IBS: What Can I Eat? -- with Elaine Magee, MPH, RD

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Live Events Transcript

For those who suffer with IBS, decisions about what to eat can make a world of difference. In observance of IBS Awareness Month, learn to eat well with WebMD's "Recipe Doctor," Elaine Magee, MPH, RD, author of Tell Me What to Eat If I Have IBS. She joined us on April 20, 2005.

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR: Welcome back to WebMD Live, Elaine. Thank you for joining us today. For those who may not know, you have IBS (Irritable Bowel Syndrome), don't you?

MAGEE: Yes, I am a third generation IBS recipient. My mom had it and it sounds like, from stories, that her father had it. It is genetically passed, much like diabetes. I have the diarrhea predominant type. I've never been constipated during my life, even during two pregnancies. But I'm happy to say that it's definitely -- of the conditions you can get -- one of the more workable ones. I haven't had an attack, so to speak, for a very, very long time. It's just about learning how to eat and what to do in extreme circumstances, like high stress or traveling.

I wrote a book called Tell Me What to Eat If I Have Irritable Bowel Syndrome. It's a couple years old and it's been selling quite well and it's translated into Spanish and Chinese. It's my pleasure to be here today to talk about this very common condition.

MEMBER QUESTION: How many grams of fiber should I eat to not get too bloated and stay regular? Less or more than a normal person?

MAGEE: A normal person, in America anyway, is eating about half of the fiber that's recommended per day. The American Dietetic Association recommends 20 to 35 grams per day. So for somebody with IBS constipation you probably want to get toward the higher end of that range.

It's really about figuring out what works best for your body. You're not going to want to eat all your fiber for the day in just one meal, you want to space your fiber out over the day. Ideally you want a variety of fiber, not just bran, not just oats, but you want fiber from all of the plant groups -- fruits, vegetables, whole grains, beans, etc.

Another important key is to not increase your fiber suddenly; you need to do it gradually. For example, increase your fiber by 2 to 3 grams per day, making sure to drink plenty of water through the day and slowly work your way up to the 30 gram mark.

MEMBER QUESTION: How do you avoid constipation? More fiber? Less?

MAGEE: That's a tricky question. It's generally going to be more fiber. We just talked a little bit about that. Another step you might want to take is to keep an IBS symptom journal, where you write down the types of foods you eat, when you ate it, the amount, any emotion or stress going on, and any symptoms throughout the day.

Besides increasing fiber, here are some other things to consider:

  • Plums, prunes and prune juice, sort of naturally encourage loose bowels.
  • Ground flaxseed has been thought to ease constipation symptoms for some; if you're interested in that, feel free to check out my book called The Flax Cookbook. I do have to say that did seem to help me with those issues, as well, having a little bit of ground flaxseed every day.
  • Drink liquids throughout the day -- this encourages bowel movements.
  • Consider limiting coffee and alcohol, because they can have a dehydrating effect and dehydration can make constipation worse.
  • That high-protein, low-carb diet that is on its way out is thought to worsen constipation.
  • Psyllium is in some of the fiber supplements you might see over the counter that you blend with water. There's some good evidence to support that can help people with constipation as well.

MEMBER: That's funny about coffee because it gives my son and other people I know diarrhea.

MAGEE: Caffeinated drinks in general are intestinal stimulants, so it's quite possible that is potentially contributing to diarrhea. I know people with constipation sometimes use it to get things moving, but for people with diarrhea predominant it's something to watch out for. More than likely the caffeine in coffee will be a trigger, more than a diet soda that doesn't have as much caffeine.

MODERATOR: Can you explain what you mean by an IBS symptom journal?

MAGEE: There's one in my book and it's called the FFS diary: F ood, F eelings, and S ymptoms. Feelings, stress and our emotions can play a big role in IBS symptoms. A diary is your best way of tracking what's going on with your intestines and determining what your triggers are.