Dear doctor;

Can bread aggravate irritable bowel syndrome? After eating white bread my stomach swells to strange proportions and goes hard. I suffer from flatulence and heartburn, particularly if I’ve eaten a lot of bread. I love bread, so do I have to give it up?

Kaitesi, Remera.

Dear Kaitesi,

Irritable bowel disorder (IBS) is a functional disorder of the bowel, that is, where there is abnormality of the function but no physical abnormality. It can occur at any age but is more common in young adults. Exact cause of irritable bowel syndrome is not known, but mental stress, allergy to certain types of foods, hypersensitivy to abdominal distension after food, reduced immunity following gut infections are some of the causes postulated.

Due to IBS, one usually gets frequent diarrhea or constipation and uncomfortable bloating sensation of the gut. There may be associated nausea and heart burn. Diagnosis is established by excluding other causes for the symptoms like infections.

Some people have allergy to wheat which is main ingredient in bread and can cause IBS. Some other foods which can trigger IBS or aggravate its symptoms include refined bread, fried and processed  foods like chips, milk products like cheese,  alcohol, coffee and carbonated drinks. Taking one or two large meals can also trigger symptoms. Prevention lies in taking small frequent meals that should include brown bread, cereals, fresh green vegetables and fruits. Avoid consuming skin of vegetables and fruits because that has insoluble fiber. Avoid coffee, alcohol and sodas. Drinking six to eight glasses of water daily is also useful. If you like bread, have brown bread in place of white bread. Try to use it with legumes and fruits, instead of margarine, cheese or jams. Learn to relax along with it. If heart burn is severe, take tablet like Omeprazole for about a week or more.