Dietary approaches to Irritable Bowel Syndrome (IBS)

by Müge Arslan (Author)
©2019 Monographs 108 Pages


The intestine (and the gut microbiota), often referred to as the «real brain» of the body, has been implicated in a wide range of diseases, including obesity, and diet has a direct impact on intestinal health. While bloating, flatulence and constipation seem like routine, everyday symptoms, one cannot deny the significant societal burden they impart partly through their effect on the quality of life and partly through the medical and surgical costs they incur on patients desperate to improve symptoms.
This book discusses irritable bowel syndrome, which is accompanied by complaints of bloating, flatulence, constipation and diarrhea, from which many people routinely suffer. Furthermore, it presents treatment methods, e.g., dietary and nutritional approaches, and recommendations to change lifestyle and manage digestive symptoms.

Table Of Contents

  • Cover
  • Title Page
  • Copyright Page
  • Dedication Page
  • Preface
  • About the author
  • About the book
  • Citability of the eBook
  • Contents
  • Introduction
  • 1 Irritable Bowel Syndrome (IBS) and FODMAP Diet
  • 1.1 Irritable Bowel Syndrome (IBS)
  • 1.2 The First Line of Dietary Approach in IBS
  • 1.2.1 Nutritional Habits
  • 1.2.2 Spicy Food Consumption
  • 1.2.3 Fat Intake
  • 1.2.4 Intake of Milk and Dairy Products
  • 1.2.5 Predominantly Plant Nutritional Intake
  • 1.2.6 Animal Protein Intake
  • 1.2.7 Dietary Fibre Intake
  • 1.2.8 Caffeine Intake
  • 1.2.9 Alcohol Consumption
  • 1.2.10 Fluid Intake
  • 1.2.11 Physical Activity
  • 1.2.12 Probiotics
  • 1.3 Second Stage Approach of Low-FODMAP Diet
  • 1.3.1 The FODMAP Mechanism
  • 1.3.2 The Application of a Low FODMAP Diet
  • 1.3.3 Low FODMAP Diet Compared to Alternative Therapies
  • 1.3.4 Hypnotherapy for the Intestines
  • 1.3.5 Gluten-free Diet
  • 1.3.6 Predictors of Response to Symptoms
  • 1.3.7 Hydrogen Breath Test
  • 1.3.8 Stool Microbioma Analysis
  • 1.4 Low FODMAP Diet in Children with Functional Gastrointestinal Disorders
  • 1.4.1 Malabsorbed Carbohydrates and Functional Abdominal Pain
  • 1.4.2 Hydrogen Breath Test in Children
  • 1.5 The Risks of a Low-FODMAP Diet
  • 1.5.1 Incorrect Use of the Low-FODMAP Diet
  • 1.5.2 Changes in Gastrointestinal Microbiota
  • 1.5.3 Irregular Meals
  • 1.6 An Example of 5-day FODMAP Diet List
  • 2 Constipation
  • 2.1 The Relationship between IBS and Constipation
  • 2.1.1 Normal Transit Constipation
  • 2.1.2 Slow Transit Constipation
  • 2.1.3 Evacuation Dysfunction
  • 2.1.4 The Diagnostic Criteria for Functional Constipation (196)
  • 2.1.5 Pathophysiological Mechanisms
  • 2.1.6 Evaluation of Constipation
  • 2.1.7 Treatment
  • 2.2 A Sample Diet for the Prevention of Constipation
  • 2.3 Constipation in Children
  • 2.3.1 The Rome III Criteria for the Diagnosis of Functional Constipation in Children – For Infants and Children in the 0–4 Years Age Group
  • 2.3.2 For Children in the 4–18 Years Age Group
  • 2.3.3 Rome IV Criteria
  • 2.3.4 Known Risk Factors for Childhood Constipation (247)
  • 2.3.5 Treatment
  • 2.3.6 Education and Behavioural Changes
  • 2.3.7 Education of Parents
  • 2.3.8 Precautions to be Taken that Provide Bowel Movements at Normal Intervals with Good Evacuation (Precautions against Impaction) and Drug Therapy
  • 2.3.9 Laxatives – Dosages and Side-Effects (289)
  • 2.4 Diet Treatment
  • List of Figures
  • List of Tables
  • Bibliography


Nutrition is one of the most important factors defining human life, and its impacts start in the womb. It is a process that includes the intake, digestion, absorption and metabolisation of nutrients necessary for the body to function. In short, nutrition is a function impacting all stages of human life, from food production to cellular use. Human health is affected by several factors, such as nutrition, inheritance and environmental conditions, while nutrition is the most significant among all. Hence, from infancy into adolescence and adulthood, healthy eating habits have a very important role in maintaining good health, preventing diseases and ensuring a high quality of life.

Nutrition also has an impact on social well-being. Insufficient or unbalanced nutrition not only leads to health problems, but also increases social burden by reducing work performance and increasing workplace accidents and relevant health costs. Therefore, an adequate, balanced and healthy diet is of great importance for a healthy society. An adequate diet consists of sufficient intake of energy, nutrients and other bioactive substances that are required by human body. A balanced diet is the balanced consumption of balanced meals based on nutrients. Healthy nutrition is the proper selection and use of nutrients, with knowledge on their potential harms during production, storage, preparation and cooking.When examined in this respect, nutrition has functions in the maintenance of many metabolic processes, such as those of the immune, endocrinological, physiological, and gastrointestinal systems. It is possible to have a healthy gastrointestinal system with optimal digestive and excretion processes.

Nutrients have a significant role in the whole digestive process. The presence of nutrients in the gastrointestinal tract affects gastrointestinal motility, sensitivity, the barrier function and intestinal microbiotics. The formation of atypical modulator mechanisms of the intestine as a response to the stimulation of intestinal receptors results in irritable bowel syndromes (IBS). The type of diet that is adopted has a role in the exacerbation of IBS symptoms as well as its treatment.

1 Irritable Bowel Syndrome (IBS) and FODMAP Diet

1.1 Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome has a long history.

IBS is a chronic, functional gastrointestinal (GI) disorder characterised by recurrent abdominal pain, bloating, and changes in the amount and quality of faeces. It is one of the most commonly seen GI disorders, with a global prevalence of 10 %–20 %. (1,2) IBS has been reported with differences between phenotypes in epidemiology, risk factors and different regions throughout the world.(3) The prevalence of IBS is higher in industrialised countries in Western Europe, USA, Canada, Australia and New Zealand compared to developing countries in Asia, the Middle East, South America and Africa.(4)

The pathogenesis of this disorder is extremely complex and probably multifactorial (abnormalities in motility, internal organ sensitivity, brain-intestine interaction, intestine permeability, immune system activation, neuroendocrine function, gallbladder acids and intestinal microbioma).(5)

Although IBS patients occasionally have food allergies, some studies reported that the exacerbation of GI symptoms is related to certain carbohydrates, fruit and vegetables, dairy products and legumes. (6)

Symptoms include bloating, abdominal pain, constipation and diarrhoea. Internal organ sensitivity, low-grade inflammation and inability to control flatulence are in the etiology of IBS.(7,8)

IBS was first defined in 1989 with the principles in the Rome I guidelines, and through development, the understanding moved to “the absence of structural disease” and “gastrointestinal function disorder,” according to the latest Rome IV criteria published in May 2016. In Rome IV, the concept was expanded with impaired motility, visceral hypersensitivity, altered mucosal and immune function, altered intestine microbiota, and the impaired intestine-brain interaction related to the altered central nervous system process.


ISBN (Softcover)
Publication date
2019 (April)
FODMAP diet Health Science Nutrition Diet
Berlin, Bern, Bruxelles, New York, Oxford, Warszawa, Wien, 2019. 107 pp., 1 fig. b/w, 2 tables

Biographical notes

Müge Arslan (Author)

Müge Arslan has worked as a dietician for many years. She is assistant professor at Bahçeşehir University, and holds a master’s degree in Public Health and a Ph.D. in Nutrition.


Title: Dietary approaches to Irritable Bowel Syndrome (IBS)
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109 pages