Diet Management

As many as 70 to 90 percent of people with irritable bowel syndrome (IBS) say their symptoms get worse when they eat certain foods. Keeping a symptom and food diary can be one way to track these triggers so you can learn to avoid them.^1,2

At this time, there is no drug that cures IBS. This has led many with the condition to try alternative ways to control symptoms. Since food and IBS symptoms are so closely tied for many with the condition, diet changes have been a go-to method of managing the condition.^1,3

Some of the food groups most often eliminated include:^1,3

• Sugars
• Dairy
• Beans
• Gluten
• Caffeine
• Alcohol
• High-gas foods

Read on to learn more about why each of these foods may be hard to digest if you have IBS.

FODMAPs

If you have IBS, you will hear about the FODMAP diet at some point. FODMAPs stands for:^1,4

• Fermentable Oligosaccharides
• Disaccharides
• Monosaccharides
• Polyols

FODMAPs are sugars that draw water into the digestive tract and lead to gas production. This causes many of the familiar symptoms of IBS. Research in recent years suggests that reducing these in the diet may help improve IBS.^1,4

Typically, the low FODMAP diet has several phases. First, a person eliminates FODMAPs from their diet as much as possible for 1 to 2 months. After this, FODMAPs are slowly incorporated back into the diet to see which, if any, cause symptoms. From there, a personalized diet can be planned and maintained.^1,5

This diet can be tricky to figure out on your own. Your doctor or a nutritionist can be helpful in planning what foods you need to eliminate or reduce. In general, foods that are FODMAPs include:^1,3,5,6

• Fructose (found in fruits, honey, high fructose corn syrup)
• Lactose (found in dairy)
• Fructans (found in wheat, garlic, onion)
• Galactans (found in legumes such as beans, lentils, and soybeans)
• Polyols (found in sweeteners and stone fruits such as avocados, apricots, cherries, peaches, etc.)

Gluten

Gluten is a protein found in some grains such as wheat, barley, and rye. This means that gluten is found in many breads, pastas, beers, and cereals (among other foods).^1,6,7

Studies so far have been mixed, but some have shown that a gluten-free diet may benefit those with IBS. Much more research with larger groups of people is needed to determine the true impact of a gluten-free diet on IBS, if any.^1,8

Caffeine

Coffee, with or without caffeine, is a known stimulant of intestinal movement. It can cause diarrhea even in people without IBS. Some with IBS report strong responses to caffeine while others are less affected. This is why caffeine and coffee intake should be monitored on an individual basis.⁸

If you suspect caffeine may be causing your symptoms, you may want to try an elimination diet. This involves removing caffeine entirely from the diet for a while to determine its impact and reintroducing it slowly if desired.⁹

Alcohol

Information on alcohol and IBS is also unclear. Some report a strong link between alcohol and their symptoms, while others are not as affected. Those who notice their symptoms get worse with alcohol vary in how much it takes to cause this effect.

Light drinking (1 drink per day) may be enough to trigger some, while others report symptoms only occurring after binge drinking (more than 4 drinks a day). As with caffeine, an elimination diet may be helpful if you suspect your body is sensitive to alcohol.⁸

Artificial sweeteners

Several artificial sweeteners trigger IBS symptoms for some people. The sugar alcohols, also known as polyols, seem to be especially problematic. Examples include:^1,8,10

• Sorbitol
• Mannitol
• Xylitol
• Lactitol
• Isomalt
• Erythritol
• Maltitol

These sweeteners are thought to ferment in the digestive tract. This leads to an imbalance of bacteria in the gut which can cause IBS symptoms to flare.^1,8,10

High-gas foods

Some foods are known as high-gas foods. These cause the body to produce gas and cause more bloating, especially in people with IBS. The most common high-gas foods:¹¹

• Beans
• Broccoli
• Brussels sprouts
• Cabbage
• Carbonated drinks
• Cauliflower
• Chewing gum
• Fruits, such as apples, peaches, and pears
• Hard candy
• Lettuce
• Milk and milk products
• Onions
• Sugar alcohols
• Whole-grain foods

Dairy

Dairy products, such as milk, cheese, ice cream, and yogurt contain the sugar lactose. Many adults have a hard time digesting lactose, even without IBS. This is known as lactose intolerance and it has several symptoms similar to IBS including:⁸

• Bloating
• Flatulence
• Abdominal pain
• Nausea
• Loose stools

This can make it hard to tell the two apart. However, there is a test for lactose intolerance called a lactose hydrogen breath test. This test can help determine if your symptoms are due to lactose intolerance. If the test is negative, you may need to try an elimination diet to see if dairy triggers your IBS symptoms.⁸

This is not a full list of all the diet changes you may need to try to manage your IBS. Changes in fiber intake, supplements like probiotics, and more are also used.⁶

Managing IBS through diet is often a trial-and-error process that takes time. Your doctor or nutritionist can work with you to make sure you get enough nutrients. You may also need to try drugs or lifestyle changes that reduce stress.