If you’ve been diagnosed with IBS, you probably have many questions about your diet and what foods you should eat and avoid to help manage your symptoms.
With countless diets claiming to help IBS, the information overload can be daunting.
In this article, we’ll discuss the different diets that might help with IBS, as well as foods to consider including and avoiding in your IBS diet.
What is IBS?
IBS stands for irritable bowel syndrome, which is a disorder that affects your stomach and intestines. IBS is a common condition estimated to impact around 11% of the world’s population.
There are three main classifications of IBS, each specifying its more common symptoms.
- IBS-C: IBS with constipation, which means that you may have irregular bowel movements, or your bowel movements will be hard and difficult to pass.
- IBS-D: IBS with diarrhea, which is when most of your bowel movements are considered loose and/or watery.
- IBS-M: IBS with mixed bowel habits, which means you may experience both diarrhea and constipation.
IBS is most likely to occur from the late teenage years to the early forties. Women are more likely to develop IBS compared to men.
Some potential risk factors for developing IBS include:
- Having a family history of IBS
- Chronic stress, tension, or anxiety
- Having food intolerances
- History of physical or sexual abuse
- Severe digestive tract infections
There aren’t any formal tests to diagnose IBS. Your healthcare provider will likely diagnose IBS based on your history of symptoms, physical exam, family history, etc. IBS may also be called spastic colon.
There aren’t any cures for IBS, but there are ways it can be treated through both lifestyle and medication management.
What are the symptoms of IBS?
The most common symptoms of IBS include:
- Abdominal pain or cramps, usually occurring in the lower half of your abdomen
- Hard and/or loose bowel movements
- Diarrhea, constipation, or a combination of the two
- Excess gas (flatulence)
- Fatty stools/mucus in stools
What can trigger an IBS flare-up?
Many potential triggers might cause your IBS to flare up. Everyone’s triggers for IBS flare-ups are different, so it might take time for you to identify the consistent ones.
Some things that might cause your IBS to flare up include:
Stress and anxiety
Emotional stress doesn’t necessarily cause IBS, but it can worsen symptoms in some people. This type of association is behind the term “nervous stomach,” which some people only experience before stressful events.
Women might notice their IBS symptoms worsen depending on their menstrual cycle when hormones change drastically. Hormonal changes during pregnancy might also worsen IBS symptoms.
Certain foods and/or drinks
As we’ll cover more in-depth in the next section, certain foods and drinks might cause your IBS symptoms to flare up.
Different IBS diets
Many different diets have become popular for managing IBS. Your success with one diet might be very different from someone else with IBS’s experience. Therefore, it’s important to experiment and try different dietary modifications to find what works best for you.
Low FODMAP diet
A low FODMAP diet is low in certain carbohydrates, which can be poorly digested and might trigger IBS symptoms.
FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols,” which describes the chemical structure of those potentially poorly-digestible carbs.
We’ll cover which foods are high in FODMAPs in the next section. If you choose to try a low FODMAP diet, it should be treated like an elimination diet.
For instance, you don’t necessarily need to avoid all FODMAPs – you might only need to avoid one or two categories like lactose or gluten.
An elimination diet is one where you avoid certain food groups for several weeks to see if it helps reduce your IBS symptoms.
An elimination diet is meant to identify your unique food triggers. You should only eliminate one main type of food at a time so you can know if it is beneficial to avoid.
If you don’t notice any improvement in your symptoms after eliminating a particular food, you should add it back to your diet and move on to the next food group to eliminate for the next several weeks.
Some people notice that gluten triggers their IBS symptoms. You don’t need to have a gluten allergy to be intolerant to gluten.
Gluten is a protein found in wheat, rye, and barley. Choosing gluten-free grains and foods without any added gluten is the main premise of a gluten-free diet.
High- or low-fiber diets
Depending on your IBS symptoms, you might choose to follow either a high- or low-fiber diet. High-fiber diets are meant to treat constipation, while low-fiber diets are more suitable for diarrhea.
Fat is one potential IBS trigger, so a low-fat diet might help you manage your IBS if that is your main trigger.
A low-fat diet is considered one that doesn’t make up more than 30% of its calories from fat. For example, a 2,000-calorie diet wouldn’t contain more than around 66 grams of fat.
A diet rich in fiber, healthy fats, and low in refined carbs and grains might help ease your IBS symptoms. An anti-inflammatory diet or Mediterranean diet fits those bills.
It typically emphasizes plant-based foods like fruits, vegetables, whole grains, nuts, seeds, legumes, and healthy fats like fatty fish and vegetable oils.
Foods to avoid with IBS
FODMAPs are in a variety of foods, so you shouldn’t eliminate all of them at once when you try a low-FODMAP diet. Instead, try eliminating one main category of FODMAPS at a time to see which ones are your triggers.
The actual list of high-FODMAP foods is quite extensive, but here is a summary of some of the common ones.
- Dairy-based milk, yogurt, and ice cream (lactose)
- Wheat-based products such as cereal, bread, and crackers (gluten); rye and barley also contain gluten
- Beans and lentils (galactooligosaccharides and fructans)
- Some vegetables, such as artichokes, asparagus, onions, and garlic (fructans)
- Some fruits, such as apples, cherries, pears, and peaches (fructose)
Fat can worsen IBS symptoms in some patients. Fat can also trigger diarrhea and fatty stools. Some examples of high-fat foods to potentially avoid for IBS include:
- beef (especially non-lean cuts)
- poultry with the skin on
- lard and cream
- ice cream
- coconut (including coconut oil)
- palm oil and palm kernel oil
- some baked and fried foods
Foods high in insoluble fiber
There are two types of fiber – soluble and insoluble. Insoluble fiber doesn’t absorb water and can shorten digestion time, which isn’t ideal if you suffer from diarrhea from IBS.
Examples of insoluble fiber include:
- Wheat bran and wheat germ
- Oat bran
- Beans, lentils, and legumes
- Whole grains
- Green peas
- Apples with the skin
- Pears with the skin
- Sunflower seeds
- Potatoes and sweet potatoes
- Dried apricots, prunes, raisins, dates, and figs
- 100% whole grain pasta and bread
If you’re intolerant to gluten and it triggers your IBS, you’ll need to look beyond the obvious foods that contain gluten.
Gluten-based ingredients are added to many foods as a thickener, so the gluten can be hidden in foods you wouldn’t have thought otherwise.
To be sure, check the ingredient list and look for any sources of gluten. Food labels also must have an allergy statement stating common allergens the products contain, and gluten is one of those common allergens (it would say “CONTAINS GLUTEN”).
Some common sources of gluten include:
- Wheat and its derivatives: such as wheat berries, durum, emmer, semolina, spelt, farina, farro, graham, KAMUT Khorasan wheat, einkorn wheat
- Malt (malted barley flour, malted milk or milkshakes, malt extract, malt syrup, malt flavoring, malt vinegar)
- Brewer’s Yeast
Lactose is the natural sugar in dairy products. It is a common IBS trigger, and some patients with IBS might also have lactose intolerance.
Lactose is highest in:
- Cow’s milk
- Evaporated milk
- Condensed milk
- Ice cream
Fermented and aged dairy products, such as hard cheeses and yogurt, are lower in lactose.
Sugar-free foods and drinks often contain sugar alcohols, which are high in FODMAPs and can worsen IBS symptoms. Avoid anything with an -ol ending, such as mannitol, sorbitol, xylitol, etc.
Best foods to eat with IBS
Foods high in soluble fiber
Unlike insoluble fiber, soluble fiber absorbs water and slows digestion. This can be especially helpful for people with diarrhea as an IBS symptom. Foods rich in soluble fiber can also help promote digestive regularity and prevent constipation.
Some foods high in soluble fiber include:
- Beans (they contain both soluble and insoluble fiber)
- Citrus fruits
Lean protein can be easier to digest than high-fat protein. Some good sources of lean protein include:
- Lean cuts of meat (lean beef, pork tenderloin, etc.)
- Skinless poultry
- White meat fish like tuna, tilapia, and cod
- Beans and lentils
- Low-fat dairy
- Higher-protein grains/seeds like quinoa, whole grains
Omega-3 fatty acids
Omega-3 fatty acids are in unsaturated fats and have anti-inflammatory properties, which might be helpful in inflammatory conditions like IBS.
Some of the best sources of omega-3 fats are:
- Fatty fish like salmon, mackerel, and herring
- Chia seeds
- Vegetable oils like flaxseed oil and canola oil
- Algae oil (a good source for vegans)
In addition to avoiding gluten and lactose, some low-FODMAP fruits and vegetables to include in your IBS diet are:
- Blueberries (¼ cup portion)
- Cantaloupe (3/4 cup portion)
- Coconut flesh (2/3 cup portion)
- Honeydew melon (½ cup portion)
- Passion fruit
- Raspberries (30 berries)
- Bamboo shoots
- Bean sprouts
- Beetroot (canned and pickled)
- Black beans (¼ cup)
- Bok choy
- Cabbage (up to ¾ cup)
- Collard greens
- Eggplant (1 cup portion)
- Green beans
- Green pepper bell pepper (½ cup portion)
- Red bell pepper
- Scallions (green part)
- Spaghetti squash
- Swiss chard
- Sweet potato (1/2 cup portion)
- Water chestnuts
Probiotic foods can help replenish beneficial bacteria in your gut that can aid in healthy digestion. Fermented foods and drinks are the highest in probiotics and include:
Treatment for IBS
Some of the more common treatments for IBS include:
- Cognitive behavioral therapy: helps patients manage their triggers and explores the mind-gut connection
- Smooth muscle relaxants
- Anti-diarrheal medications
- Low-dose antidepressants such as Zoloft
- Antibiotics when needed
Lifestyle changes to help with IBS symptoms
- Managing stress can help reduce IBS flare-ups. Try to find a stress management technique that works for you, such as exercise, meditation, etc.
- Avoid eating quickly and skipping meals, which can disrupt your digestion.
- Limit or avoid caffeine and alcohol, which may be IBS triggers.
- Keep a food diary to identify your food triggers.
Irritable bowel syndrome (IBS) is a common digestive disorder that causes symptoms such as stomach pain, gas/bloating, constipation, and diarrhea.
IBS can’t be cured but can be managed with lifestyle and/or medications and other treatments.
Some potential foods to avoid for IBS include fatty foods, foods high in insoluble fiber, high FODMAP foods, gluten, and lactose.
Foods that might help ease IBS symptoms include soluble fiber foods, lean proteins, foods high in omega-3 fatty acids, foods rich in probiotics, and low-FODMAP foods.