Dos and Don'ts of Dining Out with Irritable Bowel Syndrome

Most people see eating out at a restaurant as a wonderful treat, that is, if they don’t suffer from irritable bowel syndrome (IBS). When a body experiences unpredictable episodes of painful cramping, bouts of urgent diarrhea, or bloating from constipation, enjoying a meal in a social setting loses some of its desirability. In the spirit of trying to regain a sense of ‘normalcy,’ here is a list of Dos and Don’ts for managing your IBS symptoms, with the goal of returning you to your favorite restaurant.

Preparation is Paramount

Do spend the day making sure that your body is as calm and relaxed as possible. People with IBS often feel safest when they are at home. It is important to remember that geography doesn’t trigger IBS symptoms –-anxiety can trigger or exacerbate symptoms. Helpful activities for keeping your body as calm as possible are:

• Visualization
• Deep breathing techniques
• Progressive muscle relaxation
• Meditation
• Yoga

Do think ahead. Indeed, it is a bummer that spontaneity may not be in the cards for you now because of your IBS. However, planning is so much more helpful than projecting your anxiety into a worst-case scenario future. Anticipating all possible outcomes will help keep your anxiety at bay. Important planning items are:

• Access to bathrooms
• Arrange for transportation home should you need to leave early
• Inform your companions of any special needs

Do visualize the event as a smooth, pleasant experience. Visualization can be a powerful tool for reducing anxiety. Imagine yourself traveling to the restaurant, sitting at the table, ordering a meal and enjoying the food with a quiet, calm body. Walking yourself through the event in your mind allows you to identify any potential trouble spots. Go back to your game plan and figure out the most comfortable way for you to deal with any anxiety-provoking elements of the outing.

Don’t starve yourself in an attempt to keep your digestive system calm. Some people think that if there is no food, then the digestive system is in effect turned off. This is not true: Digestion is an ongoing process even in the absence of food. It is much better to eat small, frequent meals throughout the day. This will help your system operate smoothly. Eating throughout the day will also help keep your hunger at a low level, which will help you make optimal food choices when you are actually seated in the restaurant.

At the Restaurant

Do remember to actively keep your body calm. Take deep breaths and relax any tense muscles. Distract yourself from your digestive concerns by focusing on the décor of the restaurant and the pleasure of being with your fellow diners.

Do find out where the bathroom is and then try to forget about it. Don’t allow your brain to get caught up in worries about whether the bathroom is occupied. If you suffer from IBS-D, accidents are a common concern, but relatively rare. Keeping your body as calm as possible will increase the probability that your body will not release any stool until you are safely on the toilet.

Do choose to feed yourself a moderate amount of easily digestible food. Watch for these common culprits that could serve to strongly stimulate your gastrocolic reflex, with the end result of intense intestinal contractions:

• Large food portions
• Rich, creamy, fatty, buttery foods
• Deep-fried foods

Do choose your drinks wisely. Alcohol and caffeine can both be digestive system irritants.

Don’t scan for your body for potential signs of trouble. Scanning behavior sends a message to your brain that there is a possible threat. In response to a perceived threat, the stress response kicks in, and the next thing you know, your bowels are in an uproar. Again, use relaxation and distraction to keep yourself calm in the face of any twinges, rumblings or cramps.

Don’t perceive that ordering a meal is a situation in which you are trapped. The only commitment you make when you order a meal is that you must pay for the food. If you find that you are truly too uncomfortable to enjoy the meal, then excuse yourself, leave money to cover your costs and do what you need to do to take care of yourself. Don’t worry about the comfort of others. True friends and quality individuals will understand and support your decision to address your own physical needs.

Do focus on enjoying the company of others. We are social creatures; we all need to have contact with others for optimum physical and mental health. And, distraction is a wonderful remedy for pain and discomfort. Even if you are not feeling at the top of your game, remind yourself that you could be stuck at home alone feeling poorly. At least you are out, living your life, and experiencing the pleasure of being served food that you did not have to cook and most importantly, connecting with the lives and experiences of others.

_Sources:

Irritable Bowel Syndrome (2003) Mertz, H.R. New England Journal of Medicine 349:2136-2146.

Stress and Irritable Bowel Syndrome (2007) Tache, Y. International Foundation for Functional Gastrointestinal Disorders Fact Sheet.