It’s not just you – bloating is trending. Scroll through TikTok and you’ll quickly stumble across creators documenting their “IBS belly” with a mix of humour and frustration. While it’s refreshing to see people speaking openly about gut health, the reality behind those relatable videos is often far from funny.

@shiv_sewlal Addressing the rumours🙈 #pregnancy #allergy #ibs #bloating ♬ original sound - SHIV

Irritable bowel syndrome (IBS) affects millions of people, yet it’s still widely misunderstood. It’s more than just occasional discomfort – it’s a chronic condition that can be deeply disruptive to everyday life. Fortunately, there are ways to manage the symptoms that come with IBS. Here’s the latest.

What is IBS?

“IBS is a chronic disorder affecting the large intestine, leading to symptoms such as abdominal pain, bloating and altered bowel habits, including diarrhoea, constipation, or both,” explains Raffaella Braga, a registered dietician at Nutritional Solutions in Pretoria.

“Unlike inflammatory bowel diseases, IBS does not cause structural damage to the digestive tract,” she adds. So, it’s not physical damage that’s causing the pain and discomfort you feel. In fact, science has yet to pinpoint the exact cause of IBS. However, several factors may contribute, says Braga:

Gut-brain interaction: Disruptions in communication between the gut and brain can affect bowel function.​
Intestinal motility: When your intestines move in an abnormal way, this can lead to diarrhoea or constipation.​
Hypersensitivity: Increased sensitivity in the intestines may cause pain and discomfort.​
Gut microbiota imbalance: Changes in the composition of the good bacteria that live in your gut may play a role.​
Infections and stress: If you have a history of gastrointestinal infections, or you suffer from chronic stress, these may also potentially trigger IBS.

Common IBS symptoms 

Braga says common symptoms of IBS include:​

• Abdominal pain or cramping, often related to bowel movements
• Changes in bowel habits, such as diarrhoea, constipation, or alternating between the two
• Bloating and gas​

Of course, these aren’t uncommon symptoms – which means some people with IBS go for years without being diagnosed. “IBS is a disease of exclusion. As a result, it’s commonly misdiagnosed,” says Pretoria-based registered dietician Shaszia Alli. That’s also why it’s important to speak to your health provider, rather than relying on self-diagnosis. “IBS presents with common symptoms familiar to many other disorders and conditions, so it’s common for people to misdiagnose themselves using Google,” adds Alli.

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How to manage IBS

Right now, there is still no silver-bullet IBS treatment. However, you can manage the condition so that you have fewer IBS flare-ups. “The first line of therapy includes lifestyle and dietary changes,” says Braga.

Exercise: Exercising regularly can help reduce IBS and will also help you manage stress – a recognised IBS trigger.

Diet: When following an IBS diet, what you eat and what you don’t eat are both important. Increasing soluble fibre (found in oats, bananas and beans, for example) could help improve symptoms, but steer clear of insoluble fibre sources. Be sure to gradually increase your fibre intake, too. Avoid trigger foods such as alcohol, caffeine, fatty and rich foods,” says Braga. Gluten has not been shown to have a significant impact on IBS, notes Alli.

Eat slowly: How you eat also plays a role in managing IBS, says Alli, who recommends “taking time over meals, sitting down to eat, chewing food thoroughly and not eating late at night”.

Supplements: Taking probiotics may help – but avoid prebiotic supplements. “Probiotics seem to help reduce symptoms such as (bloating, distension and flatulence, ) but no particular strains have been shown to be more effective than others,” says Alli. “In contrast, prebiotics and synbiotics (supplements containing a combination of probiotics and prebiotics) are not recommended.” While prebiotics could be beneficial for gut bacteria, they may also be fermented by these bacteria, which could exacerbate symptoms such as bloating and gas.

Home remedies: Online home remedy guides promoting peppermint oil are onto something – it can provide relief from abdominal pain, says Alli, but the flip side is it can also cause heartburn.

Medication: In addition to lifestyle changes, your health provider may recommend medication to manage symptoms, such as antispasmodics, laxatives, anti-diarrheal, or low-dose antidepressants.​

It may take time to figure out what your body responds to. “It's important to remember that treatment is individualised, focusing on symptom relief and improving quality of life,” says Braga.

What are prebiotics, and how to get enough of them

Low FODMAP diet for IBS

So, you’re taking your probiotics, exercising, and cutting out common IBS trigger foods and you’re still having IBS flare-ups? You may need to consider a low-FODMAP diet. As this can be quite restrictive, rather get help from a registered dietician.

“FODMAPs are carbohydrates that some people are sensitive to,” says Alli. “They may be poorly digested in the small intestine and may be fermented by bacteria in the colon, forming gas.”

The word “FODMAP” is an acronym for fermentable oligosaccharides disaccharides monosaccharides and polyols – the different categories of carbohydrates that may have this effect. They’re found in certain fruits, vegetables, grains and dairy products. Alli provides a quick run-down…

Fermentable: “Pre-existing gut bacteria ferment the hard-to-digest carbohydrate in your gut and produce gas.”
Oligosaccharides: “These are fructose and galacto-oligosaccharides that naturally occur in carb sources such as rye, wheat and pasta, fruits and vegetables such as cauliflower, garlic, cherries, onions and plums, legumes including chickpeas and baked beans, chia seeds and pistachios.
Disaccharides: “Found in lactose-containing food items like milk, yoghurt and cheese.”
Monosaccharides: “Found in fructose-containing food items such as honey, high fructose corn syrup and fruits like mangoes, apples and peaches.”
Polyols: “Found in artificial sweeteners such as sorbitol and some fruits and vegetables like mushrooms, nectarines, pears and beans.”

It’s a long list of tasty foods, but the good news is you may not be sensitive to all the categories. You also may not have to cut them out forever. “Initially, trigger foods are removed from the diet to improve symptoms experienced, but they may be reintroduced into the diet once symptoms have improved,” says Alli.

In the meantime, experiment with alternative flavourings, such as spices, herbs and sauces (like Worcestershire, BBQ, soya, oyster and fish sauce). Molasses, golden syrup and maple syrup are sweet alternatives to honey.

A good meal shouldn’t come with a side of discomfort. If you suspect you have IBS, chat to your health provider or a registered dietician and start eating, pain free.