Hi Christine,

I'm sorry to hear that you have Irritable Bowel Syndrome (IBS), as this can be a painful and unpredictable condition. IBS symptoms arise through abnormal spasms of the gut wall which can be related to stress. They can include abdominal cramps, bloating, wind and alternating constipation and diarrhea.

It is surprisingly common and it is estimated that around 15% of the population have, or have had, this condition. IBS can be very difficult to manage, so I really feel for you having to cope with this as well as trying to lose weight.  But, don’t despair as over time, I am sure you will find a new diet and way of eating that will help with both issues.

Different IBS sufferers will find different dietary approaches suit them, so a little trial and error is needed in finding a routine that best eases individual symptoms, I'm sure you have tried various methods of to manage your symptoms already. The beauty of keeping a food diary as you do when using our website is that you can also make a note of when you experience symptoms which means you have a documented record of food and symptoms helping you discover which foods are a problem for you. In the meantime, here are some tips which seem to help the majority of sufferers:

• Firstly try to identify any foods that trigger your symptoms (you say you already know about lactose intolerance and fruit/veg, but there may be different combinations that you have not yet discovered having an impact). IBS sufferers don't seem to suffer from true food allergies more often than non-sufferers but they may be more likely to experience intolerances to food such as spices, wheat and milk that result in intestinal discomfort. The best way to be sure about which foods upset you is to keep a detailed diet diary which can be discussed with a health professional. Other common triggers have been found to be wheat, chocolate, eggs, citrus fruit, milk, food colourings and preservatives, so pay particular attention to those. Avoid strong spices, alcohol and coffee, as these stimulate excessive contraction of the muscles of the bowel. Plus caffeine sometimes causes flare-ups, so watch out how many coffees you drink. You could try peppermint tea, as this has been found to be particularly soothing when the gut is irritated.

Each day, use the Diary Notes section on the food page to note down how you are feeling and any symptoms you experience. Over time, you may well start to see a pattern emerging between certain foods and symptoms. You can then try removing these foods from your diet for a week or so and see if you feel better.

• Overall, make sure your diet is high in fibre and whole foods and drink plenty of water (1 ½ - 2 litres a day).  Increasing dietary fibre helps to keep the colon mildly distended which reduces the risk of it going into spasm. A goal to aim for is at least three to five servings of fruit and vegetables daily, together with higher fibre versions of cereals, bread, rice and pasta. If you avoid the white carbs and instead have brown bread, brown rice and brown pasta, in small portions, you might find this to work better for you, and brown products are also lower in calories and lower GI, so a smaller portion will keep you fuller for longer. Try non-citrus fruits for a period to see if these could be the cause of a flare up. It is also worth trying to blend or juice some of your daily fruit to see if this works better for you.

• Painful symptoms are often associated with blood sugar lows, which is why they can occur early morning, late afternoon and in the middle of the night. Because of this it is best to avoid refined carbohydrates and products with sugar, as these cause blood sugar levels to quickly rise then drop too low. Avoiding these foods will also help with weight loss.

• Reduce your fat intake - some IBS sufferers find fat acts as a stimulus to bowel contractions so need to avoid greasy meals that might send them rushing to the toilet.

• Eat regularly - IBS suffers may find large meals over-stimulate the gut and that eating little and often with a focus on starchy foods (e.g. potatoes, pasta and rice) is better.

• Supplements that may help include probiotic drinks such as Actimel, Peppermint oil to ease flatulence and cramp, psyllium husk which bulks out the bowel in constipated sufferers aiding bowel movement. Colpermin is an enteric coated peppermint supplement that may help with cramps and bloating. Use a cautious approach to start with however!

• Apart from diet, IBS often benefits from exercise and reducing stress levels. When you’ve had an episode and feel drained, try to do some mild exercise after 24 hours to aid your recovery. Then, over time, increase the exercise, making the most of periods when you are feeling well by doing more strenuous exercise to help lessen IBS symptoms over time, as well as aiding your weight loss programme and getting fitter.

Regarding your lactose intolerance, I am sure you know this, but there are a number of substitutes for dairy products.  For alternatives to milk, try soya or rice milk - these are available as unsweetened milks. Dairy-free margarine and plain soya yoghurt are also good substitutes. Take a look at the websitewww.wheatanddairyfree.com for some more ideas and inspiration.

I hope this helps and wish you well.

Regards

Angela