The Best Foods for IBS: a Guide to Managing Irritable Bowel Syndrome

Did you know that irritable bowel syndrome (IBS) affects roughly 25 to 45 million Americans? While IBS isn’t harmful, it can cause unpredictable trips to the restroom and uncomfortable bloating and gas, sometimes at unfavorable times. The good news? You’re not alone.

So, what can you do to manage your symptoms? Is there an IBS diet? If so, what are the best foods for IBS management? If you’re ready to take control of your IBS, dive in!

Understanding IBS and diet

Irritable bowel syndrome is a disorder of gut-brain interaction (DGBI), which means the nerve endings in your gut are sensitive. This may lead to unwanted digestive symptoms when consuming certain foods or when stressed.

Common digestive tract symptoms include abdominal pain, gas, bloating, diarrhea, and constipation.

While the cause of IBS is unknown, there are medical and lifestyle options available to help manage symptoms.

In particular, dietary management of IBS has shown promising results. The low-FODMAP diet may help roughly 75% of people manage IBS symptoms.

What is the low-FODMAP diet?

The low-FODMAP diet, or IBS diet, is a diet low in specific types of carbohydrates that ferment easily in the gut (causing food intolerances) in those with IBS. FODMAP stands for:

More specifically, let’s break down where these carbohydrates are found:

• Oligosaccharides exist in foods like wheat, garlic, onions, lentils, and beans. Garlic and onion rank among some of the highest FODMAP offenders.
  

In my experience as a registered dietitian, some IBS patients who limit their intake or avoid high-FODMAP offenders like garlic or onion see significant symptom improvement without needing to go on a low-FODMAP diet. This modified approach can be a great tool to simplify dietary strategies for select individuals.

• Dairy products contain disaccharides, such as lactose. While milk and soft cheeses are high in lactose, individuals with lactose intolerance do not need to follow a dairy-free diet completely, as other dairy products, like hard cheeses and some yogurts, tend to be lower in lactose.
• Monosaccharides, like fructose, appear in high amounts in certain fruits and sweeteners, such as honey and high-fructose corn syrup.
• Polyols, a type of carbohydrate, naturally occur in some fruits, vegetables, and artificial sweeteners. Food companies use these sugar alcohols, like sorbitol, in things like sugar-free chewing gum.

Although IBS patients have seen symptom improvement on a gluten-free diet, these foods are often also low-FODMAP. A gluten-free diet is not recommended for people with IBS as this diet can often be unnecessarily restrictive.

Expert comment on low-FODMAP diet

After this initial period, it's essential to gradually reintroduce avoided foods and identify specific triggers and individual tolerance levels. The individualized reintroduction phase is crucial for understanding personal triggers. More experimentation with different foods and their serving sizes in this stage may help expand food choices and support a more balanced and varied diet over time.

Foods to limit or avoid

Since high FODMAP foods may trigger IBS symptoms, it is best to avoid or severely limit them to help manage symptoms initially.

Further, there are other foods you may want to limit as they contribute to undesired symptoms:

• Certain high-fiber foods (like those high in insoluble fiber)
• Carbonated drinks
• Caffeine and alcohol

Foods to include in an IBS-friendly diet

Since the low-FODMAP diet may be an effective tool for IBS management, here are some of the best foods for IBS:

These common low-FODMAP foods tend to help with IBS symptoms as they do not draw water into the gut like high-FODMAP foods, which may lead to abdominal pain, gas, bloating, and changes in bowel movements.

How to follow a low-FODMAP diet

The low-FODMAP diet is broken down into three stages.

The first stage involves removing all high-FODMAP foods for 2–6 weeks. This stage is essential for controlling your symptoms. However, it should only be followed short term, as the goal is to bring back as many foods as you can tolerate.

Step two involves slowly reintroducing one group of high-FODMAP foods back into the diet at a time and monitoring symptoms.

For example, for 1–2 days, try adding small amounts of dairy into your diet and see if symptoms occur. If no symptoms occur, try increasing the amount. If you do not experience symptoms, move to another FODMAP group the next day.

However, if significant symptoms (some gas and bloating are normal) occur, remove that FODMAP group, continue on the low-FODMAP diet for a few days, and then trial a new FODMAP group once symptoms have subsided. It can be helpful to track your symptoms as you go.

Once you have successfully trialed all the FODMAP groups and identified your food triggers, you can move on to the third stage — personalization.

In this stage, you can start reintroducing high-FODMAP foods that you tolerated well during the reintroduction stage and continue to monitor your symptoms.

Serving sizes are crucial, as some foods may cause no symptoms when consumed in small serving sizes but can trigger symptoms when eaten in larger amounts. Everyone’s body is different; some may tolerate certain FODMAPs and certain serving sizes.

Additional tips for managing IBS

While the low-FODMAP diet is one tool for managing IBS, other non-food tools may also be helpful.

*This information is for educational purposes only and should not be considered medical advice. Please consult a healthcare provider starting or changing any management regimen, including medication or supplementation use.

Regular exercise

Regular movement is crucial as it can help support regular bowel movements and reduce bloating, particularly after meals. Remember to drink plenty of water when exercising to remain hydrated and support regular bowel movements.

Stress management

Stress and IBS are connected. The gut is known as the ‘second brain,’ as the two are interconnected through a series of nerves. The gut produces many hormones that also affect the brain.

Recent research indicates that managing stress may lead to reduced symptoms in those with IBS.

However, research mostly found positive effects in the short term, and more long-term research is needed. Further, stress management interventions vary, so more standardized research on stress management tools and IBS is required.

Chew slowly

Chewing food thoroughly helps break it down further and supports easier digestion, potentially lowering the risk of unwanted digestive symptoms.

Supplements

Numerous supplements have been studied for their potential to reduce IBS symptoms.

Notably, certain strains and species of probiotics may help with IBS symptoms like stomach pain and bloating. However, evidence in this area is still emerging.

Eating more dietary fiber, particularly soluble fiber (like psyllium), may help improve IBS symptoms. Yet, not all types of fiber may improve symptoms; for instance, insoluble fiber (found in vegetables like cauliflower, wheat bran, and beans) may exacerbate symptoms in some people.

Medications

Several medications may help with symptom management, like diarrhea or supporting regular bowel movements in the case of constipation. Talk to your doctor if medication is right for you.

Working with a healthcare professional

Working with a healthcare provider on a diagnosis is crucial before trialing a low-FODMAP diet. Since IBS symptoms are so general, it is easy to mistake them for other digestive disorders that may be more serious, like Celiac disease, which requires a strict gluten-free diet. Thus, a medical professional should first rule out other conditions.

While the low-FODMAP diet is one tool, it may not be the best tool for everyone with IBS.

“Since the low FODMAP diet is an elimination diet, it’s not appropriate for everyone. This is because the restrictive nature of the diet can make it challenging for some people to meet nutrient needs,” states Beth Nanson, BSc., RD. In particular, this may include:

• Those with a history of disordered eating patterns or a diagnosed eating disorder
• Children
• Older adults since they are prone to nutritional deficiencies (due to low food intake)
• Pregnant individuals (as the diet has not been studied in this group)
• Picky eaters (as their diet may already be limited)
• Those with poor capacity to follow a diet (which may be due to cost, busy schedule, or difficulty with food preparation)

However, if a healthcare professional has recommended a low-FODMAP diet, research indicates that the success of managing this diet increases when working with a registered dietitian trained in IBS management.

Bottom line

Managing irritable bowel syndrome doesn’t have to be overwhelming. Tools like the low-FODMAP diet and improving lifestyle factors, such as stress management, regular exercise, chewing slowly, and taking supplements or medication as directed, may help.

Remember, working with a healthcare professional is essential for long-term success in managing IBS.