Milly Gaines
If you have irritable bowel syndrome (IBS), you may be able to minimise gut symptoms triggered by certain foods with a healthy, balanced diet. There is no one-size-fits-all approach to managing IBS with diet, but there are some general strategies that can help. For example, it is recommended to stay hydrated by drinking at least 1.5 litres of fluid per day, and limit caffeine, alcohol, carbonated drinks, spicy foods, fatty foods, and greasy foods. Some people with IBS report an improvement in symptoms when they eliminate gluten from their diet, and some doctors recommend trying a low FODMAP diet for a few weeks to see if symptoms improve.
| Characteristics | Values |
|---|---|
| Diet type | Low FODMAP |
| Diet duration | Short-term, 2-6 weeks |
| Diet goals | Identify specific food triggers, improve quality of life, minimize symptoms |
| Foods to eat | Low FODMAP foods like potatoes, oats, carrots, eggs, chicken, fish, tofu, lactose-free yoghurt |
| Foods to avoid | High FODMAP foods like wheat, onions, garlic, apples, beans, lactose, sugar alcohols, fatty, greasy, spicy foods, caffeine, alcohol |
| Fluids | Drink 8-10 cups of fluids, avoid carbonated drinks |
| Snacks | 2-3 snacks a day, space fruit intake by 2-3 hours |
| Meals | Smaller, more frequent meals, cooked vegetables, lower-fat cooking methods |
| Supplements | Probiotics, fibre supplements |
| Lifestyle | Regular exercise |
| Support | Dietitian, IBS Network, Disability Rights UK |
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What You'll Learn
Try the low FODMAP diet
The low FODMAP diet has shown potential in helping people with IBS. FODMAPs are a group of specific carbohydrates that might trigger gut symptoms. FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These carbohydrates tend to ferment and increase the volume of liquid and gas in the small and large intestines, leading to flatulence, bloating, and abdominal pain.
The low FODMAP diet is a 3-step process. The first step involves identifying high (red) and moderate (amber) FODMAP foods and swapping them for low (green) FODMAP alternatives for 2-6 weeks. High FODMAP foods include apples, onions, garlic, wheat, lactose, and sugar alcohols. For example, if you normally eat wheat-based toast with honey for breakfast, you could swap it out for sourdough spelt toast with jam.
If your symptoms improve, you can move on to step 2, which involves completing a series of "FODMAP challenges" to identify which FODMAPs you can tolerate and which trigger symptoms. This involves eating foods rich in only one FODMAP group for three days and monitoring your symptoms. You can use the Monash FODMAP App to record your symptoms and identify foods for each FODMAP challenge.
In the final step, you can reintroduce well-tolerated foods and FODMAPs into your diet while restricting poorly tolerated foods and FODMAPs. It is important to note that not everyone with IBS will improve on a low FODMAP diet, and some may need to consider other therapies or dietary changes.
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Identify and eliminate trigger foods
While there is no single diet or medicine that works for everyone with IBS, there are some general strategies that can help everyone. For instance, it is recommended to drink at least 8 to 10 drinks of fluid (around 1.5 litres) a day, such as water or non-caffeinated drinks.
To identify and eliminate trigger foods, you can try a short-term low FODMAP diet to help identify specific food triggers. FODMAPs are a group of specific carbohydrates that might trigger gut symptoms. High FODMAP foods include apples, onions, garlic, wheat, lactose, and sugar alcohols.
There are five types of FODMAPs that you will want to avoid:
- Fructans (found in wheat, onions, garlic, barley, cabbage, and broccoli)
- Fructose (found in fruit, honey, and high-fructose corn syrup)
- Galactooligosaccharides (found in legumes and beans)
- Sugar alcohols, such as sorbitol, mannitol, xylitol, maltitol, and erythritol, especially if you are experiencing diarrhoea
- Stachyose (found in legumes)
In addition, some people with IBS report an improvement in symptoms when they eliminate gluten from their diet. However, there is significant disagreement in the scientific community about whether or not gluten plays a role in IBS.
It is important to note that a low FODMAP diet can be challenging, as many common foods are high in FODMAPs. It is also important to understand whether you are among the 3/4 of IBS sufferers who improve on the diet, or the 1/4 who do not experience symptom improvement and therefore need to consider other IBS therapies.
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Eat smaller, more frequent meals
Eating smaller, more frequent meals can place less stress on the digestive tract than sitting down for three large meals. The number of meals and snacks can vary depending on the individual, but a general recommendation is to have three meals and 2-3 snacks per day.
It is important to note that there is no one-size-fits-all approach to managing IBS through diet, and different changes may help different people. For example, some people with IBS may benefit from a gluten-free diet, while others may not see any improvement in their symptoms.
A common strategy to identify specific food triggers is to try a short-term low FODMAP diet. FODMAPs are a group of specific carbohydrates that can trigger gut symptoms such as flatulence, bloating, and abdominal pain. High FODMAP foods include apples, onions, garlic, wheat, lactose, and sugar alcohols. The low FODMAP diet involves restricting high FODMAP foods for a short period, typically between two to six weeks. If symptoms improve, FODMAP types can be reintroduced one at a time to assess tolerance. This diet should be followed under the guidance of a trained gastrointestinal nutritionist or a dietitian who specializes in managing IBS.
In addition to dietary changes, staying properly hydrated is essential for managing IBS. It is recommended to drink at least 8-10 cups of fluid per day, such as water or herbal tea.
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Stay hydrated
Staying properly hydrated is an important part of managing IBS. The NHS recommends drinking at least 8 to 10 drinks of fluid (around 1.5 litres) per day, such as water or non-caffeinated drinks like herbal tea.
Water is a good choice for staying hydrated, but it's important to be mindful of other drinks that may be irritating your gut. Caffeine, for example, can speed up intestinal contractions, causing cramping and runny stools. Limit coffee and strong caffeinated teas (black, green) to no more than 3 cups per day. Alcohol can also be a trigger for IBS symptoms, so it's best to limit your intake. Carbonated drinks can also be an issue for some people with IBS, as the gas they contain can contribute to bloating and discomfort.
Some people with IBS may find that drinking plenty of water helps to prevent constipation, one of the common symptoms of IBS. Fibre is another important factor in preventing constipation, and it's recommended that adults get 22 to 34 grams of fibre per day. However, it's important to introduce fibre slowly, as too much at once can cause gas and bloating, which can trigger IBS symptoms.
If you're struggling to get enough fluid from drinks alone, you may want to consider eating more foods with a high water content. These include fruits and vegetables such as watermelon, strawberries, cucumber, and celery. Just be mindful of any high-FODMAP fruits and vegetables that may trigger your IBS symptoms.
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Consult a dietitian
Consulting a dietitian is an important step in managing IBS through diet. A registered dietitian can help guide and support you in creating a long-term strategy and plan that works for you and your lifestyle. This could include helping to foster a positive relationship with food, increasing your confidence when making food choices at home and when eating out, encouraging nourishing foods that won't worsen gut symptoms, preventing unnecessary food restrictions, and managing potential food fears.
A dietitian can also help you to identify specific food triggers and recommend a diet that is best suited to your needs. For example, they may recommend a low FODMAP diet, which has shown potential in helping people with IBS. FODMAPs are a group of specific carbohydrates that might trigger gut symptoms. High FODMAP foods include apples, onions, garlic, wheat, lactose, and sugar alcohols. A dietitian can guide you through the process of eliminating and reintroducing FODMAPs to help you understand your tolerance levels.
Additionally, a dietitian can provide advice on general dietary strategies that can help manage IBS symptoms. This includes staying properly hydrated by drinking at least 8 to 10 drinks of fluid (around 1.5 litres) of water or non-caffeinated drinks per day, limiting caffeine and alcohol intake, and avoiding fatty, greasy, or spicy foods that can trigger symptoms. They may also recommend increasing your fibre intake, as fibre can improve constipation in IBS by making stools softer and easier to pass. However, it is important to introduce fibre slowly to prevent gas and bloating.
It is important to note that there is no one-size-fits-all approach to managing IBS through diet, and individual experiences may vary. Consulting a dietitian can help you navigate the complexities of IBS and find a dietary plan that works best for you.
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Frequently asked questions
There is no single diet that works for everyone with IBS, but there are some general recommendations. The low FODMAP diet has been shown to be effective in helping people with IBS, but some health professionals believe it is too restrictive. FODMAPs are a group of carbohydrates that can trigger gut symptoms.
Low FODMAP foods include potatoes, oats, and carrots.
High FODMAP foods include wheat, onions, garlic, apples, lactose, beans, and sugar alcohols.
It is recommended that you follow a low FODMAP diet for 2-6 weeks, and then reintroduce high FODMAP foods one at a time to see which trigger your symptoms. This process should be done under the guidance of a trained gastrointestinal nutritionist or a registered dietitian.
