If you have irritable bowel syndrome (IBS), knowing what to eat can feel like the holy grail. For some patients, the right diet, along with attention to exercise, can control symptoms without medication.
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Dietitian and researcher Gail Cresci, PhD, RD, says she often recommends a special diet of easily digestible food, called a low-FODMAP diet, which you’ll find outlined below.
FODMAP stands for “fermentable oligo-, di-, and monosaccharides and polyols” – a mouthful to say, but in more common terms, FODMAPs are carbohydrates that may not be digested or absorbed well, Dr. Cresci explains. Undigested carbohydrates are then metabolized by intestinal bacterial to produce excess gas, which leads to abdominal pain, diarrhea and/or constipation.
What foods to limit (and good substitutes)
Here’s a breakdown of what foods tolimit when you’re following a low-FODMAP diet, as well as some suggested substitutes:
- Lactose is found in milk and other soft dairy products like cottage cheese, cream cheese, ice cream and sour cream. Anyone can handle a very small amount of lactose, but if you eat more than your intestine can handle,
you will get gas and abdominal pain. About half the population is born with low levels of lactase, which metabolizes dietary lactose.
What to eat instead: Try lactose-free milk, oat milk, rice milk or soy milk as good alternatives to cow’s milk, as well as lactose-free yogurt. For cheese, try any of these three: hard cheeses, brie and camembert. Need butter? Go for olive oil instead.
- Fruits contain the sugar fructose, which can cause issues for
IBS sufferers. Fructose is particularly high in apples and pears, and somewhat high in watermelon, stone fruits, concentrated fruit, dried fruit and fruit juice. Fruits with lower levels of fructose include bananas, citrus, grapes and berries.
What to eat instead: Eat fruits that are lower in fructose, such as banana, blueberry, boysenberry, cantaloupe, cranberry, grape, orange, lemon, lime, kiwi and strawberry.
- Certain vegetables cause gas and
abnormal bowel habits. Avoid cruciferous vegetables such as broccoli, cauliflower, cabbage, coleslaw and sauerkraut. Also, limit artichoke, brussels sprouts, onions, shallots, leeks and asparagus.
What to eat instead: Vegetables that are good to eat include eggplant, green beans, celery, carrots, spinach, sweet potato, yam, zucchini and squash. You can enhance flavors of these veggies with herbs. On the safe list, you’ll find: basil, chili, coriander, ginger, lemongrass, marjoram, mint, oregano, parsley, rosemary and thyme.
- Legumes, or beans, are often called the “musical fruit” because they contain indigestible saccharides. Baked beans, chickpeas, lentils and soybeans have high amounts. So IBS patients should avoid them, or eat them in very small quantities.
What to eat instead: While not exactly a substitute for beans, you can enjoy rice, oats, polenta, millet, quinoa and tapioca. Also, as long as you do not have celiac disease, you can eat gluten on a low-FODMAP diet, which is an inaccuracy of some charts.
- Polyols, sugar substitutes found in sugarless gum and candy, also can cause problems. Avoid them, including sorbitol, mannitol, isomalt, maltitol and xylitol.
What to eat instead: It is perfectly fine to eat (in moderation, of course) good old-fashioned sugars, other artificial sweeteners that do not end in “ol,” (like NutriSweet® and Splenda®) and honey substitutes (maple syrup, molasses and golden syrup).
The best treatment for IBS
Sometimes IBS is treated with medications, but a change in diet is the first thing we try. A healthy lifestyle — with a low-fat diet, exercise and avoidance of alcohol and cigarette smoking — often makes a great difference. For people who still need help, special diets like a low-FODMAP diet can provide relief.
“While the low-FODMAP diet is often difficult for many to follow, it is often worth seeing if it will ease your symptoms,” Dr. Cresci says. Working with a registered dietitian can help you make the best food choices and maintain a balanced diet.
Your doctor may find that medication is also necessary to keep your symptoms at bay. These therapies include anticholinergic medicines, which calm the spasms, and antidepressants to reduce stress.
Discomfort in the lower gastrointestinal (GI) tract can affect a person's well-being, and it is very common: For instance, about 10% to 15% of Americans suffer from irritable bowel syndrome (IBS), a chronic condition that can cause unpleasant symptoms such as bloating, gas, abdominal pain and changes in bowel habits.
While there is no cure for IBS, there are certain foods and medications that can make symptoms worse. Avoiding the following foods may bring some relief:
Milk
Milk and other foods that contain lactose, like cheese and ice cream, can cause gas and bloating in people who are lactose intolerant. About 70% of adults worldwide do not produce large amounts of lactase, an intestinal enzyme that helps break down the sugar in milk. Without this enzyme, the small intestine cannot absorb lactose, which passes undigested into the colon, where bacteria ferment and cause gas.
Even though dairy products are the major culprits of discomfort for some IBS sufferers, yogurt proves to be an exception. The live cultures in the yogurt break down the lactose, so it's less likely to cause gassy symptoms.
Foods High in Fructose
High fructose corn syrup is a main ingredient in processed foods, commercially prepared sweets, snacks and soft drinks, and these items can aggravate IBS symptoms. But they are not the only source of blame (or bloat).
It turns out some very healthy foods like apples, pears and dried fruits are naturally high in fructose, which when ingested, can trigger some of the same side effects as undigested lactose. Fruits lower in fructose, such as berries, citrus and bananas, may be a better choice for people with IBS.
Carbonated Beverages
Because the bubbles in beverages like soda and seltzer can produce a similar fizzy effect in the GI tract, stick with water and lactose-free milk to quench your thirst. And before you think about adding juice to that list — remember that fruit-based drinks are frequently high in fructose!
Caffeine
Caffeine can increase diarrhea, another major symptom of IBS. High sources of caffeine include coffee, tea, cola drinks, chocolate and some over-the-counter pain relievers designed for headache relief — check labels carefully.
Sugar-free Chewing Gums
Many sugar-free gums are made with artificial sweeteners such as sorbitol and xylitol, which have been shown to cause diarrhea. In addition, chewing gum leads to more swallowed air and gassiness.
Other Foods that Can Cause IBS Symptoms
Even some healthy foods can generate digestive discomfort, including beans and cruciferous vegetables such as broccoli and Brussels sprouts, as well as nutritional and weight-reduction supplements.
Other Ways to Support Gut Health and Ease IBS
Diet is important, but avoiding these foods is not the only way to address the discomforts of IBS. Digestive disease experts advise patients living with IBS to work on reducing stress, getting adequate sleep and minimizing highly refined processed foods in general.