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Certain foods can trigger irritable bowel syndrome (IBS) and other foods can help prevent IBS attacks. It may take trial and error to find foods you can safely eat.
Foods and IBS
When you have irritable bowel syndrome (IBS), a chronic condition that affects the gut, diet plays an important role in your treatment plan. Most people with IBS say that certain foods trigger their symptoms, which include abdominal pain, gas, constipation or diarrhea or both.
Common trigger foods include dairy, some fruits and vegetables, and greasy foods like pizza and burgers. Symptoms usually start within 3 hours of eating a trigger food.
Triggers vary from person to person and sometimes by the type of IBS you have. For example, some foods may be more likely to trigger symptoms in someone with IBS-D (causes diarrhea), while other foods could be a trigger for someone with IBS-C (causes constipation) or IBS-M (mixed, causing alternating constipation and diarrhea).
Because of these differences, there isn’t one exact diet that all IBS patients should follow. It will take trial and error to learn which foods you can and cannot tolerate.
If you’ve been diagnosed with IBS, work with your doctor or a registered dietician to figure out a diet that is right for you and is also balanced. Some foods that cause symptoms contain very important nutrients, so you have to make sure you get enough of those nutrients from the other foods you can eat.
IBS trigger foods
Some foods that are high in fat, particularly fried food and fatty meats, can trigger pain, bloating, gas, and loose stools. This includes fried chicken or fish, steak, burgers, French fries, and foods with heavy or creamy gravy.
While it’s not known why high-fat foods can cause a flare-up of IBS, it may be that fat slows down the digestive process in the small intestine and interferes with your ability to get rid of gas. Fatty foods may cause more problems in people with IBS-M or IBS-D than those who have IBS-C.
Certain fruits and vegetables
Some fruits and vegetables are high in a type of carbohydrate called fermented oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). FODMAPs contain forms of sugar that are poorly absorbed by the small intestine and can trigger IBS symptoms. The bacteria in your colon ferment these foods, leading to increased gas and bloating.
You may be able to eat some of these foods as long as you don’t eat them raw. Fruits and vegetables high in FODMAPs are sometimes easier to digest when they’re juiced or cooked.
High FODMAP fruits
High FODMAP vegetables
- Brussel sprouts
Every individual has different triggers, and developing a tailored plan with the help of a specialist can help avoid having a too restrictive or too liberal diet. —Dr. Judy Kim
People with any type of IBS may have trouble tolerating dairy foods like milk and ice cream. Most dairy contains lactose, which is a type of FODMAP. Some people with IBS shouldn’t eat dairy, but others may be able to tolerate it in small portions or as part of a meal rather than by itself. Some yogurts, like Greek yogurt, have low amounts of lactose and can be better tolerated.
Gluten, a group of proteins found in grains like wheat, is one of the most common triggers of IBS symptoms. It’s not well understood why gluten triggers IBS symptoms in some people. Researchers think that it may be because of fructan, a non-digestible and non-absorbable type of carbohydrate found in wheat. It’s also in other IBS triggers like onions and garlic.
Beans and legumes
Beans and legumes—including baked beans, chickpeas, lentils, and soybeans—contain saccharides, an indigestible form of carbohydrate that produces excess gas, leading to pain, diarrhea, and/or constipation. You may only be able to eat them in very small amounts or need to completely avoid them.
Many people with IBS say that eating spicy food causes abdominal pain and burning. Researchers have found that people with IBS have a greater number of pain receptors that react to capsaicin, a component of chili peppers. This may explain why spicy food triggers IBS symptoms.
Caffeine in tea, coffee, energy drinks, and soda may overstimulate the colon, causing loose stools in some people with IBS. But it may help if you have IBS-C, so whether you should have caffeine varies from person to person.
Alcohol can irritate the GI tract, and some drinks, like cider and rum, also contain FODMAPs. You may still be able to drink alcohol if you choose the kind that is lower in FODMAPs, like beer, gin, vodka, whiskey, and wine. Just limit it to one or two drinks a day, because binge drinking can cause IBS symptoms. A study published in the American Journal of Gastroenterology found that women with IBS—particularly IBS-D—who drank 4 or more drinks a day had IBS symptoms the next day.
Some artificial sweeteners used in sugar-free candy and gum are polyols (the “p” in FODMAPs), which can trigger symptoms like diarrhea, gas, bloating, and cramps. Examples of polyols include sorbitol, mannitol, maltitol, and xylitol. Sugar substitutes that don’t contain FODMAPs, like NutraSweet and Splenda, should be tolerable.
The carbonation in soda and seltzer can trigger symptoms in people with any type of IBS. The air in the tiny bubbles can cause gas and bloating in your GI tract. The level of carbonation in drinks varies, so you may find that some are more likely to cause symptoms than others. Colas are typically more highly carbonated than fruit-flavored sodas.
Depression, anxiety, and stress play an important role in the gut-brain interaction and can worsen IBS symptoms. Working with a therapist or psychiatrist may also help IBS symptoms. —Dr. Kim
What to eat with IBS
Little research has been done to identify foods that might improve IBS or prevent flare-ups, but there are many types of foods that are known to be good for your digestive health and are not likely to make your symptoms worse. These include:
Poultry and fish are lower in fat than other types of animal protein, so they’re less likely to overstimulate your gut the way that fattier meats like burgers and sausage sometimes do. Types of fish that are high in inflammation-fighting omega-3 fatty acids, like salmon, are exceptionally good for people with IBS, who have been found to have an increase in inflammatory cells in the intestines.
Eggs are another good source of protein. If they bother you, try eating the whites only (most of the fat found in eggs is in the yolk).
Yogurt can contain low levels of lactose so people with IBS can often tolerate it. In fact, some research suggests that probiotics (good bacteria) in yogurt may help reduce IBS symptoms.
Most nuts are low in FODMAPs, including Brazil nuts, macadamia nuts, pecans, pine nuts, and walnuts. Almonds and hazelnuts are somewhat higher in FODMAPs, so it’s recommended that people with IBS eat 10 or fewer of these nuts at a time. Exceptions are cashews and pistachios, which are high in FODMAPs.
Seeds like flaxseed and chia seeds are low in FODMAPs and may help with constipation. They’re also a good source of omega-3s. Other low-FODMAP seeds are pumpkin and sunflower seeds.
Low-FODMAP fruits and vegetables include berries, grapes, honeydew, cantaloupe, carrots, spinach, zucchini, and squash.
Quinoa, unlike many other types of grains, is low in FODMAPs and is also a good source of protein. Other low-FODMAP grains include oatmeal, buckwheat, and millet.
Fermented foods like sauerkraut, kimchi, miso, and kombucha are naturally rich in probiotics. They may help prevent the overgrowth of harmful bacteria in the GI tract, which is believed to be a likely contributor to IBS.
Should I do an elimination diet?
If you have IBS, your doctor may suggest trying an elimination diet to figure out which foods trigger your symptoms. This is recommended over food sensitivity/intolerance tests, which can be inaccurate.
An elimination diet is an eating plan where you temporarily stop eating certain foods to see if your symptoms improve. These foods are then gradually added back to see which ones cause symptoms and should be limited or avoided.
There are a few types of elimination diets that are recommended for people with IBS. These target types of foods that are commonly reported to trigger symptoms.
- A person with IBS-D may try to eliminate insoluble fiber, which can have a laxative effect.
- Those with IBS-C may eliminate soluble fiber (the other kind of fiber), which slows down digestion and can cause constipation.
- Those with IBS-M may improve by eliminating fatty foods.
- Other elimination diets include a gluten-free, lactose-free, or low FODMAP diet.
How to follow a low-FODMAP diet
The most commonly recommended elimination diet for people with IBS is the low-FODMAP diet, which was specifically created for people with IBS. This diet is complex and can lead to low calorie intake, so it’s important to work with a professional to make sure your diet is balanced.
It starts with avoiding high-FODMAP foods for a short period of time. You then gradually re-introduce them to see which ones you can tolerate and which you can’t. High-FODMAP foods include:
- The fruits and vegetables mentioned above
- Wheat, rye, and barley
- Garlic and onions
- Beans and legumes like black-eyed peas, broad beans, butter beans, and split-peas
- Artificial sweeteners, honey, and high-fructose corn syrup
- Dairy such as cow’s milk and cheese. Soft cheeses like cream cheese and ricotta can cause more symptoms as they typically contain more lactose than hard and aged cheeses.
- Certain juices, like apple juice, and certain drinks such as rum, dessert wine, and coconut water.
- Processed and marinated meats (ingredients may include high-FODMAP foods such as onion and garlic)
- Cashews and pistachios
How to start an IBS food journal
Another way to identify your food triggers is to keep a food journal and share it with your doctor or dietitian. Write down what you eat every day, including the amounts of each food and any symptoms you notice after each meal.
You may also be asked to record in your journal a description of the frequency and consistency of your bowel movements. Your doctor can use this information to spot relationships between your IBS symptoms and certain foods or a combination of foods.
An important question to ask your doctor: How long should I try dietary management before considering prescription medications for IBS? —Dr. Kim
Are bananas good for IBS?
How bananas affect you depends on how ripe they are. Unripe bananas can be an excellent choice for people with IBS because they’re low in FODMAPs. They can also help relieve diarrhea. But ripe bananas can trigger IBS symptoms because they accumulate a type of FODMAP called oligofructans, so you may not want to eat them.
What vegetables are good for IBS?
Look for vegetables that are low in FODMAPs, such as:
- Greens like spinach, kale, and arugula
- Green beans
What fruits are okay for IBS?
Low-FODMAP fruits that are less likely to cause IBS symptoms include:
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