Diet and Irritable Bowel Syndrome (IBS).
One of the leading ways to address and manage IBS – and the thing I stress to my patients – is diet.
This should come as no surprise. More and more, research shows that a balanced, diverse, mostly plant-based diet is the health compass pointing north. Not to mention shifting your diet is a step that can be embraced today, within your immediate control. What’s more attractive to a struggling patient than that?
Yet with IBS, triggers, symptoms, and severity can be related to food. These troublesome chews are often the kinds of healthy things you’ve been told to eat since you were little. Having symptoms from eating healthy foods can lead to some inevitable frustration. That’s where the Low-FODMAP diet comes in.
What is the Low-FODMAP Diet, and how does it work with IBS?
With the Low FODMAP diet, you temporarily restrict foods that are classified as – you guessed it – high in “FODMAPS,” a particular set of carbohydrates notorious for causing gas, bloating, cramps, and indigestion. FODMAP stands for “Fermentable oligo-, di-, mono-saccharides and polyols.” FODMAPs are osmotic, which means they pull water into the intestinal tract. In some people, and when eaten in excess, FODMAPs are poorly digested in the small intestine, where they are supposed to be broken down. When FODMAPs reach your large intestine, they are fermented by certain bacteria, producing lots of gas. This process could actually stretch and overstimulate your intestines, resulting in painful swelling, and irregular bowel movements.
With an aim to help identify and reduce your intake of these carbohydrate culprits, the Low-FODMAP diet was developed by researchers at Monash University, in Australia. The Low FODMAP diet is a trial elimination diet in which all high FODMAP foods are eliminated for 2-6 weeks. Once symptoms improve, high FODMAP foods are introduced in small amounts, one at a time, back into the diet. As many high FODMAP foods are actually very nutritious options, following a completely Low FODMAP diet on a long term basis is not recommended. By testing each high FODMAP food separately, IBS sufferers are able to identify which specific foods actually cause symptoms on an individualized basis, and are able to reincorporate the non-problematic high FODMAP foods back into their diet.
High-FODMAP foods to avoid (or at least try to limit)
The following foods are the most infamous IBS triggers. No need to run for the hills, though. When implementing a low-FODMAP diet, it’s best to limit, then systematically re-introduce, the following:
Fruits: apples, apricots, avocados, blackberries, cherries, figs, peaches, nectarines, mangoes, pears, plums, dates, prunes, papaya, most variations of dried fruits, watermelon
Vegetables: artichoke, asparagus, broccoli, brussels sprouts, beets, leeks, cabbage (savoy), cauliflower, sugar snap peas, celery, onions, shallots, garlic
Grains: Wheat, barley, rye, as well as bread, cereals, pastas, and baked goods made from wheat, rye or barley
Proteins: beans, peas, soybeans, and lentils; processed meats like pepperoni, and sausage that may contain garlic or onions and fatty or fried meats, pistachios and cashews, hummus
Dairy: Cow and soy milk, most soft cheese varieties, yogurt, sour cream, ice cream
Other: Sugar alcohols such as sorbitol, mannitol, erythritol, xylitol (found in chewing gum); inulin and chicory root (often added to granola bars), agave nectar, and high-fructose corn syrup, bullion, garlic and onion powder
Beverages: most fruit juices, sherry, port, fennel and chamomile tea,
If you are trying a low FODMAP diet, try choosing options from the following foods during the elimination phase of the diet.
Fruits: Bananas, lemons, limes, oranges, cantaloupe, honeydew, grapes, kiwis, cranberries, blueberries, strawberries, pineapple, raspberries, tangerines
Vegetables: Alfalfa and bean sprouts, carrots, cucumbers, bell peppers, green beans, bok choy, eggplant, kale, collard green, butter lettuce, spinach, tomatoes, radishes, turnips, parsnips, yellow and spaghetti squash, zucchini
Grains: Brown rice, buckwheat, oats, millet, quinoa, sourdough spelt, gluten-free breads and pastas, corn tortillas
Proteins: tofu, eggs, unseasoned and well cooked beef and pork, unseasoned and tender poultry and fish, smooth peanut butter in small amounts (2 TB or less), chia and pumpkin seeds, walnuts, peanuts and pecans
Dairy: lactose free milk and lactose free dairy products, rice, almond and coconut milk, lactose free kefir, hard block cheeses like feta, swiss, cheddar or parmesan
Other: Maple syrup, white and brown sugar, olives, pickles, black and green tea, coffee, gin, vodka, dark chocolate
Take care to note these lists are not exhaustive – nor or they set in stone! IBS can be tricky, and aggravated by different foods for different people.
If you are interested in learning how to manage IBS through your diet, contact us at 301-288-1319 to set up a nutrition counseling appointment with our experienced Registered Dietitian, Joanna Eaton. Joanna can help you to identify your potential triggers for IBS and come up with a diet that works for you. For more information on how to keep your gut health, healthy eating advice check out our recent workshop Make Every Bite Count.