Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder (in the absence of any organic cause) that affects the entire gastrointestinal tract and can cause a variety of uncomfortable symptoms. It is estimated that IBS affects between 10% to 15% of the global population, making it one of the most prevalent gastrointestinal conditions worldwide. Despite all the medical advances in the last 100 years, the pathophysiology of IBS remains uncertain and there are several hypotheses that did not stand the test of time.
Common symptoms of IBS
The symptoms of IBS can vary widely among individuals, but commonly include:
- Impaired gastrointestinal motility: Increased frequency and irregularity of luminal contractions, abnormal transit time. In my case, simply drinking a large quantity of water gives me burps.
- Abdominal discomfort and Cramping: Recurrent abdominal discomfort after eating fatty foods, often relieved by passing stools or gas.
- Altered Bowel Habits: Changes in bowel habits, such as constipation (most common), diarrhea or a combination of both.
- Bloating and Gas: Excessive gas production and abdominal bloating, which can contribute to discomfort and distress.
- Mucus in Stools: Some individuals with IBS may notice the presence of mucus in their stools.
- Other Symptoms: Additional symptoms may include fatigue, nausea, backache, and an urgent need to pass stools.
IBS Dietary Modifications
- Identifying and avoiding trigger foods, such as certain carbohydrates (FODMAPs), fatty foods, excessive caffeine, and alcohol can help reduce IBS symptoms in almost all cases (but not a fun way to enjoy life).
- Regular exercise, adequate sleep, and maintaining a healthy lifestyle can help alleviate symptoms in some patients (not in my case).
- Probiotics, antidepressants, antibiotics (Rifaximin) may help a few IBS patients (not in my case).
What is a low-FODMAP diet?
- FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These are types of carbohydrates that are harder for the body to digest than other types because they pull extra water into your intestines and cause the normal bacteria in your intestines to make gas.
- Cereal with insoluble fiber (e.g., bran) should be avoided since it can cause bloating.
- For people with IBS, eating FODMAPs makes digestive symptoms worse and avoidance typically results in improvement.
Consuming a low FODMAP & low fatty food diet does not cure IBS
This is purely for IBS symptom relief and I have tried all these diets for almost 2 decades. I typically avoid daily consumption of carbohydrates (Indian, Thai, Chinese etc.,), deep fried foods (wings, French fries etc.,) and fatty foods (e.g., pizza). Once a week or so, I will eat one of these foods and suffer the consequences for two days.
Does IBS last for your lifetime?
IBS starts very gradually (over the years), and once it fully manifests, it tends to last over a person’s lifetime (I am counting about 20 years).
What has worked for my IBS related constipation?
In my case, eating a large amount of green leafy vegetables (lettuce more than spinach) helps to relieve my IBS constipation compared to taking soluble fiber (e.g., Psyllium) powder/pills. However, the salad needs to be consumed with a low fat dressing (e.g., poppy seed) to avoid the resulting bloat.
Overseas Travel & Salad don’t go well together
Once you leave the US, it is hard to find places that offer the salads & dressings the way you like for reasonable prices.
My Fix for IBS related constipation
I started taking Polyethylene glycol (PEG) 3350 (polyethylene glycol without electrolytes, e.g., Miralax, Glycolax, or Restoralax) which is an osmotic laxative. I usually mix one capful (17 g) in 8 oz of water, juice, or soda (not milk) and drink it every morning.
Polyethylene glycol takes around 2 days to start working and once it kicks in you will see consistent daily bowel movements with a well formed stool (in my case).
I use Sam’s Club version of PEG 3350 powder (link) for daily use to save money. For those with Costco membership, they have a Kirkland version of PEG powder (see images below).
Miralax packets while traveling
I buy Miralax packets to use daily for the travel duration from either Walmart or Amazon. I tend to use Walmart due to free Plus membership from Amex Platinum.
Switching the PEG powder from Sam’s Club to Miralax does not change my bowel habits and the transition seems to be smooth.
Conclusion
If you are one of those out of the millions of people who suffer from IBS related constipation, I recommend trying polyethylene glycol powder from either Sam’s Club or Costco. Daily PEG powder consumption has completely cured my chronic constipation without inducing diarrhea. However, my wife is not able to take the PEG powder daily due to diarrhea. Everyone with IBS has different food triggers and responses to different medications.