How to Avoid Irritable Bowel Syndrome

To recap, IBS is a disorder that affects the functioning of your stomach and intestines. The disorder is “characterized by discomfort and change in bowel habits resulting from altered bowel motility and gut sensitivity,” says Will Bulsiewicz, MD, a board-certified gastroenterologist, bestselling author, and the US medical director of ZOE. People with IBS often have abdominal pain or cramping and experience changes both in the appearance and frequency of their BMs. (Some people with IBS have diarrhea, some have constipation, and some experience both, per the National Institutes of Health.)

What’s challenging about IBS (aside from the frustrating symptoms) is that experts still aren’t sure of its cause. Potential factors that can contribute to the development of the disorder include early life stress², infections like gastroenteritis³, and nervous system issues⁴. Dr. Bulsiewicz adds that damage to the gut microbiome⁵ (the composition of the health-promoting bacteria in your digestive tract) likely plays a central role.

So what is it about lifestyle behaviors that’s potentially so powerful for preventing IBS? Ahead, Dr. Bulsiewicz walks us through the research on the healthy habits that can help prevent IBS in the first place. Plus: tips to reduce its severity if you currently struggle with the GI disorder.

5 lifestyle habits linked with IBS prevention

Because the causes of IBS are still not fully known or understood, it’s been challenging to know how to prevent (and definitively treat) the disorder. But the new Gut study provides some insight on prevention strategies—and they go hand-in-hand with overall good health advice.

Researchers looked at data from over 64,000 adults from the UK Biobank—none of whom had an IBS diagnosis when they were initially enrolled in the study. The study tracked these folks for several years, following up after 12.6 years on average, comparing their adherence to five specific healthy life behaviors with how many people developed IBS. The behaviors were:

1. Never smoking
2. Getting enough sleep
3. Regular physical activity
4. A healthy diet
5. Moderate alcohol intake

The study authors found that sticking with a greater number of these behaviors was “significantly associated” with a lower incidence of IBS. (Basically, people who did more of those behaviors were less likely to be diagnosed with IBS over the course of the study.)

“On a high level, all five of these habits are typical of people who live a healthier lifestyle and have longer life expectancy,” Dr. Bulsiewicz shares. (These behaviors, for example, are cornerstones of the “Blue Zones” communities who tend to have the longest-living populations.)

Dr. Bulsiewicz adds that each of the healthy lifestyle behaviors listed above offers protective mechanisms for the microbiome specifically (with a caveat on alcohol we’ll soon cover), which may explain why they’re linked with IBS prevention. For instance, smoking has been linked to changes in the microbiome and other intestinal changes⁶; research also suggests that people with IBS who smoke may have more severe symptoms⁷ than those who don’t. And a small pilot study from 2019 found that people who quit smoking significantly improved their gut microbiota⁸ (which was also associated with reduced heart rate and blood pressure).

Interestingly, the first three habits (never smoking, adequate sleep, and physical activity) in particular had “significant independent inverse associations with IBS incidence,” per the study. To the layman, it might seem surprising that the non-dietary behaviors could make such a strong impact on keeping IBS at bay, but Dr. Bulsiewicz isn’t fazed. “Never smoking⁹, physical activity, and sleep¹⁰ have previously been associated with lower risk of IBS in other studies,” he shares. “Further, they’ve each also been associated with improvements in the gut microbiome. Thus, based upon what we know about the pathogenesis of IBS, it would make sense that [these] habits would be protective.”

A bit more controversial, however, is the inclusion of moderate alcohol intake, which the U.S. Department of Health and Human Services defines as a maximum of one alcoholic beverage per day for women and two a day for men. “There is some limited evidence that the polyphenols found in red wine or beer may be beneficial to gut microbes, yet alcohol is also known to trigger digestive symptoms for many people with IBS,” says Dr. Bulsiewicz, “so it’s a bit surprising that they included moderate alcohol consumption along with the other four lifestyle factors.” Plus, newer evidence suggests that the antioxidant benefits of wine are a bit overblown. (As a side note, he warns that binge drinking and chronic heavy alcohol consumption are both bad news for your gut health, not to mention your health at large.)

Of course, we can’t snooze on the importance of enjoying a high-quality, nutrient-rich diet packed with diverse foods and nutrients. A healthy plate will look different from one meal (and person) to the next, but there’s one nutrient that Dr. Bulsiewicz particularly prizes for IBS prevention: fiber. “Based upon the available evidence¹¹, it seems that dietary fiber intake might protect us from developing IBS,” he shares. “By modulating the gut microbiota, fiber can help to normalize bowel motility and reduce gut sensitivity, addressing [some of] the root causes of IBS.” Moreover, in a 2017 study¹² published in the journal Neurogastroenterology and Motility, participants with IBS had a lower-quality habitual diet, namely lacking fiber and fructose—the former of which is abundant in plant-based fare and the latter of which is most often found in whole fruits.

How to reduce IBS symptoms and severity

By sticking to as many of the five behaviors above as possible, you’ll be in a good position to support your gut microbiome, stave off IBS, and promote your overall well-being. But in case you already struggle with the condition, Dr. Bulsiewicz offers a few parting tips to keep it under control.

He first mentions the low FODMAP diet as one of the gold standards for dietary intervention, as it currently has the most evidence behind it to improve IBS symptoms. (This diet typically has people cut out specific groups of carbohydrates that can be hard to digest, like lactose and fructose, then reintroduce those foods one at a time to determine which trigger symptoms and which do not.) Just note that it’s more of a bandage than a cure for IBS, as well as one piece of a larger puzzle to solve your gut health woes. Some experts also worry about the implications of using such a restrictive approach for more than a temporary period.

“Some strategies that can help those who have IBS include limiting dairy products, artificial sweeteners, caffeine, alcohol, and carbonated drinks,” Dr. Bulsiewicz adds. Last but not least, keeping your body in motion and finding ways to manage stress can also move the needle on your IBS symptoms. “There’s evidence that both exercise and stress reduction can help, which likely explains why yoga appears to be beneficial¹³,” he concludes. If a namaste a day can keep IBS away (or make it less horrible), I for one will be sure to roll out my yoga mat on the regular.