Irritable Bowel Syndrome (IBS) is a condition affecting the gastrointestinal system, particularly the large intestine of the digestive tract. In the United States IBS affects between 25 and 45 million people, with women twice as likely as men to report experiencing symptoms.
Despite its prevalence in the general population, the root causes of IBS continue to perplex scientists and medical practitioners alike. Factors such as diet, lifestyle, mental health, and environmental factors can and do play a role in the extent and severity of IBS attacks in some individuals. The spectrum of IBS symptoms includes stomach cramps and abdominal pain, excessive bloating, flatulence, diarrhea and/or constipation. While in some people the condition causes mild discomfort, in others the symptoms are completely debilitating. With no known cure for IBS, current symptom management primarily focus on symptom relief – with dietary changes being one of the key areas.
In this article, we look at the relationship between IBS and diet and eight core food groups people often avoid when trying to find an IBS-friendly diet. We also look at the best way to identify a suspected food sensitivity to relieve some of the unpleasant symptoms associated with IBS.
The connection between diet and IBS
The role of diet in helping ease or aggravate IBS symptoms is widely acknowledged, with up to 90% of IBS sufferers actively avoiding specific food products to minimize flare-ups. Whilst monitoring the foods you eat might be a minefield at first, understanding which ingredients are causing you more harm than good is a no brainer to help manage IBS long term.
Irritable Bowel Syndrome (IBS) Trigger Foods
Among the biggest category of trigger food culprits for IBS flare ups are FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols).
FODMAPs are carbohydrates and sugars that are not easily broken down and absorbed by the small intestine. In turn, undigested FODMAP foods act like a sponge by drawing water into the gut and trapping it there, along with bacteria that can cause gas, bloating, stomach pain, diarrhea, and/or constipation – all the classic IBS symptoms.
There is good evidence to suggest that a low FODMAP diet can help those with IBS. However, focusing all your dietary changes on FODMAPs can be problematic for several reasons. Firstly, lots of foods contain FOMAPs and if you were to remove them all from your diet it would be too restrictive and hard to meet your nutritional needs. Secondly, getting your head around what a ‘Fermentable Oligosaccharide’ or ‘Polyols’ is can be overwhelming and the added stress could itself contribute to a flare up. Finally, many people have food sensitivities which can trigger an IBS flare up regardless of the FODMAP status of the food.
So, to give you another way to approach making IBS-friendly dietary choices, we’ve broken down eight more familiar and specific food groups which it may be helpful to avoid:
1. Allium Vegetables
Food and flavor go hand in hand when garlic, onions, chives, leeks or shallots are thrown in the pan. Heralded for their antimicrobial and beneficial health properties, these vegetables are part of the Allium family comprising of approximately 500 species. However, for people experiencing IBS symptoms, the cons that come with consuming allium vegetables can outweigh the benefits since they are also major culprits in influencing IBS symptoms. Most allium vegetables are also classed as high FODMAP.
2. Cruciferous vegetables
Cruciferous vegetables, including broccoli, cauliflower, cabbage along with the much loved (or hated) Brussel sprouts – are also difficult for the body to digest, which is why they may trigger IBS flare-ups. When your digestive system breaks these foods down, it can cause bloating, gas, and even occasional constipation. Some vegetables can be tricky to digest even for people with no known history of IBS. If eating them raw interferes with smooth digestion for you, then roasting, boiling, or sautéing them might be enough to make them tolerable. However, if you have a known food sensitivity to cruciferous vegetables or suspect that it might aggravate your IBS symptoms, removing them from your diet might be the better option.
3. High-fructose foods
While apples, pears, prunes, apricots, mango, cherries, and other high-fructose foods like raisins are a good source of vitamins and minerals which contribute to good health, these fruits are naturally high in fructose. Unfortunately, high levels of fructose can cause unpleasant side effects for IBS sufferers. Fructose is a monosaccharide which can be found naturally in fruits and vegetables or in artificially manufactured sweeteners and added sugars such as sucrose and corn syrup. High fructose corn syrup is usually found in processed foods, commercially prepared sweets, snacks, and soft drinks.
Studies point to the benefits of a low fructose diet which can improve IBS symptoms in some patients. Fructose malabsorption leads to fermentation in the colon. This can cause unpleasant symptoms such as osmotic diarrhea (loose and watery bowel movements), gas, and bloating.
4. Gluten rich foods
Gluten rich foods such as pasta, pastries, bread, biscuits, and cakes should be enjoyed in moderation as part of a healthy and balanced lifestyle. These gluten-rich treats might help us feel satisfied and full, but they can aggravate IBS attacks.
Acting as a glue that binds food together, gluten is a protein that is found in many types of foods, including in wheatberries, durum, emmer, semolina, spelt, farina, farro, graham, and einkorn. Gluten may also be found in other products like vitamins and supplements, hair and skin products, toothpastes, and lip balm. For people who are intolerant to gluten or who experience IBS flare-ups after consuming foods containing gluten, there are many great alternatives to choose from in the local grocery store.
5. Dairy products
If you find your IBS attack is imminent after consuming products which are lactose-derived such as milk, buttermilk, cream, custard, ice cream and cheese, then a first course of action might be replacing them with dairy free alternatives. These can provide a workable solution to prevent or manage an IBS flare-up. Milk and other foods that contain lactose, can further irritate your IBS as they lead gas and bloating in people who are lactose intolerant. Lactose intolerance is extremely widespread in the global population, with approximately 70% of adults not producing enough lactase. A deficiency in this intestinal enzyme leads to an inability to break down the sugar in milk which then passes undigested into the colon where it ferments, resulting in abdominal distention and pain.
Tenderly referred to as the ‘musical fruit’, the trusted baked beans or the versatile chickpeas and kidney beans among others, also contain indigestible compounds known as oligosaccharides. While some plant foods like beans can increase bulk in stool and help prevent constipation, the saccharide compounds in certain plant foods are resistant to digestion by intestinal enzymes which can lead to gas, bloating and abdominal cramps as a result. IBS sufferers should try to replace them with low FODMAP alternatives or, if they are able to tolerate them in small quantities, eat them only very occasionally.
Popular carbonated beverages such as sodas, caffeinated drinks, certain fruit juices, fermented and alcoholic drinks can make IBS symptoms worse and aggravate flare-ups. Because the bubbles in beverages like sodas can produce surplus gassiness which can irritate your IBS, drinking water and lactose-free milk to quench your thirst might be a better option. Fruit juices and fruit-based drinks might also intensify IBS symptoms since they are high in fructose.
8. Supplementary ingredients
While seasoning can enrich and add flavor to our favorite meals, certain types of condiments, herbs, and spices as well as dips, spreads and sweeteners contain ingredients that may trigger an IBS attack. This doesn’t exclude other everyday essentials we carry around with us, including sugar-free gum. They often contain artificial sweeteners such as xylitol and sorbitol which may cause diarrhea or aggravate existing IBS symptoms. Chewing gum may also lead to additional air ingestion which can cause lead to abdominal discomfort and bloating.
What to Eat with an IBS Flare Up?
Whether you’re experiencing an acute IBS attack lasting a few hours or reoccurring symptoms lasting several days, some of the best foods to eat with IBS include:
- Vegetables like carrots, cucumbers, kale, lettuce, spinach, ginger, potato, radish, olives, pumpkin, and tomato
- Fruits like oranges, mandarins, clementines, strawberries, grapes, and papaya
- Beef, chicken, lamb, pork, and various types of seafood
- Rice, cornmeal, and gluten-free grains
- Eggs, lactose-free milk, cheese and yoghurt
- Olive oil, coconut oil, sesame oil, sunflower oil
- Iced Teas, milk free alternatives that are rice, almond or coconut-derived
While these examples are all part of a low FODMAP diet, even foods like these that might be considered low-FODMAPs should be consumed mindfully. Certain combinations of these foods can result in “FODMAP stacking” which can put you past the threshold that still causes irritable bowel syndrome symptoms.
Understanding your personal food sensitivities
Although it is helpful to understand the kind of foods that commonly trigger flare ups in IBS sufferers, identifying your personal food and drink sensitivities is vital to ensure you make the best choices to optimize your diet and quality of life. Just like with IBS symptoms, trigger foods will vary from person to person. An ingredient that can cause problems for one person could be completely acceptable for another.
Identifying and eliminating your personal high reactivity foods from your diet can be an important step forward in your management of IBS. With a simple finger prick blood test, the YorkTest Premium Food Sensitivity Test can help you to identify which foods you are reacting to and help to take control of your condition.
- Tests for reactions to 200 food and drink ingredients
- Measures all four subtypes of food-specific IgG
- Home-to-laboratory testing kit
- Secure, online results within 7 days