DR MICHAEL MOSLEY: The simple drug-free fixes to cure bloating and tummy ... trends now
People sometimes stop me in the street to chat about a health problem. And because gut health is my pet topic, the thing they often want to discuss is their bowels — and in particular, irritable bowel syndrome (IBS).
That's not surprising, given that as many as one in three of us suffers from it, according to the charity Gut UK.
IBS symptoms — such as cramps, bloating, pain and diarrhoea or constipation — normally rumble on for a while, but often get worse when patients hit their 30s, though we don't know why.
In fact we don't really know what causes the condition itself, either — and there is no known cure.
But increasingly research suggests simple lifestyle changes could help prevent (and perhaps also minimise) symptoms.
In a study just published in the journal Gut, not smoking, vigorous exercise and getting at least seven hours' sleep at night appeared to have the biggest effect — possibly because smoking raises inflammation, while exercise and sleep help regulate bowel function and support immunity.
Patients who followed dietary plans did much better than those on medication, with 76 per cent of the low-FODMAP group, and 71 per cent of those on the low-carb diet, reporting significantly improved symptoms
Now an even more recent study, reported just last week, has confirmed the benefit of cutting out certain carbs, showing that this can be more effective than medication.
Researchers at the University of Gothenburg randomly allocated patients with moderate to severe IBS symptoms to a low-carb diet; a low-FODMAP diet (where you cut out particular carbohydrates, known as FODMAPs, that our small intestine often struggles to absorb); or medication to treat their particular symptoms, such as constipation or diarrhoea.
The patients who followed either of the dietary plans did much better than those on the medication, with 76 per cent of the low-FODMAP group, and 71 per cent of those on the low-carb diet, reporting significantly improved symptoms, compared to 58 per cent in the medication group.
After six months, while some had returned to their previous eating habits, 68 per cent of the low-FODMAP group were still reporting benefits, compared to 60 per cent on the low-carb diet.
By this point most of those who'd started on medication were also on one of these diets and were delighted with the results.
So what's going on? One of the more plausible theories about IBS is that it's the result of an overly sensitive large bowel (or colon), or possibly a problem with your immune system, either of which could be the result of having had a previous gut infection.
Once your gut has been sensitised by an infection, there are certain carbs that can trigger an attack of IBS.
These are the FODMAPs — or fermentable oligosaccharides, disaccharides, monosaccharides and polyols. The trigger foods vary with the individual, but typically include:
• Dairy products, such as milk, cheese, yoghurt and ice cream
• Wheat-based foods, such as bread, cereal, biscuits and pasta
• Beans and lentils
• Vegetables, such as artichokes, asparagus, onions and garlic
• Fruits, such as apples, cherries, pears and peaches
FODMAPs in these foods can be poorly absorbed, so reach the large bowel largely undigested, where they're fermented by gut bacteria which produce gas and cause symptoms such as bloating.
