Irritable bowel syndrome (IBS) is a chronic condition which cannot be cured. For this reason, IBS treatment focuses on the relief and management of symptoms. For the majority of patients who have mild symptoms, doctors recommend diet and lifestyle modifications rather than treatment with medication.

For the rest, management can involve a multidisciplinary team, including a psychiatrist, a dietitian, a specialist as well as the family doctor.

For patients with moderate to severe symptoms, medication may be given. This may include anti-diarrhoea medicines (in the case of diarrhoea) or fibre supplements and laxatives (in the case of constipation). Muscle relaxants are commonly prescribed for stomach pain and cramps. Some patients may be prescribed antibiotics for bacterial infection. Patients with anxiety or depression may be prescribed psychiatric drugs.

“IBS is a chronic condition and we don’t have a magic bullet that cures it,” says Dr Wang Yu Tien, Consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH), a member of the SingHealth group. “It waxes and wanes so a patient will have good and bad periods.”

With diet and lifestyle modifications, IBS patients can live normal lives. Here are some useful diet and lifestyle tips:

Diet tips for IBS

  • Recognise and eliminate trigger foods from your diet. Maintaining a food diary can help. Some known trigger foods for IBS are:
    • Oily foods
    • Spicy foods
    • Alcohol
    • Caffeine
    • Dairy products
    • Carbonated drinks
    • Fructose-rich fruit juices
    • Polyol-containing artificial sweeteners such as sorbitol, xylitol, mannitol, maltitol and isomalt found in some sugar-free foods. Artificial sweeteners such as aspartame and sucralose are suitable.
    • Gas-producing legumes and vegetables such as cabbage, cauliflower, broccoli, green beans.
  • Have more soluble fibre which dissolves in water to form a thick gel. Soluble fibre-rich foods include oatmeal, seeds/nuts, citrus fruits and grains like rye. However, some soluble fibre-rich nuts such as cashew and pistachio, and some rye products can increase gas production.
  • Drink plenty of water.
  • Have foods like yogurt which contain friendly bacteria. If you have lactose intolerance, you can opt for lactose-free yogurt.
  • Eat smaller, more frequent meals.

Lifestyle tips for IBS

  • Manage stress with meditation and other relaxation activities.
  • Maintain a positive attitude.
  • Exercise regularly.
  • Get adequate sleep.

“A long-term relationship between the physician and the patient is probably the single most important factor in the management of IBS,” says Dr Wang. Oftentimes patients must trust their doctor before they comply with treatment.

Ref: S13