Irritable Bowel Syndrome

What Is It?

The term "irritable bowel syndrome" (often called IBS) refers to a collection of symptoms with no obvious cause. It is not a disease, but a syndrome -- a group of symptoms that occur together. People with IBS seem to have perfectly healthy digestive systems, but they frequently develop cramping pain in the lower abdomen along with either diarrhea or constipation or both. Typically, the pain flares up after a meal and goes away after a bowel movement. Many people also experience gas, bloating, small stools, or mucus in the stool. The symptoms tend to come and go and can occur in any combination.

About 10% to 20% of Americans have IBS at some point in their lives, and the symptoms usually start before the age of 50. Women are more likely than men to have the condition. For many years, doctors thought irritable bowel syndrome was mainly a condition of the mind. After all, these patients always had normal physical exams, and many said they noticed symptoms only during times of stress. Researchers now suspect the problem comes from a communication breakdown between the nerves and muscles that control the colon.

Without the proper controls, the contractions that move waste through the colon can speed up, leading to painful spasms and diarrhea. Alternatively, the contractions can become sluggish, setting the stage for constipation. The colon also becomes extremely sensitive, and even normal contractions can cause considerable pain. Stress and anxiety may not cause irritable bowel syndrome, but they can definitely make symptoms worse. Some people also react strongly to certain foods and drinks, especially fatty foods, dairy products, and food or drinks with alcohol or caffeine.

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What's the Treatment?

There's no single game plan for treating irritable bowel syndrome. IBS is different for everyone but, with your doctor's help, you can find an individual approach that works best for your symptoms. The treatment is focused on controlling, rather than curing, the symptoms of IBS.

First, the more you know about your condition, the more you can do to help yourself. For this reason, it's a good idea to keep a symptom diary for at least a couple of weeks. Every day, write down your symptoms and what you were doing before they started. Also keep track of food, drinks, and emotions. Then look for patterns. If something reliably causes trouble, you can try to avoid it. You may find that a simple change of diet works wonders. Many people feel better after cutting some fat from their meals. It may also help to reduce caffeine and alcohol. Some people also find that their symptoms get worse with dairy products.

If you are constipated, increasing your fiber intake to 25 grams to 35 grams every day can help keep you regular. Fiber may also help IBS symptoms by lowering the pressure inside the bowels. A high-fiber diet may worsen some symptoms, such as gas, bloating, or stomach pain, so it is good idea to start adding it slowly. Natural food sources of fiber include whole-grain breads and cereals, many fruits and vegetables, and bran. Fiber can also be added to the diet through supplements, like Metamucil® and FiberCon®.

If your bouts of IBS seem to go hand-in-hand with stress and anxiety, you may need to learn how to relax and cope with your feelings. Ask your doctor about relaxation techniques or counseling. If necessary, your doctor can prescribe medications to help control your symptoms. Your doctor may also prescribe an antidepressant. Antidepressants can help block pain and may also be useful if you have depression or anxiety along with the IBS.

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Foods to Choose If You Have IBS With Constipation Symptoms

If you have IBS with constipation you probably already know how important fiber-rich foods are to your comfort. Making the American Dietetic Association recommendation to eat 25-35 grams of fiber a day your mealtime mantra is a great place to start. But in order for a high-fiber eating plan to work its magic, you have to do three things:

• Reach the higher-fiber target (of 25-35 grams of fiber a day) almost every day.
• Spread your high-fiber foods throughout the day so it works better on your bowels.
• Drink plenty of water and other noncaffeinated, noncaloric liquids/beverages throughout the day as well. Fiber works better in the intestines if there is plenty of water to go with it.

To get enough fiber in the fastest and most painless way possible, try these five steps.

1. Get Those Whole Grains
   You can get 4 grams of fiber easily with a serving of whole grains. Here are a few examples:
   • 1 to 2 slices of whole-grain bread (depending on the brand)
   • 1 cup of brown rice
   • 1 1/2 to 2 tablespoons ground flaxseed (depending on the brand)
   • 9 Reduced-Fat Triscuits®
2. Eat Breakfast Cereals
   Some cereals contain 5 or more grams of fiber per serving. Here are a few examples:
   • 1 cup of Raisin Bran = 8 grams of fiber
   • 1/2 cup of All-Bran = 10 grams
   • 1 cup of Frosted Shredded Wheat Spoonsize = 5 grams
   • 1 1/4 cups of cooked oatmeal = 5 grams
3. Boost Fiber With Beans
   Canned bean products make it easy to eat fiber. Just 1/2 cup can get you to 6 or more grams of fiber in a snap. Here are a few examples:
   • 1/2 cup of Ortega Fat-Free Refried Beans = 9 grams of fiber
   • 1/2 cup of canned kidney beans = 6 grams
4. Enjoy a Few Fruits Each Day
   Fruits are great choices because they include both fiber and extra water. Here are a few examples:
   • 1 apple = 3.7 grams of fiber
   • 1 banana = 2.8 grams
   • 1 pear = 4 grams
   • 1 cup of strawberries = 3.8 grams
5. Work a Few Veggies Into Your Day
   Vegetables offer loads of fiber plus antioxidants that can help fight heart disease and cancer. Here are a few examples:
   • 1 cup carrot slices, cooked = 5 grams of fiber
   • 1 cup cooked broccoli = 4.5 grams of fiber
   • 1 sweet potato = 4 grams of fiber
   • 1 cup cauliflower, cooked = 3 grams of fiber
   • 2 cups raw spinach leaves = 3 grams of fiber

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Foods to Choose If You Have IBS With Diarrhea

Every person with irritable bowel syndrome and diarrhea has a personal list of foods that cause trouble. But one type of meal commonly causes problems: Greasy, rich, or high-fat foods.

Fat in food is known to exaggerate the gastrocolonic response. This means that fat makes the bowel more sensitive, so it moves food through faster, causing diarrhea. Plus, fat is simply harder to digest. You may have already noticed that large amounts of fat eaten in one sitting can cause your bowels to be somewhat "irritable."

You don't have to completely give up French fries or ice cream. Instead, eat foods with fat in small amounts, and switch to lower fat "baked" fries or "light" ice cream. And spread these treats throughout the day instead of combining them in one meal. If you have a craving for fried chicken, try an oven-fried chicken recipe. If you must eat deep fried chicken, enjoy fresh pears for dessert instead of a rich cake.

Add Soluble Fiber to Your IBS Diet

With pears for dessert, you'll be getting soluble fiber, which is key to managing your IBS and diarrhea through diet.

Soluble fiber is the gentler type of fiber that tends to stabilize the intestines. While soluble fiber is in your intestines it holds onto water and forms a gel -- slowing down the passage of food -- which is usually a good thing for people who suffer with diarrhea. Other foods high in soluble fiber include:

• Beans (beans contain both soluble and insoluble fiber and can cause gas in some people)
• Oats and oat bran
• Barley
• Peeled apples and applesauce
• Bananas
• Citrus fruits
• Carrots
• Green beans
• Pears
• Potatoes

Psyllium fiber supplements (such as Metamucil®) also provide soluble fiber.

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Recipes

Easy 7-Layer Bean Dip
Makes six big snack servings

Ingredients
16-ounce. can fat-free refried beans
1 teaspoon chili powder
1/8 teaspoon black pepper
1 teaspoon Tabasco
1 cup fat-free sour cream
1 cup reduced-fat sharp cheddar cheese, shredded
1 cup tomatoes, finely chopped
5 green onions, chopped
2 ounces chopped black olives (optional)


Suggested dippers: low-fat or reduced-fat tortilla chips, soft flour tortillas, pita bread cut into triangles, or vegetables such as celery carrot.

Directions

• Add beans to small microwave-safe bowl and heat on HIGH for two minutes to warm and soften. Stir in chili powder, black pepper, and pepper sauce to taste. Spread into an 8 x 8-inch baking dish and let cool.
• Spread sour cream over the beans. Top beans with shredded cheese then sprinkle chopped tomatoes evenly over the top. Top with green onions and olives if desired. Refrigerate until needed.
• Serve with any of the suggested dippers.

Nutritional Information Per Serving (not including dippers):
145 calories, 10 grams protein, 18.5 grams carbohydrate, 3 grams fat (2 grams saturated fat), 10 milligrams cholesterol, 4 grams fiber, 400 milligrams sodium. Calories from fat: 21%.

Cruciferous Au Gratin
Makes six side servings

Ingredients
4 cups cauliflower florets
(Reserve about 2 cups of the coarsely chopped cauliflower stems)
4 cups broccoli florets
2 tablespoons chopped shallots
1 tablespoon minced garlic
1 cup golden mushroom canned soup (vegetable or chicken broth can be substituted)
1 cup fat-free half and half (low-fat or whole milk can be substituted)
1 to 1 1/2 teaspoons horseradish (to taste)
Salt and freshly ground pepper to taste
1 cup grated Gruyere cheese (reduced-fat Swiss can be substituted)

Directions

• Add cauliflower and broccoli florets to large microwave-safe dish with 1/4 cup of water. Cover dish and microwave on HIGH until just tender (about four-six minutes).
• Meanwhile, start heating a medium-sized nonstick frying pan over medium heat. Coat the pan with canola cooking spray. Add the coarsely chopped cauliflower stems, shallots, and garlic, and gently saut until soft (do not brown). Add the golden mushroom soup or vegetable or chicken broth and cook until the stock is almost evaporated. Transfer the mixture to a food processor or blender along with the fat-free half-and-half and pulse until fairly smooth. Add the horseradish and season with salt and pepper to taste.
• Coat a 9-inch pie plate with canola cooking spray. Add the cauliflower and broccoli florets to the dish and pour the half-and-half mixture over the top. Gently toss to blend. Sprinkle the cheese over the top. Bake at 350 degrees for about 15 minutes until golden brown.

Nutritional Information Per Serving:
115 calories, 10 grams protein, 12.7 grams carbohydrate, 3.5 grams fat (1.9 grams saturated fat), 11 milligrams cholesterol, 3.5 grams fiber, 240 milligrams sodium. Calories from fat: 26%.

High-Fiber Berry Parfait
Makes one parfait

Ingredients
1 cup strawberry or berry yogurt (low-fat or light depending on preference)
1 cup sliced strawberries
1 cup Raisin Bran cereal
Garnish parfait with: a small dollop of light whipping cream or light Cool Whip and a whole strawberry or fan a few slices of strawberries on top (optional)

Directions

1. In 2-cup measure, blend yogurt with sliced strawberries. Spoon half of the mixture into parfait glass.
2. Sprinkle half of the Raisin Bran over the yogurt mixture.
3. Top that with the rest of the yogurt mixture and sprinkle the remaining Raisin Bran over the top with a dollop of light whipped cream and a strawberry if desired. Enjoy immediately.

Oatmeal Pancakes
Makes 12 pancakes

Ingredients

1 cups quick one-minute oats
2 cups low-fat buttermilk
1 cup unbleached white flour
1 teaspoon baking soda
1 teaspoon salt
1 large egg
1 cup egg substitute

Directions

• Add oats and buttermilk to large mixing bowl.
• Combine flour, baking soda, and salt in 4-cup measure and stir to blend. Add to the oat & buttermilk mixture and beat on low speed until just blended.
• Add egg and egg substitute and beat on low speed just until blended.
• Start heating griddle or nonstick skillet over medium heat. When the pan is hot enough, use a cup measure to drop batter onto the hot pan or griddle (if the pan or griddle is not "nonstick," coat with canola cooking spray first).
• Turn pancakes over when the entire tops of the pancakes in pan are covered with bubbles. Cook other side of pancake until nicely brown and cooked throughout. Repeat with the rest of the batter.

Nutritional Information Per Three Pancakes: 249 calories, 14 grams protein, 38.5 grams carbohydrate, 4.5 grams fat (1.4 g saturated fat), 57 milligrams cholesterol, 4 grams fiber, 619 milligrams sodium (if 1/4 teaspoon used) and 485 milligrams sodium (if no added salt). Percent calories from fat: 16%.

Peaches Banana Smoothie
Makes 2 smoothies

Ingredients

2/3 cup orange juice
1 1/3 cups peach slices (frozen unsweetened, ripe, or canned in juice and drained)
1 medium banana, sliced
2/3 cup low-fat or light peach yogurt (vanilla can also be used)
2/3 cup non-fat frozen yogurt or light ice cream

Directions

• Add all Ingredients to your blender or large food processor.
• Blend on highest speed until smooth, about 10 seconds. Scrape sides of blender and turn on blender for 5 seconds more.
• Pour into two glasses and enjoy!

Nutritional Information Per Smoothie:250 calories, 8 grams protein, 47 grams carbohydrate, 3.5 grams fat (1.8 g saturated fat), 2 milligrams cholesterol, 4 grams fiber, 80 milligrams sodium. Calories from fat: 13%.

Italian-Style Acorn Squash
Makes 4 servings

Ingredients

1 medium acorn squash (or similar winter squash)
1 tablespoon margarine with 8 grams fat per tablespoon
2 tablespoons shredded Parmesan cheese
1 teaspoon Italian herb blend
1 teaspoon garlic powder

Directions

• Cut acorn squash in half lengthwise. Add squash; cut side up, to a large microwave-safe baking dish with cup water. Cover dish and micro-cook on HIGH until tender throughout (about 15 to 20 minutes).
• Cut each half crosswise about -inch deep several times. Spread margarine evenly over the top.
• In small dish, blend Parmesan cheese, Italian herbs, and garlic powder. Sprinkle this mixture evenly over the top of each half.
• Microwave uncovered on HIGH until cheese starts to melt (about two minutes). Cut each half in half to make four servings total.

Nutritional Information Per Serving:
132 calories, 3 grams protein, 30 grams carbohydrate, 2 grams fat (.5 grams saturated fat), 1 milligrams cholesterol, 9 grams fiber, 64 milligrams sodium. Calories from fat: 14%.

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