Brenda Khan
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects a significant number of people worldwide. While there is no one-size-fits-all diet for managing IBS, certain dietary changes can help alleviate symptoms such as abdominal pain, bloating, and diarrhea. The low FODMAP diet, which involves limiting poorly absorbed short-chain carbohydrates, has been found to improve symptoms in a large percentage of people with IBS. Additionally, gluten-free diets and gradual increases in fiber intake may also help manage IBS symptoms. It is important to consult with healthcare professionals and dietitians to ensure nutritional needs are met and to avoid potential risks associated with restrictive diets.
Characteristics of a safe IBS diet
| Characteristics | Values |
|---|---|
| Single universal diet | No single diet or medicine works for everyone with IBS |
| Fluid intake | Drink at least 8-10 drinks of fluid (1.5 litres) per day |
| Foods to avoid | Cabbage, broccoli, cauliflower, brussels sprouts, beans, onions, gluten, lactose, sweeteners, high-fibre foods |
| Dietary approach | Low FODMAP diet, gluten-free diet |
| Dietary Guidelines for Americans, 2020-2025 | Adults should get 22-34 grams of fibre per day |
| FODMAP | Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols |
| FODMAP foods | Fruits, vegetables, sweeteners, dairy, oats, bananas |
| Dietary changes | Can have a big impact on IBS symptoms |
| Other therapies | Antibiotics, laxatives, low-dose antidepressants |
| Medical intervention | Referral to a dietitian or specialist |
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The low-FODMAP diet
FODMAP is an acronym for a certain class of carbohydrates, called fermentable short-chain carbohydrates, which are more difficult for people to digest. The full acronym stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are short-chain carbohydrates (sugars) that the small intestine absorbs poorly.
It is important to note that not everyone with IBS will improve on a low-FODMAP diet. It is always good to talk to your doctor before starting a new diet, especially the low-FODMAP diet, since it eliminates so many foods. It is not a diet anyone should follow for long.
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Gluten-free diets
While there is no one-size-fits-all diet for IBS, gluten-free diets have been recommended to alleviate symptoms. Gluten is a protein found in wheat, barley, and rye, and is present in most cereals, grains, pasta, and processed foods.
Some people with IBS experience more symptoms after eating gluten, even if they do not have coeliac disease. Coeliac disease is a condition where the body reacts to gluten, damaging the gut lining. Non-coeliac gluten sensitivity (NCGS) does not have any biomarkers, but it is known that some people experience digestive issues like bloating, constipation, or gas, or even systemic issues like brain fog, skin problems, or sleep disruptions.
Before trying a gluten-free diet, it is important to rule out coeliac disease, as this requires a strict gluten-free diet. A doctor can perform a test to check for this.
The low FODMAP diet is often recommended to help determine which foods trigger IBS symptoms. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are short-chain carbohydrates that the small intestine struggles to absorb. This diet is restrictive and should only be followed for a short time, in conjunction with medical advice.
If a gluten intolerance is suspected, it is important to ensure adequate fibre intake from gluten-free sources, as fibre helps regulate bowel movements and keeps the large intestine healthy. Pulses, fruits, and vegetables are good sources of fibre. Gluten-free whole grains such as brown rice, quinoa, buckwheat, and oats can also be included in the diet.
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Fibre intake
Fibre is a crucial component of a healthy diet, and it can be especially beneficial for individuals with IBS. Fibre softens stools, making them easier to pass and helping to alleviate constipation, a common symptom of IBS. The recommended daily fibre intake for adults is 22 to 34 grams.
However, it is important to note that too much fibre, especially if introduced suddenly, can have negative effects. Consuming too much fibre at once can lead to gas and bloating, which are also common IBS symptoms. Therefore, it is advisable to increase fibre intake gradually, adding 2 to 3 grams of fibre to your diet each day. This slow increase allows your body to adjust and can help prevent unwanted side effects.
Soluble fibre, in particular, is recommended for relieving IBS symptoms. This type of fibre dissolves in water to form a gel-like substance, which can help to add bulk to stools and soften them. Good sources of soluble fibre include oats, legumes, fruits such as apples and oranges, and certain vegetables like carrots and broccoli.
While fibre can be beneficial for IBS, it is important to tailor your fibre intake to your individual needs. Some people with IBS may find that they are more sensitive to fibre, so it is advisable to work with a healthcare professional or dietitian to determine the optimal fibre intake for your specific condition. Additionally, it is worth noting that a sudden increase in fibre can be challenging for the digestive system, so it is generally recommended to increase fibre intake gradually and ensure adequate fluid intake to help with digestion and prevent constipation.
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Fluid intake
However, it is important to note that while staying hydrated is crucial, the type of fluid matters as well. For example, some people with IBS find that drinking caffeine can trigger their symptoms. Caffeinated drinks can act as a diuretic, increasing urine production and potentially leading to dehydration if fluid intake is not adequately managed. Therefore, it is generally recommended to limit caffeine intake and prioritise non-caffeinated beverages.
Additionally, the low FODMAP diet, which is often recommended for IBS, also takes fluid intake into consideration. FODMAPs are fermentable sugars that can be poorly absorbed by the small intestine, leading to increased fluid in the bowel. This can result in bloating and changes in digestion speed, causing IBS symptoms such as gas, pain, and diarrhoea. By reducing FODMAP intake, individuals may be able to manage their fluid balance and associated IBS symptoms more effectively.
It is worth noting that restrictive diets, such as the low FODMAP diet, should be approached with caution. While they can be beneficial in managing IBS, they may also lead to nutritional deficiencies if not properly managed. It is always advisable to consult with a healthcare professional or registered dietitian before making significant dietary changes, especially when considering a restrictive diet. They can provide guidance on safely incorporating a range of fluids and ensuring adequate hydration without triggering IBS symptoms.
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Medical advice
There is no one-size-fits-all diet for managing irritable bowel syndrome (IBS). However, certain foods are known to trigger symptoms in people with IBS, and dietary changes can have a significant impact on easing them.
It is important to consult a doctor or dietitian before making any dietary changes to treat IBS. They may recommend a low FODMAP diet, which is a temporary, restrictive eating plan that can help identify which foods are problematic and which alleviate IBS symptoms. FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—short-chain carbohydrates that the small intestine struggles to absorb. These include fruits like apples, apricots, and cherries; vegetables like cauliflower and mushrooms; sweeteners like sorbitol and xylitol; and dairy products.
The low FODMAP diet involves eliminating high FODMAP foods for 2 to 6 weeks and then slowly reintroducing them one at a time to determine which ones trigger symptoms. It is important to note that this diet does not remove all fruits, vegetables, and dairy products. For example, lactose-free milk, rice milk, and almond milk are low FODMAP foods.
In addition to the low FODMAP diet, doctors may recommend other dietary changes, such as increasing fiber intake gradually and avoiding gluten. While IBS cannot be cured, a combination of dietary changes, medications, and stress management techniques can help manage symptoms and minimize the impact on overall health and quality of life.
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Frequently asked questions
There is no single diet that works for everyone with IBS, but there are some general guidelines that can help. Doctors often recommend a low-FODMAP diet, which involves limiting your intake of certain sugars that may cause intestinal distress. This diet is designed to help people with IBS figure out which foods are problematic and which reduce symptoms. It is meant to be followed for a few weeks, and if symptoms improve, you can slowly add FODMAP foods back into your diet.
Low-FODMAP foods include lactose-free milk or nondairy alternatives such as rice milk and almond milk, and fruits like oranges, blueberries, strawberries, and grapes. However, it's important to note that this diet does not remove all fruits, vegetables, and dairy products.
Some people with IBS report an improvement in symptoms when they eliminate gluten from their diet. Gluten is a protein found in wheat, barley, and rye, and is present in most cereals, grains, pasta, and many processed foods. However, there is disagreement in the scientific community about whether gluten plays a role in IBS.
