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Trust Your Gut

Karen Alexander, Licensed Registered Dietitian Nutritionist

April 27, 2021

Living with Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common condition that affects the large intestine. While only 5 to 7 percent of American adults have been diagnosed with irritable bowel syndrome, the actual number of adults estimated to be suffering from IBS is double that percentage. IBS is hereditary, and people with a relative who has IBS are twice as likely to be diagnosed.

Top 5 Facts to Know About IBS
  1. 15 percent of the global population has IBS
  2. IBS affects more women than men
  3. IBS is triggered by stress and certain foods
  4. A low FODMAP diet can improve IBS symptoms
  5. The impact of IBS can range from mild inconvenience to severe debilitation

Some cancer treatments for the abdomen and pelvic area, including chemo and radiation, can produce changes in the digestive tract. These symptoms include: diarrhea, temporary lactose intolerance, constipation or excess abdominal gas. For people with a history of IBS, cancer treatments can trigger and/or aggravate these symptoms, which can compromise their adherence to treatment.                              

IBS can be triggered by an intestinal infection, for which there is a specific diagnosis test. However, there is no clear cause for IBS. Symptoms for IBS are very general and similar to other conditions, so it can be hard to diagnose. Often times, IBS is diagnosed when a patient has gone through several tests, and they have not been able to find a reason for his or her symptoms. These symptoms include: cramping, abdominal pain, bloating, gas, mucus in the stool, diarrhea or constipation.

5 Tips to Relieve IBS Symptoms
  1. Minimize stress
  2. Learn and avoid your food triggers
  3. Exercise regularly
  4. Try over-the-counter medicines
  5. Visit a gastroenterologist

Mild and moderate IBS can be managed with diet, stress reduction techniques and physical activity. However, severe cases might require medication to control the symptoms. IBS symptoms are triggered by the components of food, specifically due to the fermentation of certain sugars in the gut (FODMAPs or fermentable fructo-oligosaccharides, disaccharides, monosaccharides, and polyols) that pull in water. For this reason, avoid or limit the intake of foods with a high content of FODMAP sugars to reduce symptoms. It is important to note that not everybody has IBS symptoms when eating foods with a high FODMAP. Science has not yet found a reason as to why some people do and some people do not. To find out which foods have high or low FODMAP, one can access extensive lists of FODMAP foods online, or one can download several apps to help manage your IBS.

Top 10 Foods that Trigger IBS
  1. Garlic
  2. Onions
  3. Beans & pulses
  4. Cauliflower
  5. Dried fruits (apples, figs, mango, pear, prunes)
  6. Dairy products with lactose
  7. Gluten (rye, wheat, spelt, barley)
  8. Cashews
  9. Pistachios
  10. Energy bars with dried fruits and nuts

Another important factor to keep in mind is how the serving size or combination of different foods can affect the amount of FODMAP in a meal. For example, one may be able to tolerate a very large amount of food chosen from the FODMAP-free list, but not food listed on the high-FODMAP list. You will notice that as the serving size of the FODMAP foods increases, it also increases the severity of the symptoms. It is recommended to eat FODMAP-free or low-FODMAP foods for about two weeks, and to introduce one new food item from the moderate and high-FODMAP list at a time. This allows for people to identify their personal tolerance to the food as well as the serving size that will trigger symptoms. At the end of several weeks, one will have a personalized low-FODMAP diet that will improve his or her quality of life.

The recipe of the week is for sweet and spicy roasted almonds.

Sweet and Spicy Roasted Almonds

Ingredients

  • 2 cups whole almonds
  • 1 tablespoon extra virgin olive oil
  • 1 ½ tablespoon honey
  • ¼ teaspoon kosher salt
  • 2 tablespoons sugar
  • ½-1 ¼ teaspoons cayenne pepper
    • Cayenne pepper can vary in intensity (start with less and add more to taste)
  • 1 teaspoon kosher salt

Directions

  1. Preheat oven to 350˚F with a rack in the center of the oven
  2. Line 2 sheet pans with parchment paper and set one of the prepared sheet pans near the oven
  3. Measure out almonds onto the center of the other sheet pan in an even layer
  4. Drizzle the oil and honey over the almonds
  5. Sprinkle with ¼ teaspoon salt.
  6. Place the almonds in the oven for 3 minutes
  7. Remove and stir well to make sure all the almonds are coated with the honey mixture
  8. Spread the almonds back out to an even layer
  9. Return the pan to oven and roast for 10-13 minutes or until almonds are golden brown (stir and spread to an even layer one more time half way through baking time)
  10. While almonds are in the oven, combine sugar, cayenne pepper and kosher salt.
  11. Stir the sugar, cayenne pepper and kosher salt and set aside.
  12. Remove the almonds from oven and transfer to the clean parchment paper, leaving any pooled honey/oil on the pan.
  13. Immediately sprinkle the almonds with the sugar/cayenne mixture and toss with two spoons till nuts are thoroughly coated.
  14. Spread nuts to a single layer and cool completely
  15. Transfer to an airtight jar or container, leaving any excess sugar on the pan

References

  1. https://gi.org/topics/irritable-bowel-syndrome/#:~:text=Common%20is%20IBS%3F-,IBS%20is%20a%20very%20common%20disorder%20and%20scientific%20tests%20show,women%20having%20it%20than%20men.
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921083/
  3. https://www.merckmanuals.com/home/quick-facts-digestive-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs?query=irritable%20bowel%20syndrome
  4. https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html
  5. https://www.ibssmart.com/post-infectious-ibs
  6. https://www.monashfodmap.com/about-fodmap-and-ibs/
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