How can my diet treat the symptoms of IBS? Eating smaller meals more often, or eating smaller portions, may help your irritable bowel syndrome (IBS) symptoms. Large meals can cause cramping and diarrhea if you have IBS. Eating foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may help. Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 that adults should get 22 to 34 grams of fiber a day.[3] While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in people with IBS. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating. What should I avoid eating to ease IBS symptoms? Certain foods or drinks may make symptoms worse, such as foods high in fat some milk products drinks with alcohol or caffeine drinks with large amounts of artificial sweeteners beans, cabbage, and other foods that may cause gas To find out if certain foods trigger your symptoms, keep a diary and track what you eat during the day what symptoms you have when symptoms occur Take your notes to your doctor and talk about which foods seem to make your symptoms worse. You may need to avoid these foods or eat less of them. Your doctor may recommend that you try a special diet—called low FODMAP or FODMAP—to reduce or avoid certain foods containing carbohydrates that are hard to digest. Examples of high FODMAP foods and products you may reduce or avoid include fruits such as apples, apricots, blackberries, cherries, mango, nectarines, pears, plums, and watermelon, or juice containing any of these fruits canned fruit in natural fruit juice, or large quantities of fruit juice or dried fruit vegetables such as artichokes, asparagus, beans, cabbage, cauliflower, garlic and garlic salts, lentils, mushrooms, onions, and sugar snap or snow peas dairy products such as milk, milk products, soft cheeses, yogurt, custard, and ice cream wheat and rye products honey and foods with high-fructose corn syrup products, including candy and gum, with sweeteners ending in “–ol,” such as sorbitol mannitol xylitol maltitol 12 Week Elimination Diet for IBS When you have irritable bowel syndrome (IBS), eating can often present challenges. It would help to know if certain foods may worsen symptoms or bring about unwanted reactions. This often differs from person to person and there is no simple answer. But by taking a systematic approach you should be able to sort out which, if any food, has an effect on your symptoms. The 4 Step, 12 Week Elimination Diet for IBS Make a list of the foods which you think may worsen your IBS. If you aren't certain which foods bother you, start your list with fiber, chocolate, coffee, and nuts. One at a time, eliminate a food on this list from your diet for about 12 weeks to see if you notice improvement. If you do not notice improvement after 12 weeks, begin eating that food again and try eliminating the next food on your list. Begin your elimination diet with fiber. Why This Works There are two types of fiber – soluble which is found more in fruit and vegetables, and insoluble which is mainly derived from cereal. Insoluble fiber seems to most often cause problems. Simply removing cereal fibers (commonly found in brown bread, whole grain bread, some breakfast cereals, cereal bars, and crispbreads) from the diet may be helpful. On the other hand, some people do find cereal fiber improves their symptoms. If so, continue it. But if it does not improve your symptoms or appears to upset you, be bold and completely exclude it for several weeks to see if your symptoms improve. Twelve weeks is a reasonable amount of time to be certain that any improvements you see are not just normal symptom fluctuations. If there is no change after 12 weeks, there is no point in continuing, as eliminating fiber is obviously not the right approach for you. Next move on to one of the other foods to be wary of. It is important to leave them out of your diet one at a time, otherwise you will not be able to identify which one is causing the problem. With regard to coffee, it does not necessarily seem to be the caffeine that causes the problem, as tea can usually be continued without affecting symptoms. Caffeine-containing drinks (such as energy drinks or carbonated sodas) may cause problems, more because they are gassy rather than a result of their caffeine content. Somewhat surprisingly, spicy foods do not necessarily cause a great deal of trouble, although not everyone can tolerate them. Summary Dietary changes can be important in helping to control IBS symptoms, but diet is not always the answer. Sometimes simply the act of eating (smelling, tasting, or chewing food) can activate the intestines even before the food is swallowed, and the particular food being eaten does not matter. If eliminating a suspected food offender for 12 weeks does not work for you, there is little point in continuing to avoid that food. Try it with the 4 foods listed above, or any other foods you suspect. In general, it is worth remembering that if you have to question whether a particular approach has helped your problem, it probably has not worked and should be discontinued. References [3] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition. Washington, D.C.: U.S. Government Printing Office; 2010. Booklet. Source 1 Source 2
