Irritable bowel syndrome (IBS) triggers and prevention

By taking steps to prevent the symptoms of irritable bowel syndrome (IBS), it is possible to lead a productive, healthy life. With some planning, you can avoid IBS triggers that cause symptom flares. Your GP can provide a complete treatment plan for IBS prevention.

Print out this list of common IBS triggers and prevention strategies. Keep it handy for reference. It may help you identify your personal triggers in your IBS symptom journal. Triggers and symptoms may vary depending on your type of IBS. And when you're having a bad day, remember to persist with healthy management of your condition.

1. Diet triggers for IBS constipation

Some foods can worsen IBS-related constipation. These include:

• refined breads and cereals
• refined foods such as crisps and biscuits
• drinks such as coffee, fizzy drinks, and alcohol
• high-protein diets.

Prevention strategies:

• gradually boost fibre intake by two to three grams per day until you're eating 20 to 35 grams per day. Good sources of fibre include whole grain bread and cereals, beans, fruits, and vegetables
• consume a moderate amount of foods higher in sorbitol, such as dried plums and prune juice
• drink eight glasses of plain water a day
• try ground flaxseed. It can be sprinkled on salads and cooked vegetables.

2. Diet triggers for IBS diarrhoea

Some foods can worsen IBS-related diarrhoea. These include:

• too much fibre, especially insoluble fibre found in the skin of fruits and vegetables
• food and drinks with chocolate, alcohol, caffeine, fructose, or the sugar substitute sorbitol
• fizzy drinks
• large meals
• fried and fatty foods
• food and drinks with dairy
• foods with wheat, some people may be allergic or have a negative reaction to gluten.

Prevention strategies:

• eat a moderate amount of soluble fibre. It adds bulk to the colon and can help prevent spasms. Good sources are whole wheat breads, oats, barley, brown rice, pasta, the flesh of fruit (as opposed to the skin), and dried fruits
• Try not to consume foods with extreme temperatures, such as ice- cold water and steaming hot soup, in the same meal
• Reduce or avoid foods like broccoli, onions, and cabbage if you find these make diarrhoea or bloating worse
• eat smaller portions
• drink six to eight glasses of plain water a day, but drink the water an hour before or after meals, not with meals
• consult with your doctor or a dietitian if you suspect you may have a wheat allergy.

Some people with IBS have symptoms similar to lactose intolerance with excess wind. A trial of a lactose-free diet and avoidance of foods that produce excess wind such as beans, brussels sprouts, wheat germ, raisins, and celery may help reduce symptoms.

3. Stress and anxiety triggers for IBS

Stress and anxiety can exacerbate IBS symptoms such as constipation, diarrhoea, stomach pain, and bloating. Different things cause stress for different people. Stress can include:

• problems at work
• commuting
• problems at home
• financial problems
• a sense that things are beyond your control.

Prevention strategies:

• practice healthy living. Eat a well-balanced diet that is appropriate for your IBS. Get regular exercise and enough sleep
• do something fun. Listen to music, read, shop, or take a walk
• try behavioural therapy. Learn how to calm yourself down with the help of techniques such as relaxation therapy, hypnotherapy, cognitive behavioural therapy, and psychotherapy
• talk to people. If you feel comfortable doing so, tell your family members, close friends, boss, and colleagues about your IBS. They may provide vital support. Plus, the conversation may prevent any misunderstandings when your symptoms flare up and you are not able to meet expectations
• plan ahead. Ease worries about going out if your symptoms flare up. Get up earlier if you know IBS makes you late for work. If you are driving, map your route so that you know the locations of toilets. At social events, choose aisle seats close to the toilets. Know what's on the menu so you can eat beforehand if the food will not be agreeable to you.