What to Eat if You Have IBS

If you have IBS, then you know it’s nearly impossible to eat almost anything without developing stomach pain, cramping, bloating, gas, constipation, and/or diarrhea. Likely if you have IBS, you are either on such a restrictive diet or just suffer through the pain and symptoms that come along with eating a normal diet. There are many different foods that can trigger IBS symptoms and oftentimes food triggers differ from one person to another. Let’s review some diet types to determine which one may be best for you.

DIET TYPES

Low FODMAP

The low FODMAP diet is by far the most popular diet when it comes to IBS, even gastroenterologists are recommending it to their patients. But does that mean it is right for you? FODMAP stands for fermentable oligosaccharides disaccharides monosaccharides and polyols - all of which are types of carbohydrates. The reason for eating low amounts of these specific carbs is that they are often poorly digested in those with IBS. Large amounts of FODMAP foods often lead to gas and bloating because they get fermented by bacteria in the gut and draw in lots of water into the intestines.

A low FODMAP diet may bring symptom relief to those with IBS, but this is not a long-term solution. This type of diet is very restrictive and can lead to nutrient deficiencies over time. The maximum amount of time a person should be exclusively on this diet is 1-2 years. The goal of using this diet is for only short-term symptom relief while addressing the underlying cause or during SIBO (small intestinal bacterial overgrowth) treatments. Once you address the root cause of your IBS, you can begin to ‘challenge’ high FODMAP foods and hopefully get back to normal eating!

SPECIFIC CARBOHYDRATE DIET

The specific carbohydrate diet (SCD) was originally used to induce remission in active Crohn’s disease, however, it has also been found beneficial in reducing IBS symptoms. The specific carbohydrate diet is a grain-free diet also low in sugar and lactose. While both this diet and a low FODMAP diet minimize carbohydrate intake, the SCD restricts all sugars except for monosaccharides (glucose, fructose, galactose). The low FODMAP diet only restricts fermentable carbohydrates. The SCD is not encouraged for those who have fructose malabsorption. Fructose malabsorption can cause IBS-like symptoms (bloating, diarrhea or constipation, gas, stomach pain) and be detected by your doctor with a simple breath test.

GAPS DIET

Inspired by the specific carbohydrate diet, the GAPS diet focuses on removing difficult-to-digest foods in a step-by-step process. There are 6 stages to the GAPS diet. The first stage is aimed at removing any food triggers such as high fiber and inflammatory foods. This is the most restrictive stage but it is meant to eliminate any symptoms before moving forward with the healing stages. Stage 1 lasts for a minimum of 5 days and potentially longer depending on the time it takes for all major symptoms to resolve. After the first stage, you can then begin to introduce 1 food from stage 2 each day. If you develop any digestive symptoms, you must wait a full week before trying again. You continue introducing more and more foods as you move through each stage until you are able to tolerate all foods again.

ELIMINATION DIET

An elimination diet is a short-term diet that requires you to remove numerous foods from your diet for 21 days, although the length of time may vary depending on how quickly your symptoms resolve. After those 3 weeks, you enter into the reintroduction phase where you add a small portion of a specific food into your diet and monitor for a reaction. If no symptoms appear, you can then try again with the same food but in a larger portion. If still no reaction, then that food is likely okay to add back to your diet for good. You repeat this process on a different day with a different food. If you do develop a reaction, you should avoid that food for 3-6 months before trying to reintroduce it again. If a reaction still occurs after a few months, likely you cannot eat that food again.

This diet should not be used for IgE-mediated food allergies, unless under the supervision of a licensed healthcare professional due to the risk of anaphylaxis upon food reintroduction.

RAW FOOD DIET

Although a raw food diet sounds healthy, this may actually cause more pain and digestive discomfort for IBS sufferers. The reason is due to the high fiber and poorly digestible carbohydrates found in raw fruits and vegetables. A raw food diet could be considered if you are lacking fiber in your diet but often aggravates those with chronic IBS. For most of those with IBS, it is actually better to cook your fruits and veggies until the gut is healed up.

LOW HISTAMINE DIET

While this may not be one of the top diets you commonly hear about for IBS, it may be helpful for a few different reasons. One reason a low histamine diet may alleviate IBS symptoms is because of the DAO (diamine oxidase) enzyme. The DAO enzyme breaks down histamine in the gut. If you have a slow-functioning DAO enzyme, histamine can build up in the digestive tract and cause IBS-like symptoms such as bloating, gas, stomach pain, and diarrhea. By eating foods that contain or produce low amounts of histamine, you may be able to lessen inflammation in the gut and achieve symptom relief. This diet can be restrictive depending on how sensitive you are to histamine-rich foods. Therefore, it is not a long-term solution and should only be used while addressing the root cause of histamine intolerance.

GLUTEN-FREE DIET

Even though most people with IBS don’t have celiac disease, gluten may still be a trigger of IBS symptoms. It may be worthwhile to eliminate gluten for 3-6 weeks and then slowly reintroduce gluten to determine if it causes any digestive distress. It is important to note that most gluten-containing foods are also high FODMAPs (specifically fructans), so it may not necessarily be the gluten you having a reaction to.

DAIRY-FREE DIET

Several studies have shown a lactose-free diet improves symptoms of IBS. Although some individuals may also be sensitive to casein, another protein found in dairy products. Therefore, it may be best to avoid all dairy products for 3-6 weeks. After avoiding all dairy, you can then introduce those with casein first and then lactose after to determine if you are sensitive to just one or all types of dairy.

HIGH FIBER DIET

As mentioned above in the raw food diet section, fiber may be helpful in some and may be a trigger for others. When comparing fiber types, it appears soluble fiber is less likely to aggravate IBS symptoms when compared to insoluble fiber. Soluble fiber can be found in most fruits and veggies, as well as in oats and legumes. Insoluble fiber is found mostly in whole grains and nuts. When increasing your fiber intake, it is important to do so gradually and increase water intake as well. Increasing fiber too quickly will lead to more digestive symptoms and upset.

CARNIVORE DIET

The carnivore diet is by far one of the most extreme diets based on only eating animal products like meat and eggs. This diet may be more beneficial for those who cannot tolerate fiber or high FODMAP foods. Some individuals find it easier to digest meat, therefore this diet helps give their digestive system a rest. This should never be a long-term solution, as it may negatively affect your cardiovascular health and gut microbiome. It may also cause more constipation due to a lack of fiber.

LOW-FAT DIET

Some individuals with IBS may find high-fat foods more difficult to digest, causing gas, bloating, stomach cramps, and diarrhea. If you are looking to adopt a low-fat diet, it would be wise to start by avoiding fried foods and highly processed fats.

Most of the diets listed above are not meant to be a long-term solution to your IBS. Even if your symptoms resolve after committing to a diet, that does not necessarily mean your IBS is healed. IBS is only truly healed if you are able to tolerate a wide variety of foods without any lapse of symptoms.

If you looking to get to the root cause of your IBS and heal your gut for good, schedule a FREE 15 minute phone call to determine if working together is right for you.