Does diet cause IBS?
The association of diet and IBS is not completely clear. We do know that about thirty to fifty percent of IBS patients will report that their symptoms worsen after meals. There is definitely patients who have a food intolerance, it's not so much a food allergy, it's a food interolerance. And if they eat something that their bowels do not tolerate, they'll develop symptoms of IBS. There is lactose intolerance and fructose intolerance and some patients are intolerant of those products. Now, they can be coexistent with IBS meaning that even if, like for example, I'm lactose intolerant, if I stopped eating dairy products I won't have those lactose intolerant symptoms but I can still have symptoms compatable with IBS. So, they can actually be coexistent. So, they dont necessarily explain --if all my symptoms went away, then I don't have IBS. I just have lactose intolerance. So, even though there are food intolerances, they can just be coexistent but they can mimic IBS. Now, sometimes with patients when they're feeling well they can eat a lot of different types of foods. When they're not feeling well, they can't eat those foods. So, its very inconsistent. But there are patients who have food triggers and the patients should really do symptom diaries. I'm really thinking and believing that symptom diaries can be helpful. Just for a certain period of time because you don't want patients to only think about their symptoms but you want to gain more information that's going to be helpful to them. And they may find that there's certain food triggers that lead to a flare of their symptoms and its important for them to recognize that and avoid that. But there are different diets. In general, fatty foods stimulate the bowels more, they empty out of the stomach slower, they stimulate the colon more so patients will very commonly report when they eat fatty foods they feel worse. The other thing that I've found that's never been proven in a study, but I hear a lot of patients say this-- when they eat a large amount of food, like the volume, the amount, they'll have more symptoms. So, it's almost like the food is the stressor to the gut. It's not the particular food but the amount of the food itself that's being stressor.
