Irritable bowel syndrome is a common functional gastrointestinal disorder that manifests as recurrent episodes of abdominal pain, bloating, and changes in bowel habits. The prevalence has been increasing in recent years, with a prevalence of 10% to 20% in the domestic population. Many people are often troubled by the disease, multiple examinations, seeking medical advice, although after a comprehensive examination, often can not find the exact cause, a variety of drugs with little effect, some people with long-term uncontrolled symptoms will also appear anxiety and other psychiatric symptoms. In recent years, a study reported that about 2/3 of the irritable bowel syndrome patients’ symptoms may be related to a certain food, especially high hairy food, and 55.2% of the patients’ symptoms improved significantly after eliminating these foods, indicating that the relationship between diet and irritable bowel syndrome is very close, and if irritable bowel syndrome is always not cured, you may need to change your diet. First of all, let’s see what is fermented food Fermented food is actually food that is easily fermented, mainly oligosaccharides, disaccharides, monosaccharides and polyols, and many common fruits, vegetables, nuts and food additives are fermented food. They are not easily absorbed by the body, which can increase the intestinal osmotic pressure and trigger diarrhea. When such foods encounter the bacteria in the intestine, they can easily ferment and produce gas, thus producing bloating. If the gas produced contains more methane, it will slow down the intestinal motility and cause constipation. Some studies have now demonstrated that limiting the intake of methane producing foods can improve the symptoms of irritable bowel syndrome and other functional gastrointestinal disorders, including abdominal pain, bloating, diarrhea or constipation. Why diet can cause symptoms of irritable bowel syndrome The pathogenesis of irritable bowel syndrome is complex and may be related to visceral hypersensitivity, intestinal inflammation, abnormal gastrointestinal dynamics, immune response, psychological state, and brain-gut axis activity. Recent studies have found that diet is closely related to the symptoms of irritable bowel syndrome, mainly due to the effects of intolerance of certain foods, food on intestinal osmotic pressure, intestinal flora, and visceral sensitivity. 1. Intolerance to certain foods Food intolerance, also known as chronic food allergy, is a gastrointestinal response that occurs when a person lacks the enzymes to digest a specific food, rather than an immune system response. Symptoms of food intolerance often occur hours or days after the food is eaten. Common symptoms include: abdominal pain, diarrhea, indigestion, rash, itchy skin, headache, insomnia, etc. 50% to 70% of patients with irritable bowel syndrome have food intolerances, and common intolerant foods include: high sugar diet, coffee, alcohol, milk, chocolate, beans, onions, cabbage and foods with high fat and spice content. 2. Altered intestinal osmolarity Altered intestinal osmolarity is a potential pathogenic mechanism of diet-induced irritable bowel syndrome, which is common in patients with diarrhea-type irritable bowel syndrome. Some studies have found that microscopic intestinal mucosal epithelial damage, intraepithelial lymphocytosis, and widening of the villi gap are more common in patients who consume wheat, soy, milk, and yeast. Certain hairy foods are highly permeable, which means that they can easily absorb a lot of water and bring a lot of water into the intestine, which may affect the rate of intestinal motility and lead to diarrhea. 3, affect the intestinal flora The composition of food is closely related to the changes in the intestinal flora of the body, although different fermentation substrates can selectively promote the proliferation of different bacteria, but most of the hairy food is a good substrate for the intestinal flora, so the diet with high content of hairy food may induce or aggravate the intestinal microecological disorders in patients with irritable bowel syndrome, the overgrowth of bacteria in the intestine fermented in advance of the body can not fully digest these The overgrown bacteria in the intestine ferment these foods that cannot be fully digested by the body in advance, making the patient gather a large amount of gas in the intestine, thus inducing flatulence and spasm. 4. Visceral hypersensitivity Diffuse food cannot be hydrolyzed due to the lack of hydrolytic enzymes in the intestinal tract, resulting in non-absorption, which, together with its slow transmission and retention in the intestinal cavity, can increase the production of water and gas in the intestinal cavity, raising the hypersensitivity of the viscera of patients with irritable bowel syndrome. Patients with irritable bowel syndrome are more likely to have abdominal distension or abdominal swelling, and patients with constipated irritable bowel syndrome have longer retention of intestinal gas, further indicating that visceral hypersensitivity and reduced intestinal transmission capacity are the mechanisms of abdominal distension in patients with irritable bowel syndrome. How to change your diet 1. Avoid intolerant foods Many people may have intolerances to three or more foods at the same time. Because of the insidious onset and the lack of specificity of symptoms, it is difficult for people to identify intolerant foods on their own and professional testing is required. Many large hospitals have developed this program, which requires only 05 to 1 ml of blood to test for intolerance to some common foods in life. The 14 common tests currently available include beef, chicken, cod, corn, crab, eggs, mushrooms, milk, pork, rice shrimp, soybeans, tomatoes and wheat, etc. Some also offer 90 tests for food intolerances, including various vegetables, meats and fruits. If you find out what foods you are intolerant to through the food intolerance test, the method is simple, and you can get rid of your intolerance without either medication or injections, just by making dietary adjustments and avoiding intolerant foods. Each person has different types of food intolerances and symptoms, so the time required for dietary adjustment varies. According to the test results, foods are divided into three categories: avoidance, rotation and safe consumption. If there are many intolerant foods, foods with moderate and severe sensitivity can be classified as contraindicated and foods with mild sensitivity can be included in the food rotation. See the attached chart for foods that can be replaced. 2. Avoid irritating foods. Nearly half of the patients with irritable bowel syndrome experience abdominal pain, diarrhea and increased bowel movements after eating cold and spicy foods, as well as drinking alcohol and caffeinated beverages. This is because alcohol affects gastrointestinal motility, absorption and mucosal permeability, and caffeine in beverages such as coffee and strong tea can produce chronic stimulation of the gastrointestinal tract, increasing gastric acid secretion and colonic motility activity. Capsaicin can stimulate transient receptors to lower the threshold of nociception, which in turn causes abdominal pain and other discomfort. Therefore, patients with irritable bowel syndrome should try to avoid cold, spicy and irritating food. 3, reduce the intake of fat, increase dietary fiber. Because fat can stimulate the gastrocolonic reflex, this response is amplified in patients with irritable bowel syndrome, and the absorption of lipids will increase colonic sensitivity. Dietary fiber can be divided into soluble fiber (e.g., egg-leaf psyllium and plantain) and insoluble fiber (e.g., rice bran, bran). Soluble fiber can significantly improve the symptoms of irritable bowel syndrome, while insoluble fiber tends to worsen the symptoms. Therefore, patients with irritable bowel syndrome can try to intake soluble fiber, it is recommended to start with a low dose of soluble fiber (3-4g per day) and gradually increase to 20-30g per day as tolerated, but it should be noted that adding too much too quickly may aggravate the original abdominal pain and bloating and other discomfort. 4, low hair diffusion diet Recent studies have shown that the low hair diffusion diet can improve the symptoms of 50% to 80% of patients with irritable bowel syndrome. This diet can significantly improve the symptoms of diarrhea, bloating and excessive gas production, it also has a role in relieving abdominal pain, it can improve the overall digestive status and significantly improve the quality of life of patients. The key to the effectiveness of a low-fluff diet is the regulation of flora. Restricting dietary fiber to high-fluff foods allows bacteria that prefer low-fluff to prevail, and the change in flora reduces inflammation and makes the intestinal tract less sensitive. The total intake of febrile foods in the daily diet is generally 15-30 g/d. A low-febrile diet emphasizes controlling the total daily intake of febrile foods down to 5-18 g, rather than avoiding certain foods altogether. A low-fat diet can be implemented in three phases. The first phase is the “restriction phase”, in which all foods rich in hair manga are strictly restricted for 4-8 weeks. The second phase is the “reintroduction phase”, in which the reintroduction of foods is gradual and the tolerance level of different foods is determined. The third phase is the “individualization phase”, in which different dietary habits are chosen and adhered to over time according to individual tolerance levels. Of course, the pathogenesis of irritable bowel syndrome is very complex, and dietary factors are only one of the causes, but psychological factors are also important factors in the development of the syndrome. Patients who do not respond well to dietary changes need to go to the hospital for further examination and treatment.