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05 · Clinical Nutrition — Gastrointestinal

Irritable Bowel Syndrome

Personalised dietary approaches (e.g. low-FODMAP) for managing the symptoms of IBS.

What it is

IBS is a chronic disorder of the bowel that causes recurring episodes of abdominal pain, bloating and disturbances in bowel habits (constipation or diarrhoea).

Symptoms

  • Functional constipation or diarrhoea
  • Abdominal pain or cramps
  • Bloating

Nutritional management

First-line management:

  • Small, frequent meals
  • Good eating behaviours (taking time over meals, eating at a table, chewing well, avoiding meals late at night)
  • Avoiding alcohol
  • Reducing consumption of caffeine, tea, fizzy drinks and spicy foods
  • Avoiding supplementing the diet with wheat bran
  • Probiotic use is suggested, as it can contribute to symptom improvement

Second-line management:

  • A diet low in FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides And Polyols), a dietary protocol that consists of excluding and then gradually reintroducing foods rich in FODMAPs. FODMAPs are short-chain carbohydrates and include monosaccharides, disaccharides, polyols and oligosaccharides.
  • The low-FODMAP protocol consists of excluding FODMAPs for 4–6 weeks. Then, if symptoms improve, gradual reintroduction of FODMAPs follows for 6–10 weeks, with the aim of first identifying tolerated and non-tolerated foods and tolerance doses, and finally designing a personalised diet plan and liberalising the diet.

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