World IBS Day, being marked today, offers an important opportunity to raise awareness about irritable bowel syndrome, one of the most common functional gastrointestinal disorders worldwide, yet still widely misunderstood.
IBS is characterised by symptoms such as abdominal pain, bloating and altered bowel habits, including diarrhoea, constipation or a mixture of both. Although not life-threatening, it can significantly affect daily life, influencing work, social activities and emotional well-being.
In Malta, awareness and diagnosis of IBS have been steadily increasing as more people seek medical advice for ongoing digestive symptoms. While exact prevalence rates in Malta are still under investigation, international data estimate that IBS affects around 14% of the global population (Arif et al., 2025). If similar trends apply locally, IBS may be more common than previously understood, making public awareness, especially around safe and effective dietary management, more important than ever.
Although IBS is long term and currently has no cure, a range of treatments can help manage symptoms and improve daily quality of life. Among these, dietary management has become a central part of care.
There is a well-established link between certain dietary components and symptom flare-ups, and research shows that most people with IBS believe that what they eat plays a major role in triggering or worsening their symptoms (Melchior et al., 2021).
Food, symptoms and the risk of over-restriction
One of the most common questions people with IBS ask is: “Is it something I ate?”
The relationship between IBS and food is real but complex. Certain foods can trigger or worsen symptoms, yet these triggers vary widely from person to person. Because of this unpredictability, many individuals begin to self-manage by cutting out foods they believe are causing discomfort.
This is where problems often begin.
Eliminating entire food groups and commonly consumed food such as wheat-based bread and pasta, certain fruit and vegetables, dairy and pulses without professional guidance can lead to unintended nutritional deficiencies.
For example, avoiding dairy without suitable alternatives may reduce calcium intake, while cutting out fortified cereals can lower iron and B-vitamin intake.
Similarly, restricting grains, fruits, vegetables, legumes and pulses can significantly reduce fibre (Bek et al., 2022; Chey et al., 2021; McKenzie et al., 2016). Over time, these gaps can increase the risk of malnutrition, particularly if avoided foods are not replaced with nutritionally equivalent options or appropriate supplementation.
Given the strong association between IBS symptoms and food, several dietary patterns have been proposed to help manage symptoms and offer relief. These include traditional dietary advice based on guidelines from the British Dietetic Association (McKenzie et al. 2016) and the National Institute for Health and Care Excellence (NICE 2017), the low-FODMAP diet (Tuck and Barrett, 2017; Bertin et al., 2024; Sultan et al., 2022), the gluten-free diet (Rej et al., 2022), and other targeted approaches.
“For anyone living with ongoing digestive symptoms, seeking help is not only appropriate, it is empowering”
However, all of these dietary strategies involve limiting or excluding certain foods or food groups, which can lead to nutritional deficiencies if not followed with the support of a qualified dietitian.
Managing IBS
Dietitians play a crucial role in helping individuals manage IBS safely and effectively. Evidence-based dietary strategies, such as the low FODMAP diet, fibre modification or targeted trigger identification require careful assessment, structured implementation and personalised reintroduction phases. These steps are designed not only to reduce symptoms but also to protect long-term nutritional adequacy.
A dietitian’s role extends beyond food lists. It includes:
• Assessing an individual’s eating patterns, lifestyle and symptom history;
• Identifying potential triggers without unnecessary restriction;
• Ensuring that any eliminated foods are replaced with alternatives of similar nutrient profiles;
• Supporting patients through reintroduction phases to broaden the diet again; and
• Reducing the anxiety and confusion that often accompany IBS self-management.
This professional guidance is especially important in Malta, where cultural eating patterns, traditional food and social dining play a central role in daily life. People deserve strategies that help them feel better without compromising their nutritional health or their enjoyment of food.
A call for awareness and support
On this World IBS Day, it is worth recognising that IBS is not “just a sensitive stomach”. It is a legitimate medical condition that requires understanding, evidence-based care and multidisciplinary support.
Increased awareness in Malta is a positive step forward, but it must be matched with access to accurate information and qualified professionals who can guide individuals safely.
For anyone living with ongoing digestive symptoms, seeking help is not only appropriate, it is empowering. With the right support, IBS can be managed effectively, and people can regain confidence in both their health and their relationship with food.
Heather Galea is a registered dietitian.
