Nearly one in 10 Singaporeans suffers from IBS

If your abdomen hurts or bloats when you eat a particular food, you may have irritable bowel syndrome (IBS).

IBS is a disorder that affects the intestines, causing symptoms such as abdominal discomfort, bloating, diarrhoea or constipation, or a sensation of incomplete bowel clearance. Symptoms vary from one person to the next; some people experience only mild symptoms, while for others, it can disrupt everyday life.

The exact causes of IBS are unknown. "Individuals may have overly sensitive nerves in the bowels; this causes muscles to contract too much after eating and abdominal cramps occur," says Dr Ling Khoon Lin, senior consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital .

A condition that typically develops in early adulthood

Other possible causes could be food intolerance, yeast overgrowth or unfriendly bacteria in the gut. In other cases, food is either forced through the bowel quickly, causing diarrhoea; or passes too slowly resulting in constipation. Stress could also be another contributing factor.

Irritable bowel syndrome cannot be diagnosed by standard tests. Diagnosis is usually based on the patient's symptom history.

"While IBS can affect people of any age, the condition develops commonly in individuals aged between 20-30. In Singapore, almost one in 10 people suffers from IBS," says Ling.

Did you know? "Women are twice as likely to suffer from IBS as men" (excerpt from Beautiful Inside Out)

While IBS isn't curable, it can be managed. Eating smaller meals and exercising aid the digestive system, and could ease symptoms. More effectively, the answer could be as simple as adjusting one's diet.

How to find and stick to a diet that will help

The fundamental idea behind an IBS-friendly diet is that you should avoid foods that aggravate your intestines. While sounding simple, it can take a while to figure it all out. But once you do, you'll find eating a lot less of a task.

The following steps will help you discover what foods you should and should not eat.

The elimination process

First, eliminate from your diet the foods you suspect trigger symptoms. This can be done sequentially. The list of foods to avoid includes:

• Foods high in saturated fat

• Alcohol or caffeine

• Dairy products

• Certain sugars such as fructose-rich fruit juices, table sugar and corn syrup (found even in so-called healthy cereals); artificial sweeteners like sorbitol and maltitol used in sugar-free foods.

• Gas-producing vegetables and legumes, such as cabbage and green beans

Looking for yummy food ideas? Check out Health Xchange's Healthy Recipes section

Adding back foods

After the elimination phase, you can re-introduce one-by-one the foods you cut out. You'll know what works for you when what you eat doesn't set off symptoms.

The grocery list

There is no one-diet-fits-all for IBS, but this suggested list of foods might ease symptoms.

• Soluble fibre-rich foods such as oatmeal, seeds, citrus fruits, and certain types of grains like rye. Insoluble fibre found in foods like whole wheat bread is beneficial to health but may not help IBS symptoms. Unlike soluble fibre, which dissolves in water to form a thick gel, insoluble fibre remains largely unchanged throughout the digestive process.

• Water. Too much fibre + lack of water = constipation, so drink up! The body's digestive tract requires fluids to move faecal matters along.

• Fermented foods such as plain, unsweetened yoghurt, tempeh and miso. They contain good bacteria that improve digestion.

Supplementing your diet

Various supplements and over-the-counter medicines claim to ease symptoms that plague IBS sufferers.

• Laxatives. Whilst they provide almost-instant relief, stimulant laxatives should not be taken over the long term. Other types of laxatives pull water back into the colon to soften stools or to form soft, bulky stools prompting normal contraction of intestinal muscles. Possible side effects include cramping, bloating, gas or dehydration.

• Probiotic pills. Probiotics fight bad bacteria in the gastrointestinal tract. "Probiotics can improve intestinal function, promote a healthy digestive system and also help fight off diarrhoea-causing organisms," says Ling.

• Constipation-prone IBS sufferers may turn to bulking agents such as psyllium to increase bowel movements. However, such agents can worsen other symptoms like bloating if taken in excess.

• Antispasmodics. As they relax the smooth muscles of the gut, they can relieve stomach cramping. Side effects include drowsiness, dry mouth or even constipation.

Want to win a free thumbdrive? Health Xchange is featuring "Irritable bowel syndrome" on its "Ask the Specialist" Q&A session this month (November 2011). The first 20 people to post a valid question will receive a free thumbdrive! Visit HealthXchange.com.sg, Singapore's trusted health and lifestyle portal.

This article was written by Lydia Ng for Health Xchange, with expert input from the Department of Gastroenterology and Hepatology at Singapore General Hospital.

Health Xchange's articles are meant for informational purposes only and cannot replace professional surgical, medical or health advice, examination, diagnosis, or treatment.