Managing irritable bowel syndrome (IBS) with diet
If bloating, gas and changes in your bathroom habits are cramping your style, changing your food choices can be an effective route to relief.
- What are FODMAPs? Should they be banned from your diet?
- Identifying and eliminating your trigger foods is a key step.
- Knowing which foods are “safe” keeps variety on the menu.
[3 MIN READ]
Irritable bowel syndrome (IBS) is a fairly common condition that affects up to 15 percent of the general population, according to the International Foundation for Gastrointestinal Disorders. Many of them remain diagnosed. IBS Awareness Month in April focused on raising awareness by sharing information and education about this debilitating illness. Find out tips below on managing this illness using food from both a dietitian and gastroenterologist.
Between 25 and 45 million Americans are affected by IBS, which causes a wide range of symptoms, including:
- Excess gas and bloating
- Cramping and abdominal pain
- Diarrhea, constipation or a combination of both
- Mucus in your stool
IBS affects more women than men. It is most often experienced by people younger than 45 but anyone can have this common condition. With IBS, it’s not uncommon to alternate between periods during which your symptoms worsen and intrude on your daily life and periods during which your symptoms seem to fade or even disappear.
The specific cause of IBS is unknown. Research is starting to uncover a link between IBS and gut health, which could one day increase the treatment options you have to choose from. Our Talk with a Doc podcast with Dr. John Brooling, a gastroenterologist with Pacific Medical Centers in Seattle, answers your questions about gut health and its impact on your life. Listen to it here.
Make some changes
High stress levels may aggravate your symptoms but they are rarely the cause. Your eating habits, on the other hand, can play a major role in the effects of IBS on your life and how frequently it disrupts your routine. Adjusting your diet to include certain foods and limit others can make a noticeable difference in how you feel.
“Modifying your diet works better than meds to control IBS. It can be life changing,” said Christy Goff, MS, RDN, CD, a dietitian with Pacific Medical Centers in Seattle.
What’s a FODMAP?
FODMAP stands for Fermentable Oligosaccharides Disaccharides Monosaccharide And Polyols. It refers to a group of small chain carbohydrates consisting of fructose and sucrose, which are both forms of sugars that are difficult to absorb.
During digestion, these carbohydrates draw excess water into your colon—kind of like a water balloon—and produce large amounts of gas as they ferment. If that water and gas build up in your large intestine it can lead to bloating, gas, pain, constipation and diarrhea.
Eliminating or restricting the FODMAPs that your body doesn’t tolerate well can have a significant impact on how IBS affects you. Some studies report as many as 75 percent of people with IBS experience relief with a low FODMAP diet that restricts the foods that produce the unwanted, often painful, affects.
“It’s a good way to find out your triggers and how much you can eat before you have symptoms,” said Christy.
The low FODMAP diet
With a low FODMAP diet you eliminate any foods that are high in FODMAPs like dairy products or certain vegetables and grains for 3 – 6 weeks. This gives them all time to leave your system completely. Once you are symptom-free for several weeks, you begin reintroducing different foods into your diet and monitoring their effects. Those that don’t produce a negative reaction can retain their spot on your regular menu. Those that bring on side effects like bloating or gas should probably not make the cut.
With a low FODMAP diet you eliminate any foods that are high in FODMAPs like dairy products or certain vegetables and grains for 3 – 6 weeks. This gives them all time to leave your system completely. Once you are symptom-free , you begin reintroducing different foods.
A low FODMAP diet can be challenging to carry out on your own. For the best results you should always work with a qualified healthcare provider to develop a manageable plan for eliminating and re-introducing the foods in question to your eating plan. A registered dietitian can help you determine your specific trigger foods and how to adjust your diet for the best results.
“The low FODMAP diet can be really challenging, but it lasts for a short time and the results are really worth it,” said Christy. “Many people feel better within three to four days. It’s really powerful to get control of your symptoms.”
High FODMAP foods to avoid
Eliminating your FODMAP food triggers can provide relief from your digestive issues. But don’t self-diagnose! Consult with your doctor or a registered dietitian for help in navigating the many nuances of this diet.
The list below is not exhaustive and may vary for each individual, but we’ve gathered a list of some of the highest FODMAP offenders to avoid:
Dairy and dairy alternatives containing lactose
- Soft cheeses like ricotta, cream cheese or cottage cheese
- Condensed or evaporated milk
- Full-fat cow, goat or sheep milk
- Ice cream
- Soy milk made with whole soybeans
Vegetables and herbs
- Garlic
- Onions, leeks, scallions and shallots
- Broccoli
- Cabbage
- Cauliflower
Fruit
- Apples
- Pears
- Watermelon
- Dried fruit
- Fruit juice
Nuts, seeds and oils
- Cashews
- Pistachios
Grains
- Barley
- Rye
- Wheat
Beverages
- Rum
- Cow’s milk
- Most fruit juices
- Oolong, chamomile or strong chai tea
- Kombucha
Legumes
- Baked beans
- Chickpeas
- Lentils
- Soybeans
Baking products, condiments, spices, sweeteners and sweets
- Artificial sweeteners like sorbitol, xylitol, maltitol and isomalt
- High-fructose corn syrup
- Flour blends made with wheat
- Gluten-free flowers made with bean flours
- Ketchup
Foods to add
Following a low FODMAP diet doesn’t mean you have to omit all the foods you love. A dietitian can help you determine a realistic, healthy way to fine-tune your diet.
Some of the lowest FODMAP foods to keep or add to your diet include:
Dairy and dairy alternatives
- Lactose-free milk or yogurt
- Almond, rice or coconut milk
- Hard or aged cheeses like brie, feta and camembert
Vegetables and herbs
- Potatoes
- Carrots
- Cucumbers
- Ginger
- Lettuce
Fruit
- Bananas
- Blueberries
- Grapefruit
- Oranges
- Strawberries
Nuts, seeds and oils
- Peanuts and peanut butter
- Almonds
- Walnuts
- Macadamia
- Olive and avocado oils
Grains
- Oats and oat bran
- Gluten-free pasta and bread
- Corn flour
- Quinoa
- Rice
Beverages (in moderation)
- Most red and white wine
- Beer
- Coffee and espresso
- Black, green, peppermint and white tea
Legumes
- Chickpeas
- Edamame
- Lentils
- Tempeh
- Firm tofu
Baking products and additives
- Gluten-free flour blends
- Brown, powdered, palm, raw and white sugar
- Stevia
- Vanilla and almond extract
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Find a doctor
Managing your symptoms by avoiding some foods and regularly eating others can be an effective way to reduce the impact IBS has on your life. Our team of nutrition specialists can help you fine-tune your eating plan for maximum impact or find a doctor using our provider directory. You can search for a primary care doctor in your area.
Related resources
9 signs your stomach pain isn't normal
Gut health: your mysterious second brain
Support #IBSAwareness by sharing the dietary challenges and success you’ve experienced while managing your IBS with readers @providence.
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.