While my career path veered away from orthodoxy more than a decade ago, I remain a regular reader of the British Medical Journal. One thing I like about this particular publication is it’s ability to email-alert me to any nutritionally-related content. Recently, the BMJ published an editorial on the management of irritable bowel syndrome (IBS) - a condition characterised by symptoms such as constipation and/or loose stools, abdominal bloating and wind, but for which no specific cause can be found. As I had not had electronic notice of this review, I imagined the BMJ’s automatic alerting service had somehow broken down. All became clear, however, when I read the review and discovered it contained not a single reference to diet.

Even those without any explicit knowledge of the inner workings of the digestive tract might suspect that symptoms emanating from this organ may well have something to do with food. This does indeed turn out to be the case, as IBS symptoms are quite often triggered by unwanted reactions to specific foods. This mechanism has not gained widespread acceptance as an underlying factor in IBS by the medical establishment, which usually advises IBS sufferers to increase fibre intake. However, one study found that increasing roughage in the diet was generally ineffective, and actually exacerbated symptoms in more than half of individuals afflicted with IBS. This seemingly paradoxical reaction is likely to be explained by the fact that individuals seeking additional fibre will generally find this in bran-filled breads and cereals based on wheat - which many nutritionally oriented practitioners (myself included) find is the most common offender in IBS of all.

While wheat is a frequent trigger factor in IBS, it is not always at fault, and other foods can be implicated too. Individuals with IBS can therefore benefit from individual identification of problem foods. Several methods of testing exist including kinesiology (muscle testing) and dowsing. My belief is that all such methods have some validity, though individuals who are more comfortable taking a more ‘scientific’ approach may have their blood tested for what are known as IgG antibodies to specific foods. One study published last year in the journal Gut found that elimination of these foods identified with this form of testing was generally beneficial for IBS sufferers. For more details on IgG blood testing see www.allergy-testing.com.

No tests are foolproof, however, and there is usually no reason why individuals should not make self-styled changes to their diet without testing. I generally advise such individuals to try a diet devoid of wheat (e.g. pasta, bread, biscuits, pastries, and breakfast cereals) and cow’s milk (another common offender) for a week or two. Better tolerated grain include rice and oats (e.g. oat-based muesli, porridge and oatcakes), and rice and oat milks are good swaps for dairy milk too. Next week, I’ll be focusing on what I find to be the other major underlying factor in IBS, namely an imbalance in the microbiological ecosystem that resides within the gut. In the meantime, IBS sufferers might find dietary exclusion does much to reduce the risk of unwanted gut reactions.

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