Feature Article
Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management

https://doi.org/10.1016/j.nurpra.2015.12.007Get rights and content

Highlights

  • Irritable bowel syndrome (IBS) is a chronic gastrointestinal (GI) disorder denoted by abdominal pain and changes in bowel patterns, affecting 5% to 15% of the general population.

  • Patients with IBS have long associated certain foods with exacerbation of their symptoms. More than half of IBS patients have self-reported food intolerances and worsening of symptoms with certain foods or meal related.

  • IBS patients often attempt dietary modifications on their own by excluding foods they perceive to be causing their symptoms.

  • Research is starting to catch up with what patients have reported about food interaction and their symptoms, and the role of diet is being increasingly recognized for the management of IBS.

  • For clinicians, understanding the nuances of individual symptoms is vital to providing the most useful and beneficial dietary recommendations.

Abstract

Patients with irritable bowel syndrome (IBS) have often associated the worsening of symptoms with specific foods. Research is starting to catch up with what patients have reported about food interaction and their symptoms, and the role of diet is being increasingly recognized for the management of IBS. Clinical guidance for nurse practitioners can be challenging because of limited data and guideline consensus along with the nuances of symptoms associated with IBS subtypes. This article summarizes some of the key themes and dietary recommendations by various gastrointestinal organizations, public health agencies, and dietary associations. By addressing the relevance of diet for symptom alleviation, nurse practitioners are able to better support patients and collaborate with dietitians to improve symptom management.

Section snippets

Foods Associated With IBS Symptoms

Many IBS patients associate certain foods with their IBS symptoms and perceive food intolerance. For individuals with IBS-D, there may be a higher prevalence of food trigger reactions.4 The most common foods reported as symptom triggers are fruits (citrus and banana), grains (wheat, barley, rye, oats, and corn), vegetables (onions, peas, and potatoes), dairy products (yogurt, milk, cheese, eggs, and butter), legumes (beans and lentils), wine, chocolate, coffee, tea, and fried foods.3, 4 Using

Alcoholic Beverages

The direct contact of alcoholic beverages with the mucosa lining of the GI tract can lead to mucosal damage, disrupting the assimilation of nutrients and intestinal motility.12 Prior studies have been inconclusive or conflicting for alcohol, and alcohol intake was not correlated with IBS in epidemiologic studies.9 For individuals with IBS-D, alcohol intake may exert a more potent influence on symptom severity than for IBS-C or IBS-M.12 An association between alcohol intake, particularly binge

Conclusion

In clinical practice, the reporting of specific foods with IBS symptoms by patients is sometimes viewed with uncertainty or oversight, but the role of food and diet is being increasingly recognized to play a pivotal role in the management of symptoms. With the variation of IBS symptom presentation, successful management with diet and lifestyle changes involves the careful discrimination of dietary treatments based on the predominant symptoms and severity. Current dietary recommendations are

Acknowledgment

This work was supported by the National Institutes of Health research grants R01NR013695 and R01NR010730.

All authors are affiliated with New York University College of Nursing. Bernadette Capili, PhD, NP-C, is an assistant professor of nursing and an associate director at the Division of Special Studies in Symptom Management and can be reached at [email protected].

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    All authors are affiliated with New York University College of Nursing. Bernadette Capili, PhD, NP-C, is an assistant professor of nursing and an associate director at the Division of Special Studies in Symptom Management and can be reached at [email protected].

    Joyce K. Anastasi, PhD, DrNP, FAAN, is a director of Special Studies in Symptom Management and the Herbs, Nutraceuticals, and Supplements Program.

    Michelle Chang, MS, Lac, is research associate at the Division of Special Studies in Symptom Management.

    In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.

    This activity is approved for 0.9 contact hour(s) of continuing education by the American Association of Nurse Practitioners (AANP). Program ID 16042169. This activity was planned in accordance with AANP CE Standards and Policies. AANP members may receive 0.9 CE contact hours from AANP by completing the online posttest and evaluation at cecenter.aanp.org/program?area=JNP.

    American Association of Nurse Practitioners (AANP) members may receive 0.9 continuing education contact hours, approved by AANP, by reading this article and completing the online posttest and evaluation at cecenter.aanp.org/program?area=JNP.

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