Q. My mother-in-law, who is 74 years old, has irritable bowel syndrome (IBS) and is very sensitive to a variety of foods.

To make matters worse, she has thalassemia B. She cannot tolerate eggs, which give her stomach pains. Spicy food is out as she will purge, and she doesn't take beef or mutton.

On average, she has stomach cramps once or twice a month. She also frequently has colic lasting for two to three days. Please help me find a diet that is ideal for her condition, especially her blood disorders.

A. Diet and stress appear to be common triggers of IBS although specific causes have yet to be determined.

Foods known to trigger IBS include oily foods, drinks with caffeine, carbonated drinks, chocolate, dairy products and alcohol. However, foods that can trigger IBS may be specific to an individual. Keeping a food diary would help to identify foods that can cause distress.

Dietary fibre can lessen IBS symptoms. Include foods such as oatmeal, dried beans, fruit and vegetables in your diet for fibre. Having small frequent meals and a low-fat diet also help in minimising IBS symptoms.

For people with thalassemia minor who have mild anaemia, a diet change and iron supplements do not improve symptoms. People with thalassemia major requiring blood transfusions may need to limit iron intake.

Foods that are high in iron include pork, liver and beef, and should be taken in moderation. These foods may be substituted with tofu or soya products at times.

I would recommend that you obtain a dietitian's referral for your mother-in-law who can devise a personalised meal plan based on her medical conditions. Dietitian services are available in most hospitals, polyclinics and private health-care settings.

MS MAH WAI YEE IS A QUALIFIED MEMBER (DIETITIAN) OF THE SINGAPORE NUTRITION AND DIETETICS ASSOCIATION