The flow chart further below is adapted from the current UK NHS and NICE guidance regarding IBS, adding elements from my own experience and research, that I have found useful for my own IBS journey and the approach that I would have taken, if I had been armed with this information at the onset of symptoms.
Standard treatments certainly have their place. However, for example, one thing that I would have done differently if I had known, was to not conduct a FODMAP elimination and reintroduction diet from the outset. The new approach, described in the diagram below, is to try to make the body as tolerant to as many foods as possible, through probiotics and, if necessary, medication prior to starting any elimination diets, otherwise some foods may be eliminated unnecessarily and foods containing FODMAPS are good for your health. Additionally, having as wide a diet as possible increases bacterial diversity, which improves the number of good bugs in the gut versus the bad and it is the bad bugs that can contribute to IBS symptoms.
Even before this, there is a check to ensure that a person is eating a healthy balanced diet. Sometimes unhealthy diets, containing lots of processed foods and few nutrients, can reduce feed for the good bugs in the gut, so they are unable to keep the bad bugs under control. By moving towards a healthy balanced diet (the Mediterranean diet being a great example of this) including whole grains, different coloured fruits and vegetables, fish including oily fish, olive oil (as the main fat source) plus pulses, nuts and seeds, the good bugs grow in numbers and, for some individuals, this may be enough to improve symptoms.
That said, since IBS is still under research, the cause of one person’s IBS symptoms may be different to another person’s, meaning remedies are not necessarily ‘one size fits all’, unfortunately, and each sufferer needs to do experimenting to find out what works best for them. However, statistically there can be some common threads, so the below approach is worth trying.
Further Reading And References
(2) NHS, Coventry and Warwickshire, Integrated Care Board (GP Gateway): Irritable Bowel Syndrome
IBS Researcher 