Modify what you eat to help manage IBS.Nata Bene/Shutterstock
For most people with irritable bowel syndrome (IBS) — a common disorder that affects the large intestine and often causes cramping, pain, bloating, gas, diarrhea, or constipation — managing the condition requires a long-term strategy that involves healthy eating and reducing stress.
One key to managing IBS is figuring out which foods tend to cause symptoms.
Try to keep a record of what you eat, along with any symptoms, to help you figure out which foods trigger symptoms, especially since it’s different from person to person. But sometimes it’s not possible to figure this out on your own, and you may need the guidance of a healthcare professional.
Your doctor, dietitian, or nutritionist may recommend eliminating certain foods from your diet for a period. It’s important to follow the steps that your provider recommends to help determine which foods may be worsening your IBS.
Note that most adverse reactions to food in people with IBS represent a food intolerance or food sensitivity, not an allergy. According to clinical guidelines published in 2021 by the American College of Gastroenterology (ACG), food allergies occur in only 1 to 3 percent of adults and are no more common in people with IBS. And testing for food allergies when you have IBS will likely yield false positive results.
Foods that Can Trigger IBS
Learn the triggers and dietary changes that can help manage IBS.
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Foods That Could Be Aggravating Your Symptoms, and How to Reduce Your Intake
Individual food triggers and the symptoms they cause can vary in people with IBS. So a food that causes bloating in one individual with IBS might cause gas in another and no reaction in a different person. If you’re not sure which foods are causing or worsening your symptoms, there are certain items you should try removing from your diet before others. Some likely suspects:
Milk and Lactose Up to 70 percent of adults worldwide don’t produce large quantities of lactase, an enzyme that breaks down the sugar lactose in milk, according to Johns Hopkins Medicine. This means that milk and other dairy products can cause gas and bloating, since the lactose gets broken down by bacteria in your large intestine (colon).
Soft dairy products like cottage cheese, sour cream, cream cheese, and ice cream tend to be higher in lactose than hard cheeses. To limit lactose in your diet, you can switch to lactose-free milk or try substituting soy, nut, oat, or rice milks. Go for hard rather than soft cheeses, and try using vegetable oils or a nondairy spread instead of butter.
Fruits and Fructose Any fruit or other food that’s high in fructose, a type of sugar, can cause problems in people with IBS. Common sources of fructose include apples, pears, dried fruits, and fruit juice.
Fruits like these, which are lower in fructose, may be more tolerable:
While acidic citrus fruits like oranges, lemons, and limes tend to be lower in fructose, they can also act as an IBS trigger in some people.
Cruciferous and Other Vegetables Certain vegetables can be more difficult to digest than others because of the compounds they contain. These include cruciferous vegetables like broccoli, Brussels sprouts, cabbage, cauliflower, and kale. Other veggies that may be difficult to digest include these choices:
Artichokes
Asparagus
Leeks
Onions
Shallots
Fortunately, a large number of vegetables tend to be well tolerated by people with IBS:
Carrots
Celery
Eggplant
Green beans
Squash
Sweet potatoes
Yams
Zucchini
Beans and Legumes Beans and related legumes like chickpeas, black-eyed peas, split peas, and lentils — also known as pulses — contain indigestible carbohydrates called saccharides, which can cause gas and bloating. As a general rule, people with IBS should limit beans in their diet and try to get enough fiber from other sources.
Beans do contain soluble fiber, which the ACG recommends to treat IBS symptoms. If beans are intolerable for you, soluble fiber is also found in psyllium (think Metamucil), oat bran, and barley.
Polyols This naturally occurring carbohydrate is a common ingredient in sugar substitutes — like sorbitol (Arlex), mannitol (Osmitrol), and xylitol — and is found in sugar-free chewing gum and certain candies, such as breath mints. Polyols are naturally found in avocados, berries, and peaches as well. Consuming high amounts of polyols has been shown to cause diarrhea and bloating in many people with and without IBS.
If you’re determined to chew sugarless gum or use breath mints, watch out for any symptoms they may cause and consider looking for products containing alternative sweeteners like aspartame or sucralose. Also note that chewing gum can lead to bloating, as excess air gets pushed into your stomach.
What Is a Low-FODMAP Diet, and Can It Help Your IBS?
For many people with IBS, following a healthy diet and lifestyle, along with avoiding known food triggers, provides adequate relief from symptoms.
But some people still experience bothersome symptoms after following these steps. If this includes you, you may benefit from trying a special diet, such as a low-FODMAP diet, which cuts down on many IBS culprits. The ACG recommends trying a low-FODMAP diet, noting in its 2021 guidelines that the diet is associated with a significant reduction in IBS symptoms.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Together, they are a group of carbohydrates found in a variety of grains, fruits, vegetables, dairy products, and sweeteners, but they are often difficult to digest.
You may be able to tolerate certain foods containing FODMAPs but not others. To figure this out, your doctor may recommend that you follow a low-FODMAP diet for a few weeks, then slowly add back foods to see if they cause symptoms.
Researchers in the department of gastroenterology at Australia’s Monash University developed the concept of a low-FODMAP eating plan. They’ve identified foods in several categories that contain significant amounts of FODMAPs.
Fruits
Apples
Blackberries
Cherries
Dried fruit
Mangos
Nectarines
Pears
Plums
Watermelon
Vegetables
Artichokes
Asparagus
Beans (red kidney, navy, pinto, split peas, and baked beans)
Cauliflower
Garlic
Green peas
Lentils
Mushrooms
Onions
Sugar snap or snow peas
Dairy Products
Milk
Soft cheeses
Yogurt
Ice cream
Soy milk and rice milk (nondairy, but often found in the dairy section)
The basic principle is to eat healthy fats, proteins, and carbohydrates. Researchers include these items in a low-FODMAP eating plan.
Eggs and meat
Cheeses, including hard ones like Cheddar, Parmesan, and feta, as well as aged soft ones like Brie
Almond or oat milk, or lactose-free milk
Oats and oatmeal
Corn flakes
Quinoa
Plain rice cakes
Sourdough spelt bread
Pasta made from quinoa, rice, or corn
Vegetables, including eggplant, carrots, potatoes, cucumbers, green beans, bok choy, green bell pepper, lettuce, and zucchini
Fruits like cantaloupe, oranges, kiwi, and pineapple
Sweeteners such as dark chocolate, maple syrup, rice malt syrup, and table sugar (sucrose)
Always talk to your doctor, dietitian, or nutritionist before starting a diet.
Additional reporting by Jordan Davidson.
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Sources
Irritable Bowel Syndrome: Symptoms and Causes. Mayo Clinic.
