IBS: your questions answered

Mellers - 'How do you deal with a high-fibre diet?'

Simon: With regards the issue of fibre, it used to be thought that a high-fibre diet helped IBS but this has now been found not to be the case. However, fibre, which comes in two types, soluble (fruits, veg, oats, barley) and insoluble (skins, husks, wheat, rice, nuts) does help with constipation in IBS and is important for good passage.

The ideal balance of soluble and insoluble fibre is different for each person but too much insoluble fibre can be a powerful trigger for IBS. As you are eating lots of fibre I suggest reducing the amount of insoluble fibre in your diet by peeling veg/fruit and reduce the amount of raw veg/fruit. Also increase the amount of soluble fibre foods such as pasta.

Wholewheat bread should not be avoided, but eaten with care as it contains a lot of insoluble fibre. Insoluble fibre should be eaten not on an empty stomach, in large quantities or without soluble fibre foods.

Exercise is also important in losing and maintaining weight loss but did you know it is also very important in IBS. I suggest that you maintain a regular programme of physical exercise and activity; for example, walking three times a week for a minimum of 30 minutes.

sezza2005 asked about the links between IBS and stress

Simon: While IBS may not be initially caused by stress and anxiety we do know that it does make all of the symptoms worse. We also know that many people suffering from stress will experience many symptoms of IBS without having full-blown IBS.

However, people with IBS will be more reactive as they already have a hypersensitive gut. This makes you more likely to suffer from increased symptoms when experiencing any kind of stress.

So, although IBS may have physical causes that we have yet to discover, what a person does, thinks and feels will aggravate and maintain many of the IBS symptoms. IBS is likely to be connected to our lifestyle, level of anxiety and the way we view the world.

There are many other things you can do. Anxiety management can really help. Your GP surgery may have a counsellor or psychologist attached to them where you can get anxiety management and there are many good books which include techniques for reducing your anxiety levels.

One of the most important is accepting the IBS itself. This sounds easy to say but is very important and can reduce your symptoms significantly. For example, what do you say to yourself when you get symptoms of IBS. If you think 'Oh my god, I've started to feel bloated, it's bound to get worse and then ruin my night out' this is more likely to lead to increased worry, stress and focusing on the bloating.

The way we think about our IBS will affect our symptoms. Recognise when this is happening and challenge those thoughts.

Acceptance of the IBS is the key to living with it and not letting it beat you or stop you from having a good and enjoyable life. It's also OK to have IBS. It's nothing to be ashamed or apologetic about.

You need to be aware that your IBS is very sensitive to stress levels and do everything you can to plan your work and avoid that last-minute rush (my daughter is also at university, so I am very aware of this at the moment).