Which diet for IBS is best?

Thankfully, there is a selection of diets available for you to experiment with. Finding the right management strategy takes time with some trial and error, and additional support and direction from a healthcare provider is recommended.

Let’s explore some IBS diet options.

Low FODMAP diet

Low Fodmap is often considered one of the most effective diets for managing IBS symptoms. It was designed to help identify and remove foods that may trigger an undesirable gut response (such as diarrhea and/or constipation, abdominal pain, bloating, gas, etc.) and provide you with alternatives that are less challenging for the digestive system to break down and absorb nutrients from.

The diet eliminates foods containing compounds known as FODMAPS:

• Fermentable Oligosaccharides
• Disaccharides
• Monosaccharides, and
• Polyols

Some examples of high FODMAP foods include wheat, onion, garlic, apple, watermelon, mango, asparagus, mushrooms, almonds, cashews, lentils, agave, honey, and high fructose corn syrup.

Examples of low FODMAP foods include unripe bananas, kiwi, oranges, pineapple, carrots, cucumbers, eggplant, lettuce, tofu, tempeh, eggs, and maple syrup.

You can find out more about high and low FODMAP foods via the Monash University website.

It consists of three phases:

1. Low FODMAP diet = high FODMAP foods are swapped for low FODMAP foods for 2-6 weeks
2. FODMAP reintroduction = slowly test high FODMAP foods over 8-12 weeks to see which triggers gut symptoms
3. FODMAP personalization = now that triggers have been identified, well-tolerated foods are reintroduced back into the diet

Research shows that 50-80% of those using the diet will see a noticeable improvement during phase 1.

The low FODMAP diet  is the only highly studied and widely accepted dietary treatment for IBS and is regularly recommended to IBS patients by their healthcare providers. However, It’s important to remember that the low FODMAP diet wasn’t designed for long-term usage.The three steps should be followed closely in the appropriate time frame. It’s recommended that you work with a healthcare provider to guide you through the process.

Anti-inflammatory diet

The Anti-inflammatory Diet emphasizes consuming whole, unprocessed foods and minimizing the consumption of foods that promote inflammation in the body. This diet is believed to help alleviate chronic inflammation, which is associated with various health conditions such as heart disease, arthritis, diabetes, and certain types of cancer.

When the diet is used for IBS management, the aim is to reduce inflammation in the body by limiting processed and refined foods such as white bread, fizzy drinks, red meat, and fried foods, steering clear of high-FODMAPs, and focusing on consuming foods that promote general gut health.

Some anti-inflammatory foods include:

• Oily fish such as salmon and tuna
• Leafy green vegetables such as kale and spinach
• Fruits, specifically berries, stone fruit, citrus, grapes, apples, and pomegranate
• Nuts and seeds
• Tumeric and ginger‍

The anti-inflammatory diet is not researched for the treatment or management of IBS, but there are some preliminary studies that have found a link between IBS and inflammatory foods.

Gluten-free diet

Gluten is a protein found in wheat, barley, and rye. For those with celiac disease, gluten can cause damage to the lining of the small intestine, prevent nutrient absorption, and result in severe gut symptoms such as abdominal pain, chronic diarrhea and/or constipation, nausea, and vomiting. Celiac disease is an autoimmune condition and is not to be confused with IBS.

People with IBS may feel as if they are sensitive to gluten, but research has shown that fructans, gas-producing sugars found in gluten, are to blame rather than gluten itself.

As always, it’s important to speak with your doctor to determine whether a gluten-free diet is the right IBS management approach for you. A gluten-free diet can be restrictive and keep you from obtaining adequate nutrition if not followed correctly. It’s unnecessary to follow a gluten-free diet unless medically advised.

Dairy-free diet

A diet free from dairy is another commonly used management tool for IBS. Lactose, which is a sugar (and disaccharide) found in dairy products, can cause a reaction in those who may have an intolerance.

When the digestive enzyme, lactase, is deficient in the gut, the digestive system struggles to break down and digest the lactose, leading to symptoms like gas, bloating, abdominal pain, and diarrhea.

IBS and lactose intolerance are two different conditions but have similar symptoms. A lactose intolerance is directly caused by the inability to digest lactose. It is possible to have both IBS and lactose intolerance, which is why avoiding products containing lactose can reduce symptoms, but if no intolerance is present, a dairy-free diet may not be necessary. Speak to your doctor if you have any questions about lactose intolerance and IBS.

Plant-based diet

Following a plant-based diet means consuming foods derived directly from plants, such as fruits, vegetables, legumes, whole grains, nuts, and seeds. Animal products, like meat, dairy, and eggs, are entirely or partially excluded. Research says that a plant-based diet may be especially beneficial for those with obesity, Type 2 diabetes, high blood pressure, lipid disorders, or cardiovascular disease.

Plant-based diets can be helpful for people with constipation-dominant IBS, as it is naturally high in fiber, making bowel movements easier to pass.

On the contrary, foods like cauliflower, beans, and lentils are classified as high FODMAP and can trigger IBS symptoms like diarrhea, bloating, gas, and abdominal pain.

If you are interested in exploring a plant-based diet, try the following suggestions:

• focus on consuming a wide variety of whole, unprocessed foods
• experiment with different plant-based foods and keep note of any reactions
• slowly increase fiber to prevent shocking your gut and causing discomfort
• consult with a healthcare provider to ensure you are correctly following directions and getting adequate nutrition

Are there any risks?

While using diet change as an IBS management tool can be effective, it still comes with risks. If not followed correctly, restrictive diets can cause more harm than good. Removing food groups without nutritious replacements, mineral, and vitamin deficiencies become a cause for concern. When our bodies don't get enough of a particular vitamin, it can lead to a wide range of health problems and complications.

It’s also very important for those with a history of disordered eating to work closely with a healthcare provider when following any restrictive diet.

An alternative approach is gut-directed hypnotherapy. This can be used alongside a diet that has been recommended to you by a health professional, or on its own. Research has shown that gut-directed hypnotherapy can be as effective as the low FODMAP diet in managing symptoms of IBS.

The Wrap Up

Learning how to manage IBS symptoms may involve a lot of trial and error. While there is no cure, there are several strategies you can implement to help guide you to symptom reduction.

Following a diet plan is one of the most commonly used tools for IBS management, specifically the low FODMAP diet. If you wish to experiment with other diets or strategies that the IBS community has tried, you can look into anti-inflammatory, gluten-free, dairy-free, plant-based diets (just to name a few), or gut-directed hypnotherapy, like Nerva. As always, work closely with your healthcare provider if you’re interested in diet change. If diets are not followed correctly, you may not be adequately reaching your daily vitamin and mineral needs.