Combating irritable bowel syndrome symptoms with the right diet

Stomach pain isn’t easy to talk about. After all, the symptoms aren’t visible to others. But one in five people regularly experiences stomach pain after eating.

A bloated belly, flatulence and problems with bowel movements resulting in constipation or diarrhoea are common symptoms of a spastic bowel. This means that the bowels move too much or too little. Around 60% of people also experience increased sensitivity in their gut, as a reaction to the intestinal wall expanding. This is known as irritable bowel syndrome, or IBS. Symptoms can differ from person to person and from day to day.

Better quality of life

As part of the IBSQUtrition (Dutch) study, scientists from Wageningen University & Research are researching whether specific foods can alleviate the symptoms of IBS and improve quality of life for those with the condition. IBSQUtrition therefore encompasses IBS, Questionnaire, Quality of Life and Nutrition.

Do you often experience abdominal discomfort? Then please help us with the study by filling in the online questionnaire (Dutch).

The questionnaire for people with IBS is a core part of the study and takes around 30 minutes to fill in. ‘The questionnaire is structured in such a way that we hope to gain an understanding of the relationship between foods and symptoms,’ explains Nicole de Wit, project leader of this part of the study. ‘It could well be that people whose most common symptom is diarrhoea have a different diet to those who experience constipation the most.’

Various forms of irritable bowel syndrome

What is more, there are sub-groups of IBS patients, says De Wit. ‘For some, diarrhoea is the biggest symptom, for others it’s constipation. But for some people it varies. We also have people who don’t experience any problems with bowel movements, but still suffer from serious discomfort in their stomach. That is the kind of stuff we need to know in detail if we are to distinguish between sub-types. Ultimately, we want people to be better informed about which foods can reduce their specific symptoms.’

One of the last questions is about taking part in a follow-up study. Once the questionnaire answers have been analysed, researchers want a hundred volunteers to provide a stool sample, using a kit that will be sent to them. ‘These faecal examinations will give us the opportunity to link the symptoms experienced by IBS patients and their food intake to bacterial populations in the gut,’ explains De Wit. ‘A link seems to have already established between gut flora and IBS, but due to the huge variety of symptoms and patients, this has not yet actually been proven.’

Effect on IBS symptoms

Researchers have since begun a study using intestinal models in the lab, allowing them to replicate various irritable bowel syndrome symptoms. They are looking for substances which have a positive effect on one or more symptoms of IBS. ‘We will be testing almost 50 substances,’ says Coen Govers, who is leading the research. These include prebiotics (fibre), probiotics (bacteria drinks), protein and fats. ‘With our intestinal models, we can test the substances for four things: influence on stomach pain, microbiotics (Dutch), immune cell activity and interaction with the intestinal wall. What’s unique about this study is that we are testing these substances for all of these effects at the same time.’

“With this study, we want to help IBS patients become the boss of their own belly again.”

Ben Witteman, Professor by special appointment in Nutrition and Bowel Health in Transmural Care at WUR and gastroenterologist

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Diet

Both lines of research will eventually come together in a follow-up study in humans: do substances which seem to be the most effective actually offer relief for people with IBS and therefore form a scientific basis for an IBS diet? ‘With this study, we want to offer patients a solution to their symptoms, which is backed up by science,’ says Ben Witteman, Professor by special appointment in Nutrition and Bowel Health in Transmural Care at Wageningen University & Research and gastroenterologist at Gelderse Vallei Hospital.

If these substances relieve the symptoms of IBS, then that is great news for patients first and foremost. Witteman continues, ‘We hope that people with IBS will become the boss of their own belly again over the years to come.’ Secondly, it would mean that the lab model system can help to predict the effect of substances on IBS symptoms. ‘Then we could determine what effect a certain product has on people with IBS much more quickly in future,’ concludes Govers.