Abdominal Health Diary

Identifying key triggers

Symptoms recap

Irritable Bowel Syndrome (IBS) is a gastrointestinal disorder that has a wide and varying range of symptoms including:

  • Abdominal pain and discomfort
  • Bloating
  • Changes in your bowel habit – constipation or diarrhoea

Other related symptoms include wind, fatigue, nausea and lower back ache. You are able to track all of these symptoms in the Abdominal Health Diary in order to keep an accurate record of your abdominal health history.

There are a variety of lifestyle factors that can trigger IBS symptoms and, as everyone is different, these vary from person to person. However, the most common IBS triggers are listed below, some of which may or may not apply to you. You can track each factor on the Abdominal Health Diary.

Common triggers

Food (and drink) for thought

Cereal and bread
It is normally important to eat plenty of fibre which gives bulk to bowel movements, triggering contractions in the bowel and keeping things moving. However, in some cases, insoluble fibre such as wholemeal bread and breakfast cereals containing a high amount of bran can actually make the problem worse. Therefore, it is important to work out what's best for you.
Vegetables and salad
IBS sufferers may be intolerant to certain vegetables such as broccoli and cabbage whereas carrots and potatoes seldom cause problems. As a result, it may be worth tracking which vegetables you are consuming and altering your choices if required.
Fruit
Fruits high in fructose such as apples and pears can sometimes cause abdominal pain and loose bowel movements, so in a similar way to vegetables it may be worth experimenting. Don't forget that fruit juices may cause the same problems.
Fatty foods
It is important to bear in mind that the fat content of food rather than the food itself could be a problem, eg frying or mashing potatoes with butter.
Dairy
Whilst it isn't very common for dairy products to cause IBS symptoms it may be useful to track this food group if you suspect dairy products may be having an effect on your symptoms. Remember that full fat milk and cream contain a lot of fat so it might be worth trying low fat versions.
Chocolate
Chocolate upsets a small number of patients with IBS.
Spicy foods
Spicy foods rarely contribute to IBS despite common misconceptions, although some popular spicy dishes such as take-away curry are often high in fat which may contribute to symptoms.
Sweets and chewing gum
Many sweets and chewing gum contain sorbitol, an artificial sweetener that can cause bloating, wind and diarrhoea. Therefore, sugar-free products may not always be a better alternative - read food labels to identify all ingredients. The chewing action from gum can also stimulate symptoms.
Caffeine
Caffeinated drinks such as coffee and some carbonated soft drinks can aggravate symptoms and should be limited.
Fizzy and diet drinks
Fizzy and diet drinks (containing sorbitol) should also be limited.
Alcohol
It is well known that alcohol, especially in excess, can have a direct impact on your bowels. You may not realise how much you are actually drinking each week so using the Abdominal Health Diary may highlight a few surprises! However, cutting alcohol out of your diet completely may not have a positive effect. See what works for you.

Breakfast benefits

Eating breakfast may be something that is easy to forget when things get busy, but it is important to eat breakfast to stimulate what is called the 'gastro-colic' reflex. Having a full stomach stimulates your bowel to move. If you delay this until later in the day, any solids sitting in your bowel stay there longer with more water being absorbed, increasing the chance of constipation.

Eating habits

IBS symptoms tend to be increased following large meals, especially if eaten quickly. It can sometimes be helpful to spread the food over three meals and three snacks per day. Avoid eating quickly and try to relax after a meal.

Wonderful water

It is important that you don't become dehydrated, so you may want to increase your fluid intake. Completing the Abdominal Health Diary will help you monitor how much fluid you are drinking each day. Remember, this doesn't include cups of coffee or alcohol!

Exercise - getting it right

Exercise can range from the gentle to the extreme. Whilst it is important to incorporate regular exercise into your lifestyle some exercises may not suit you and could actually be triggering IBS symptoms. Find out what works for you. Exercise that can be particularly helpful in improving digestive health includes aerobics, Tai Chi, swimming, yoga and pilates.

Stress busting

Stressful times in your life such as moving house or specific events like a job interview can trigger or worsen IBS symptoms. Some stressful situations can be controlled but it is those that can't be avoided that are often more troublesome. Keeping track of particularly stressful times can be useful to identify whether they are causing your symptoms and may mean that you can actively avoid certain situations in the future. If unavoidable, incorporating exercise or relaxation techniques into your daily routine may help relieve symptoms. When completing the diary it is important to consider that the impact of stress can sometimes be delayed and happen after the event, rather than on the actual day.

Key considerations

Whilst the factors listed above are simple to track and may directly correspond to symptom flair-ups, there are some key considerations to take into account which may explain why it is harder to pinpoint your triggers:

  • Lack of sleep and disruption to your routine (whether going on holiday or at the weekends), can often lead to bowel problems. This may be why your symptoms increase or decrease on particular days regardless of your diet and other lifestyle factors
  • Women on and before their periods may notice a flair-up of symptoms. This is natural, and also affects women not suffering from IBS
  • It may be harder to notice whether a food is upsetting you if you are consuming it on a daily basis. For example, drinking orange juice or eating bran flakes every day. To sort this out it may be worth leaving the potentially offending food completely out of your diet for a while to see if your symptoms improve
  • Unfortunately for some severe IBS sufferers, the physical action of eating can stimulate symptoms regardless of the specific foods you are eating. In this situation symptoms usually start very shortly after eating
  • There are normally one or two food items that just don’t agree with people, such as onions. However, it is important to remember that this can be completely normal and there may be no underlying problem
  • You may notice that some treatments such as anti-inflammatory painkillers or antibiotics upset your IBS. It is worth paying attention to any problems as alternative options may be available to you. Speak to your pharmacist or GP for advice

For further advice on any of the above symptoms or triggers, consult your GP.

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