAP is an acronym for:
- Fermentable: The process through which undigested carbohydrate is fermented by gut bacteria to produce gases.
- Oligosaccharides: Fructans, which are found in foods such as wheat, rye, legumes, onions and garlic.
- Disaccharides: Lactose, which is found in dairy products such as milk, yoghurt and soft cheese.
- Monosaccharides: Fructose, which is found in honey, sugar, high fructose corn syrup and fruits such as apples and pears.
- Polyols: Sorbitol and Mannitol which are used in artificial sweeteners and found in some fruit and vegetables.
A low FODMAP diet reduces or removes certain foods which can relieve the symptoms of some IBS sufferers. The diet is not a diet for life, it is used as a diagnostic tool to monitor tolerance to foods which are high in FODMAPs. Generally, the diet starts with a period of high restriction for 2 to 6 weeks, then transitions to the next phase where certain foods are gradually re-introduced to assess tolerance levels. It is best followed under the supervision of a qualified healthcare practitioner who is experienced in the diet and management of IBS.
What Is the Treatment for IBS?
Western high-carbohydrate diets are contributing to obesity, diabetes and heart disease, as well as having a negative impact on our microbiomes. Following the Paleo diet can assist gut recovery by increasing consumption of vegetables, fruits, and lean protein. Eliminating processed foods filled with excessive sugar, unhealthy fats and refined grains is surely the way toward improved overall and digestive health.
Eating foods such as bone broth (made from water and the meat and bones of animals), fermentable fibres (found in fruits, vegetables, starches, nuts and seeds) and fermented foods (such as sauerkraut, kimchi, pickles, kombucha) will nourish the gut.
Living with IBS doesn’t mean extensive lists of do’s and don’ts at the supermarket nor does it mean that you have to live on nothing but plain meat and vegetables. You can modify your Paleo diet to exclude eggs, foods classed as FODMAPs, nightshades, nuts and any other foods which trigger your IBS symptoms and still have delicious and varied meals!
Why not cook a roast for dinner? This will then provide plenty of leftover meat and vegetables to give you a quick and healthy lunch. Check out our list of Paleo-friendly savoury snacks to have in place of unhealthy crackers or cookies.
Over time keep a food diary to learn more about the foods that trigger your IBS, and you will build up a valuable record of foods that can be eaten. Only re-introduce one food at a time every few days to ensure you don’t suffer a reaction to it before moving on to another one. With patience and diligence, you will find a way of eating that works for you.
Many IBS sufferers find that the Paleo diet helps their symptoms. With many more vegetables and whole foods rather than packaged and pre-made food they were consuming more vitamins, minerals and fibre from these foods and their overall health improved.
Remember, Paleo is always about listening to your body and adapting your diet accordingly.
Until a definitive test and cure for IBS is found, the best general advice is to nurture your gut as much as possible by reducing inflammation and creating a healthy environment for gut flora. By identify foods which trigger your IBS symptoms and eliminating these from your diet and increasing gut-friendly foods.
Chris Kresser, M.S., L.Ac, is a practitioner of integrative and functional medicine and the creator of ChrisKresser.com, one of the most respected natural health sites in the world. He developed “Your Personal Paleo Code” based on over ten years of research, his own recovery from a debilitating, decade-long illness, and his clinical work with patients.
In his books, “Your Personal Paleo Diet” and “The Paleo Cure“, Chris has looked at the role of the gut, how it performs, and the role of the foods you eat, including those that may irritate an already inflamed gut. Chris’s books are an excellent reference both for developing the right Paleo diet for you and for addressing medical problems such as Coeliac disease, Gluten intolerance, heart disease, obesity, IBS and SIBO.