�鶹����

A��“gut-brain mis-interaction”—that’s how��gastroenterologist Michelle Cohen, MD,��refers to irritable bowel syndrome (IBS), a condition experienced by five to��15% of the global population, and much of her own medical practice.����

“We��evaluate��the different sub-types of IBS—d��������hea, constipation, and mixed pattern—and try to look at it in terms of whether a patient is experiencing the condition mildly, moderately, or severely,��and how much it impacts their quality of life,” explains��Dr. Cohen,��Assistant Professor of Clinical Medicine in the Division of Gastroenterology and Hepatology at �鶹���� (WCM).

Based on a detailed medical history��and limited test workup, gastroenterologists can diagnose the condition and help patients manage it��by creating an individualized treatment approach.��

Treating Symptoms of IBS

Medication can be of limited use for some IBS patients, so diet is an effective way to start addressing IBS.��

“The response rate for medications for IBS is not crazy high and can sometimes cause only a modest improvement in symptoms,” Dr. Cohen says. “That tells us we need to look at other things��at��play.”��

For patients with less severe cases of IBS, diet can sometimes be enough to improve symptoms. But even dietary changes have to be customized based on the patient.��

“The puzzle picture��of IBS��is the same��from one patient to the next, but everyone’s puzzle��pieces��are different,” Dr. Cohen says. “But we know there is some response to diet—it can be a key player in managing symptoms for patients with a��mild case��of IBS.”��

Maintaining a Low FODMAP Diet

One of the go-to diets for patients with IBS-D (diarrhea) is called the��, which can be used to help patients identify which foods trigger their symptoms.��The diet is an attempt to limit foods that��may��cause gas and bloating, namely,��fructose,��lactose,��fructans,��galactans, and��polyols.��

“Certain foods definitely promote diarrhea, and some patients have food intolerances that get tied into IBS symptoms,” Dr. Cohen says.��

Constipated patients, she adds, may see results by balancing��the different fibers the ingest��and��making modifications to the low FODMAP diet.��

“Other dietary tweaks like lowering fat and caffeine intake can be helpful,” Dr. Cohen says.��

WCM dietitians and nutritionists��can��be an important��resource for IBS patients.��

“We know some patients need a lot of dietary help, and it’s useful to find their specific triggers,”��Dr. Cohen says.��“They sit with patients and go through their diets��to talk about what works and what doesn’t work.”����

It’s also an��effective��way to individualize care.��

“Adjusting a patient’s diet is not a one-size fits-all approach,” Dr. Cohen adds. “Sometimes��adjusting diet��is enough for a patient to experience relief, and sometimes it’s��just��one��way to help��treat the overall condition.”��