Although the relationship between IBS and food is far from clear-cut, most of the people who have found significant relief from their IBS will tell you that they have cut out all junk food from their diet. Perhaps your friends who have “stomachs of steel” can eat fast food or processed food, but you may no longer have that luxury. In the short-term, this can be challenging, as junk food is often readily available and can be quite appealing. In the long-term, the avoidance of this type of nutritionally-deficient food may be the silver lining of the IBS cloud, as you will be fueling your body with more wholesome options.

Why is junk food so bad for IBS? Here are some of the reasons:

• High-fat content: Fat in foods can intensify the strength of intestinal contractions, contributing to abdominal pain.
• Low fiber content: Due to the lack of any true plant material, most junk food is low in fiber. Although fiber and IBS might not be the easiest of bed-fellows, fiber is important in helping to keep stool both soft and firm—important whether you suffer from IBS-C or IBS-D.
• Artificial sweeteners: Some artificial sweeteners, particularly those that end in “-ol,” have been associated with increased symptoms of gas and bloating.
• Food additives: Although there is much controversy on the effect of food additives on overall and digestive health, it is safe to say that your body was not initially designed to handle the types of ingredients that are added to many processed foods. These additives are there to extend shelf life and make foods look more attractive, not because they are good for us.

It is common for people with IBS to significantly restrict their diet when they first start to experience symptoms. It is only natural to blame the last thing you ate when you are experiencing abdominal pain, cramping, bloating or diarrhea. However, it is essential to remember that there are a variety of things that can trigger IBS symptoms such as stress, hormonal changes, or simply eating a large meal. When you significantly restrict your diet to only foods that you feel are “safe,” you run the risk of nutritional deficiency.

A similar risk of excessive restriction can occur if you are following the low-FODMAP diet. The diet is not intended to be followed long-term as many foods with higher FODMAP levels can be quite good for you. Working with a qualified dietary professional can help you to identify the FODMAPs that are problematic for you. On the low-FODMAP diet, it is also important to periodically re-introduce problematic FODMAPs to see if your tolerance has improved.

For some reason, the word “fiber” strikes fear in the hearts of many people with IBS. They associate the consumption of fiber as increasing their symptoms, whether it be bloating, diarrhea, or constipation. This usually happens because of a “too much, too soon” situation. Make fiber your friend—it is essential for overall digestive health and helps to soften the stool, which is helpful for constipation, and firm up the stool, which is helpful for diarrhea.

One caveat is to avoid bran as it may be irritating to your digestive system. You can also use bulk laxatives. Don’t be put off by the word “laxative”—bulk laxatives are simply fiber supplements.

Sadly, there are doctors out there who have terrible bedside manners. IBS is a functional disorder and some doctors have difficulty treating IBS patients with patience and empathy. However, the quality of the doctor-patient relationship may influence how well or poorly you feel.

Whenever possible, be an educated consumer and choose your doctor carefully. You might consider changing doctors if yours does any of the following:

• Blames your symptoms only on psychological factors and stress
• Treats you as if you are exaggerating your distress
• Makes you feel like a drug addict because you are seeking pain relief

The fact that IBS is diagnosed after ruling out other diseases does not always lead to a strong feeling of confidence in the diagnosis. This uncertainty might lead you to be vigilant for any unusual physical symptoms that may indicate a more serious condition. A common practice is to compulsively check the color and appearance of each bowel movement. The problem with this is that bowel movements come in all sorts of sizes and colors without being indicative of serious disease. The one major exception to this is a concern about blood in the stool.

Every person on the planet deals with digestive symptoms. Bowel noises and smells are a part of everyday life. You are not defined by the fact that you have troublesome intestines.

Don’t worry that other people will judge you based on your symptoms. If you pass gas, oh well. Excuse yourself and get on with your day. If others are using the public toilet and you need to go, don’t add to your discomfort and stress by thinking that you need to wait for an empty restroom. The people in your life have an opinion of you based on who you are as a person. This opinion will not change if they hear noises or odors coming from the bathroom stall.

Keeping your IBS a secret can be stressful and end up making your symptoms worse. It also blocks having positive social support that has long been associated with better treatment outcomes. Hiding your IBS is unfair and unnecessary. Why should a bowel disorder be any different from one affecting any other part of the body, such as asthma or diabetes?

As with any personal revelation, assess the trustworthiness of the other person before opening up. If you feel that they will be supportive and understanding, give yourself permission to let them know what you are dealing with. This allows the people who care about you to work with you to make sure that your unique needs are being met.

Remember that IBS affects a fairly large portion of the population. Once you start opening up, you may be surprised to find out who else experiences IBS.

Many IBS patients find themselves overcompensating because of their IBS. Because of missed work or missed family activities, there is a self-imposed pressure to be perfect. This includes taking on extra responsibility and/or feeling that you can never say no to requests. Your IBS is not a personal failing—it is a health problem, pure and simple. Therefore, there is no need to “make up” for it.

IBS has forced you to make your own health and well-being a top priority. Remember that it is not good for you to put yourself in situations that are going to make you unduly uncomfortable. IBS symptoms often result in an inability to make commitments or to follow through on plans. It is what it is and all you can do is the best that you can.

While it is true that the unpredictability of IBS makes it hard to plan activities and might make you apprehensive about leaving your house, it is also important to not let the disorder take over your entire life. Social isolation and avoidance of pleasurable and mastery-type activities can lead to a depressed mood state. Look for opportunities and activities that lift your mood and buoy your energy level. It is good to make plans; just let others know that due to health reasons, you may need to cancel at the last minute.

When the time comes to engage in an activity, assess how you are feeling. If you truly feel that you cannot be far away from a bathroom, then by all means cancel. However, if you are experiencing abdominal pain and discomfort, you may find that participating in a distracting and rewarding activity may reduce your suffering.

It is essential to keep in mind that geography is not an IBS trigger—anxiety is. It is often the anxiety about being out and about that worsens symptoms. Therefore, work hard on developing anxiety management skills, such as relaxation exercises, to use to try to keep your stress level low and the pressure off of your GI system when you are not at home. IBS may be an unwanted part of your life, but it doesn’t have to be your whole life.

Many IBS patients get told by their doctors, “There is nothing that can be done; just live with it.” However, read any IBS memoir or IBS success story and you will see that for most people with IBS it takes multiple strategies to ease symptoms.