Dealing with Irritable Bowel Syndrome (IBS)

Over the past 10 years, more and more people have contacted me about gastro-intestinal issues.  It ranges from general discomfort, cramps, constipation, diarrhea, and can adversely affect one’s quality of life.  Most of these people have been diagnosed with Irritable Bowel Syndrome, or IBS.  Many of these individuals are coming to our clinic because they are looking for a nutritional or dietetic solution to their problem.  Baruch Hashem we have been able to help many of these individuals to improve their quality of life and lessen their symptoms by simply working on diet.  But more often than not, IBS has other components to it.  This was exactly the case two years ago when Yanky, an Avreich learning here in Eretz Yisroel, came to see me.  He had been here for a few years and was soon returning to his country of origin. He desperately wanted to try to conquer this problem before his return and to try to have a more normal life.   So, he signed up for both coaching and personal training and we got to work.  Our dietician worked on his diet but he was also coming in twice a week for intense exercise. He also had homework in exercise on his days away from out workout facility.

No Medicine for this

A few years ago, I was discussing certain diseases that involve the gastrointestinal system with a gastroenterologist that I know.  This doctor told me that there are two things he sees all the time where he felt my staff could actually be the “doctors” in this case.  Those were Fatty Liver Disease and Irritable Bowel Syndrome.   He said that there really isn’t any medicine for them that is effective however, programs like ours serve these people well.  This article isn’t going to cover fatty livers.  I hope to do that another time.  However what can one do to in order to deal with an irritable bowel?

IBS is the most prominent of the GI disorders, but also the least understood.  It is a disorder of the large intestine and causes recurrent abdominal pain, bloating, discomfort and changes in the consistency and frequency of bowel movements.  No one knows the exact cause but many experts think it is a manifestation of a hypersensitive GI tract that is easily pained and stimulated. This in turn can cause bloating, gas and cramping, particularly after a large, bulky meal. In order to diagnose this syndrome, a person must have pain or discomfort for a minimum of 12 weeks out of one year and will usually feel relief of pain upon defecation, has looser or more frequent stools or harder and more frequent stools.  Symptoms often worsen when eating large meals, taking certain medications, becoming emotionally upset or when ingesting milk products, chocolate, alcohol, caffeine, carbonated beverages, or fatty foods.  Many times it is a diagnoses of exclusion.  That is, we can’t really find anything else wrong, so it must be IBS.

According to Dr. Anthony Lembo, a gastroenterologist with Beth Israel Deaconess Medical Center. “IBS is most common in people in their 30s and 40s; however, it can occur at any age. Since older individuals tend to have greater problems with constipation or diarrhea, it is particularly important that they be made aware of IBS.”

The good news is that with all the discomfort and distress, IBS does not permanently harm the intestines or lead to a more serious condition, such as inflammatory bowel disease or colon cancer. IBS may not be able to be cured, but it can be well managed so it does not interfere with your overall health and quality of life.

According to the Harvard Health Newsletter, people with IBS usually have multiple symptoms, including

  • Abdominal pain and cramping that are related to abnormalities in bowel movements, such as constipation, diarrhea, or both.
  • Constipation (often with incomplete bowel movements)
  • Diarrhea (often with an urgent need to move the bowels)
  • Alternating constipation and diarrhea
  • Bloating and gas
  • The urge to move the bowels, but an inability to do so.

You should see your doctor if you have persistent gastrointestinal symptoms, particularly if they are new, if you notice blood in your stools or unintentional weight loss, or if you have a family history of colon cancer or inflammatory bowel disease. Because no one knows what causes IBS, it is impossible to prevent. “Once you have been diagnosed, the goal is to manage the condition,” says Dr. Lembo.

Nutrition-Stress Management-Medications/Supplements

IBS requires a multipronged approach in order to relieve symptoms.  It’s rarely just one thing.  Let’s first look at some general rules about food intake. What you eat (and what you don’t) has the biggest impact on IBS symptoms. Avoiding or reducing trigger foods linked with IBS symptoms is a good first step. These include chocolate, alcohol, caffeine, dairy products, and fried and fatty foods. “Also, you should consider avoiding soft drinks, fruit juices, and sport drinks,” says Dr. Lembo.  KEEP PROCESSED FOODS OUT OF YOUR DIET AS MUCH AS POSSIBLE.

You also may benefit from adopting a low-FODMAP diet. This acronym stand for all of the short-chain carbohydrates that are poorly absorbed in the gut and can cause problems like diarrhea, bloating, abdominal pain, and flatulence. Although the list of foods to keep to a minimum is quite extensive, things like onions, garlic, and fermented or pickled foods should be avoided.  A meta-analysis in the January 2017 Gastroenterology & Hepatology found that 50% to 80% of people with IBS respond well to a low FODMAP diet.

One of the best stress management strategies is to exercise.  For many, calming and low intensity exercises like yoga may be quite effective, but for others, a more moderate intensity form of exercise is better. Regular exercise helps the digestive system work more effectively.  Low to moderate intensity exercise actually helps digestion.  This makes more energy available by stimulating the intestinal muscles to contract.  This, in turn, causes the muscles to push more food waste through the digestive system.  It is important to note that very high intensity exercise slows digestion and can lead to nausea, vomiting, side-ache, and other upper GI ailments.  This is because your muscles and heart require more blood flow and that takes blood away from the GI tract and stomach.  Of course, one must be smart about how close to an exercise session you eat.  Eating large meals, fats, and protein right before you work out can cause much gastric discomfort while you work out.   Be sure to drink sufficient fluids before, during and after your workout.  Also, make sure that you eat a good well-rounded meal after your workout to replace energy stores. 

Your doctor may recommend over-the-counter remedies, like fiber supplements and laxatives to help with constipation, or meds to help with diarrhea.  Depending on your symptoms, your doctor may prescribe other medications to help ease and control symptoms.

Another possible option is probiotics, which are live microbes that are taken in capsule or powder form, or consumed from many yogurt products (labeled as containing “live and active cultures”). Probiotics are thought to help with intestinal problems by restoring bacterial balance in the gut and possibly enhancing the immune system.

Yanky stayed in our program for three months.  Although he wasn’t totally symptom-free, he dealt much better with his stresses and that in and of itself alleviated much of his discomfort.  He stated on several occasions that he always felt best after exercise, and that the good feeling lasted for many hours after his sessions.  Part of his stress management was also helped by coaching through some of his life problems.  Many times during our sessions he was able to get better perspective on his daily issues and that in turn helped him to worry less and enjoy life more.

Having a gastrointestinal disorder can be uncomfortable, painful, or even debilitating.  But making the appropriate dietary changes and keeping up a balanced and consistent exercise routine can help alleviate some or most of this discomfort and improve your quality of life.  Consult your doctor about possible medications that can help you and remember that taking care of your digestive system is integral in order to “add hours to your day, days to your year, and years to your life.” 

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a CERTIFIED WELLNESS COACH with over 19 years of professional experience. Alan is the creator and director of the “10 Weeks to Health” program for weight loss.  He is available for private coaching sessions, consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at   Check out the his web site –    US Line: 516-568-5027