Healing Ibs: Can A Plant-Based Diet Help?

Irritable Bowel Syndrome (IBS) is a chronic condition that affects the large intestine, causing symptoms that range from mild to debilitating. While a plant-based diet is often touted as a cure-all, it's not a clear solution for those with IBS. Many plant-based foods can irritate the gastrointestinal (GI) system and cause or worsen IBS symptoms. However, a plant-based diet can also improve the gut microbiome, which can, in turn, improve IBS symptoms. So, will a plant-based diet heal IBS? The answer is: it's complicated.

Pros and cons of a vegan diet for IBS

Pros

Veganism may align with your values and overall health goals. It may also encourage you to be more mindful of your diet and prompt you to plan well-rounded meals. A vegan diet promotes the consumption of plant-based foods, which contain a wide variety of nutritional benefits. Research on which plant-based foods irritate the gastrointestinal (GI) system means you can create a vegan diet without trigger foods.

Cons

Many plant-based foods can irritate the GI system and cause or worsen IBS symptoms. A vegan diet that avoids triggering foods may leave out essential vitamins and minerals, such as protein, iron, and calcium.

Additional Considerations

Adopting a low FODMAP diet may reduce IBS symptoms by eliminating hard-to-digest foods from your meals. This can be done in conjunction with a vegan diet, but it is recommended to seek advice from a healthcare professional to ensure nutritional balance.

Tips for Eating with IBS

• Eat regular meals and snacks according to a schedule.
• Make meal plans that pack a nutritional punch and stick to your diet.
• Watch your food portions and avoid large meals and long gaps between meals.
• Eat slowly and chew your food carefully before swallowing.
• Exercise at least 150 minutes per week.
• Drink 6 to 12 cups of water per day.
• Avoid processed foods.
• Consume sugary or spicy foods in moderation.
• Keep a journal of your symptoms and note any suspected triggers.

A vegan diet is not a clear solution for IBS. However, with careful planning and guidance from a healthcare professional, it is possible to adopt a vegan diet that may improve IBS symptoms.

High and low FODMAP foods

FODMAP is an acronym for a class of carbohydrates called fermentable short-chain carbohydrates, which are harder for people to digest. These include:

• Fermentable
• Oligosaccharides
• Disaccharides
• Monosaccharides
• Polyols

High FODMAP Foods

High FODMAP foods are those that are high in FODMAPs and should be avoided or limited. These include:

• Fruits high in fructose and sorbitol (a natural polyol), such as canned fruit in heavy syrup, apples, watermelon, and stone fruits.
• Vegetables such as garlic, onions, leeks, scallions, and pickled onions.
• Bread, crackers, cereals, and snacks containing grains like wheat, rye, and barley.
• Dairy products such as milk, soft cheese, yogurt, and cottage cheese.
• Most beans, including baked beans, kidney beans, and chickpeas.
• Processed and marinated meats that may contain garlic, onion, or sweeteners.
• Nuts such as cashews and pistachios.
• Sweeteners that end in "-ol", such as sorbitol and xylitol.

Low FODMAP Foods

Low FODMAP foods are those that are low in FODMAPs and are less likely to cause IBS symptoms. These include:

• Fruits such as bananas, blueberries, cantaloupe, oranges, and strawberries.
• Vegetables like carrots, eggplant, lettuce, ginger, peppers, potatoes, spinach, and tomatoes.
• Plain cooked meats, tofu, and eggs.
• Nuts and seeds such as hazelnuts, macadamias, peanuts, pine nuts, pumpkin seeds, and walnuts.
• Brown sugar (in small amounts) and table sugar (sucrose).
• Grains such as corn, oats, quinoa, and rice.
• Dairy alternatives like coconut milk, lactose-free milk, and almond milk.

It is important to note that not all high FODMAP foods need to be avoided completely, and some low FODMAP foods should still be consumed in moderation. For example, potatoes and sweet potatoes are low FODMAP but can deliver too much sugar if eaten in large portions.

How to eat vegan on a low FODMAP diet

A vegan, low-FODMAP diet can be restrictive, but it may help people with IBS to figure out how to ease their painful symptoms. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are types of carbohydrates that are more likely to ferment in the gut, causing pain and other symptoms for people with IBS.

A low-FODMAP diet is a way to figure out which foods might be affecting you by cutting them out and then slowly reintroducing them. This can be a very restrictive way of eating, so it is often recommended to do so for only a few weeks.

A low-FODMAP diet can be done as a vegan, but it is more restrictive, and it is important to consult a dietitian or healthcare provider to ensure it is done safely and correctly. There are still many vegan foods that are low in FODMAPs, including firm tofu, tempeh, peanuts, quinoa, and walnuts. Fruits and vegetables that are low in FODMAPs include kiwis, cantaloupe, oranges, bell peppers, green beans, and oyster mushrooms.

• Check the Monash app for low FODMAP portion sizes and be cautious of FODMAP stacking.
• Try low FODMAP smoothie recipes like a Honeydew-Kiwifruit Smoothie or a Strawberry Maple Smoothie.
• Try low FODMAP vegan recipes for 'scrambled eggs', like a Chickpea Scramble.
• Try low FODMAP vegan baked goods like Buckwheat Pancakes, Blueberry Muffins, or Strawberry Waffles.
• For breakfast cereals, try low FODMAP options like Maple Walnut Granola or Granola with Big Clusters.
• For lunch and dinner, there are many suitable options that can still be high in protein, such as Indian Potato and Lentil Soup, Tofu and Tomato Chinese Noodle Soup, or Vegetable Lentil Stew.
• For snacks, try a Granola Bar with Peanut Butter, Peanut Butter Baked Oats, or Pumpkin Spice Crumble.
• For dessert, try Strawberry Banana Ice Cream with Chocolate Fudge Sauce, Fudgy Brownies, or Sweet Potato Chocolate Chip Cake.
• To increase your protein intake, include canned lentils and chickpeas, nuts (such as peanuts and walnuts), and seeds (such as sunflower and pumpkin seeds).

Other healthy modifications

Gluten-free

The gluten-free diet is a diet that excludes wheat and wheat products. This diet is necessary for those with coeliac disease and diagnosed non-coeliac gluten sensitivity (NCGS). The gluten-free diet has gained popularity among the IBS community, in part due to perceived symptom improvements on a gluten-free diet. However, gluten and FODMAPs (especially fructans) co-exist in grain and cereal foods. This pattern might explain the benefits that people report on a gluten-free diet, which may be wrongly attributed to the removal of gluten when it is actually the reduction of FODMAP intake. A combination of veganism and gluten-free could be unnecessarily restrictive, so it is suggested to work with a dietitian and follow a structured FODMAP reintroduction plan to determine what’s best for you.

Fibre

Fibre is important for gut health, but it can also be a culprit for symptoms in IBS. Fibre can be consumed through diet (from foods such as fruit, vegetables, bread and cereals), or taken as a supplement (for example, bran, psyllium and methylcellulose). Fibre is also divided into two categories: soluble and insoluble. If you experience constipation (IBS-C), soluble fibres like oats, psyllium, and linseeds can help loosen things up. Work with a dietitian to slowly increase the amount of fermentable fibres you eat. Typically, insoluble fibres (like wheat bran) are ineffective and may exacerbate abdominal pain and bloating. If you experience frequent loose stools (IBS-D), try reducing your insoluble fibre intake.

Alcohol

Alcohol does have gastrointestinal effects, and many IBS patients report poor tolerance to alcohol. Despite this, little is known about whether alcohol causes IBS symptoms and at what level. If you suspect that alcohol triggers symptoms, adjust your alcohol intake in isolation, allowing for effects to be monitored.

Caffeine

Caffeine also has gastrointestinal effects. However, there is virtually no research that suggests manipulating caffeine intake improves IBS symptom control. It is quite individual, and you should work with your dietitian to figure out what’s best for you. If you are adjusting your caffeine intake, make sure you make this change in isolation, allowing for effects to be monitored.

The role of exercise

Exercise may help relieve some IBS symptoms, such as bloating, but the evidence is limited. The benefits of exercise vary from person to person, and intense exercise may even worsen IBS in some cases.

Types of Exercise

Low to moderate-intensity exercises, such as yoga, aerobic exercise, and treadmill walking, are recommended for people with IBS. These exercises may help reduce IBS symptoms such as bloating and abdominal pain.

Yoga

Yoga is a recommended form of exercise for people with IBS. Some studies have found that yoga can help reduce IBS symptoms and improve quality of life. However, the evidence for the effectiveness of yoga is not conclusive, and more research is needed.

Intensity and Duration

The intensity and duration of exercise are important considerations for people with IBS. Intense, long-lasting forms of exercise, such as long-distance running or cycling, may trigger IBS symptoms or make them worse.

Managing IBS While Exercising

• Start new activities gradually and monitor how they affect your symptoms.
• Wear comfortable and loose clothing during workouts.
• Stay hydrated, as dehydration can worsen constipation.
• Check nutritional labels on protein powders and supplements, as some ingredients may trigger digestive problems.

Frequently asked questions