Irritable Bowel Syndrome (IBS): More Than Just Bloating

Irritable bowel syndrome (IBS) is more than just cute post-meal bloating. It can be uncomfortable, painful, and even embarrassing. If you have been told you have IBS, you’ve joined the estimated 15–20 percent (one in seven) of New Zealanders who suffer from this disorder.

A quick online search on IBS will have you drowning in advice, ranging from helpful suggestions like meditation to bizarre remedies like drinking chia seeds. So, let’s break down the evidence and make it more digestible.

What Causes IBS?

A combination of factors is thought to contribute to IBS, including:

• Hypersensitivity of the gut – imagine someone turning up the dial on the nerves that communicate symptoms from your gut to your brain.

• Gut bacteria imbalances.

• Food intolerances.

IBS symptoms vary between individuals and can include bloating, abdominal pain, wind, constipation, and diarrhoea. Most people with IBS experience a combination of these symptoms.

If you’re living with IBS, you don’t need me to tell you how much it can impact your quality of life. The unpredictability of symptoms can lead to skipping meals, nervously checking for bathrooms, or avoiding social situations (and even work) when symptoms are at their worst.

IBS can also be a symptom of other conditions, such as endometriosis or mental health disorders like anxiety. Those with other gastrointestinal disorders are more likely to experience IBS, so it is important to rule out conditions like coeliac disease with your doctor.

Red Flags to Rule Out Other Conditions

While IBS is relatively common—especially among females—it can be tricky to manage. Your GP is the best person to rule out any red flag symptoms that may indicate something more serious. These include:

• Blood or mucus in your bowel motions.

• Unintentional weight loss.

• Painful periods that do not improve with over-the-counter pain medication or prevent you from attending work, school, or social events.

• Iron deficiency.

Why IBS Management is So Individual

Each person with IBS has their own unique symptom threshold. Think of it like a bucket—factors such as hormones, stress, food intolerances, and inflammation (from conditions like endometriosis) all add to the bucket.

When that bucket overflows, IBS symptoms appear. The key is reducing the load in the bucket to help keep symptoms at bay.

So, what can you do to lower your chances of an IBS flare-up?

Step One: Look at Your Overall Eating Patterns

Before diving into specific gut fixes like probiotics or food intolerances, it is important to get the foundations right—just like building a house.

Eating habits that support gut function:

• Eat at regular intervals—every three to four hours. Skipping meals (including breakfast) has been linked to increased bloating and constipation.

• Chew your food properly. Good digestion starts in the mouth and prepares your gut for the meal ahead.

• Slow down at mealtimes—rushed eating can worsen IBS symptoms.

Step Two: Reduce Common Gut Irritants

Some foods and drinks can exacerbate IBS symptoms, particularly:

• Caffeine – more than 200 milligrams per day (about a double-shot flat white in New Zealand) can be problematic.

• Alcohol – especially beer and cider.

• Certain artificial sweeteners – particularly sorbitol, mannitol, and xylitol, which are commonly found in sugar-free gums and lollies.

Step Three: Identify Possible Food Intolerances

During digestion, most food is processed in the small intestine. However, some fermentable carbohydrates (FODMAPs) make their way into the large intestine, where they interact with gut bacteria.

This fermentation process can lead to bloating, water being pulled into the bowel (resulting in loose stools or diarrhoea), and increased gas production, which can cause abdominal pain or discomfort.

FODMAP foods that commonly trigger IBS:

• Wheat-containing foods such as bread and pasta.

• Fruits such as apples and pears.

• Vegetables such as cauliflower, onion, and garlic.

It is no surprise that pizza, which contains wheat, garlic, and sometimes onions, is considered a high-FODMAP food.

The Low FODMAP Diet: The Gold Standard for IBS

The low FODMAP diet was developed by Monash University and follows a three-phase approach:

1. Elimination Phase – Remove high FODMAP foods for a set period to assess symptom changes.

2. Reintroduction Phase – Systematically test foods to identify which groups trigger symptoms.

3. Personalisation Phase – Develop a long-term eating plan based on your individual tolerances.

Why Work with a Dietitian?

A dietitian or registered nutritionist can guide you through the low FODMAP diet to ensure you maintain a nutritionally balanced diet. This is especially important for:

• Vegans or vegetarians, since many plant-based proteins (like lentils and chickpeas) are high in FODMAPs.

• Those with multiple food intolerances, to prevent nutrient deficiencies.

Not everyone with IBS needs to follow a low FODMAP diet, but simply reducing your overall FODMAP intake can help ease symptoms and give you more control over your diet.

Step Four: Stress Less

We all know that long-term stress is not good for our health, but for those with IBS, the gut-brain connection plays a huge role in symptoms.

How Stress Triggers IBS Symptoms

• Stress hormones reduce blood flow to the gut, impacting digestion.

• Shallow breathing (in the chest instead of the belly) can worsen bloating and discomfort.

How to Reduce IBS-Related Stress:

• Exercise – Any movement helps, particularly if it is something you enjoy.

• Diaphragmatic breathing – Focus on belly breathing rather than shallow chest breathing. Imagine a book on your stomach rising and falling.

• Meditation – Mindfulness does not have to mean sitting still for hours. Try noticing three things you can see, hear, and smell when you step outside. If you prefer guided practice, apps like Headspace can help.

Final Thoughts: Managing IBS for the Long Term

No two people experience IBS the same way, but the good news is that research shows long-term symptom relief is possible with a combination of dietary, lifestyle, and stress management techniques.

If you are struggling with IBS, know that you are not alone and that your symptoms are valid. Small, consistent changes can help you feel more in control of your gut health.