If you have irritable bowel syndroms (IBS) knowing what to eat can feel like the holy grail. For some patients, the right diet, along with attention to exercise, can control symptoms without medication.
For my patients, I often recommend a special diet of easily digestible food, called a low-FODMAP diet, which is detailed in this chart
FODMAP stands for “fermentable oligo-, di-, and monosaccharides and polyols” – a mouthful to say, but in more common terms, FODmaps are carbohydrates that may not be digested or absorbed well. Undigested carbohydrates are then metabolized by intestinal bacterial to produce excess gas, which leads to abdominal pain, diarrhea and/or constipation.
What foods to limit (and good substitutes)
Here’s a breakdown of what foods to *limit* when you’re following a low-FODMAP diet, as well as some suggested substitutes:
Lactose is found in milk and other soft dairy products like cottage cheese, cream cheese, ice cream and sour cream. Anyone can handle a very small amount of lactose, but if you eat more than your intestine can handle, you will get gas and abdominal pain. About half the population is born with low levels of lactase, which metabolized dietary lactose.
What to eat instead: Try lactose-free milk, oat milk, rice milk or soy milk as good alternatives to cow’s milk, as well as lactose-free yogurt. For cheese, try any of these three: hard cheeses, brie and camembert. Need butter? Go for olive oil instead.
Fruits contain the sugar fructose, which can
cause issues for IBS sufferers. Fructose is particularly high in apples and
pears, and somewhat high in watermelon, concentrated fruit, dried fruit and
fruit juice. Fruits with lower levels of fructose include bananas, citrus,
grapes and berries.
What to eat instead: Eat fruits that are lower in fructose, such as banana, blueberry, boysenberry, cantaloupe, cranberry, grape, orange, lemon, lime, kiwi and strawberry.
Certain vegetables cause gas and abnormal bowel habits. Avoid cruciferous vegetables such as broccoli, cauliflower, cabbage, coleslaw and sauerkraut. Also, limit artichoke, brussels sprouts, onions, shallots, leeks, and asparagus.
What to eat instead: Vegetables that are good to eat include eggplant, green beans, celery, carrots, spinach, sweet potato, yam, zucchini, and squash. For more good options, see this chart. You can enhance flavors of these veggies with herbs. On the safe list, you’ll find: basil, chili, coriander, ginger, lemongrass, marjoram, mint, oregano, parsley, rosemary and thyme.
Legumes, or beans, are often called the “musical fruit” because they contain indigestible saccharides. Baked beans, chickpeas, lentils and soybeans have high amounts, and IBS patients should avoid them, or eat them in very small quantities.
What to eat instead: While not exactly a substitute for beans, you can enjoy rice, oats, polenta, millet, quinoa and tapioca. Also, as long as you do not have Celiac disease, you can eat gluten on a low-FODMAP diet, which is an inaccuracy of the chart
Polyols, sugar substitutes found in sugarless gum and candy, also can cause problems. Avoid them, including sorbitol, mannitol, isomalt, maltitol and xylitol.
What to eat instead: It is perfectly fine to eat (in moderation, of course) good old-fashioned sugars; other artificial sweeteners that do not end in “ol,” such as NutriSweet®; Splenda®; and honey substitutes such as maple syrup, molasses and golden syrup.
The best treatment for IBS
Sometimes IBS is treated with medications, but a change in diet is the first thing we try. A healthy lifestyle — with a low-fat diet, exercise and avoidance of alcohol and cigarette smoking — often makes a great difference. For people who still need help, special diets, such as a low-FODMAP diet, can provide relief.
The good news is that a low-FODMAP diet is not a terribly restrictive diet. When you study the FODMAP chart, you will find there are plenty of good foods you can eat.
Your doctor may find that medication is also necessary to keep your symptoms at bay. These theraphies include anticholinergic medicines, which calm the spasms, and antidepressants to reduce stress.
(IBS) is an uncomfortable disorder characterized by dramatic changes in bowel movements. Some people experience diarrhea, while others have constipation. Cramps and abdominal pain can make everyday activities unbearable.
Medical intervention is important in the treatment of IBS, but did you know that certain diets may improve your symptoms? Explore the most common diets available to reduce uncomfortable symptoms, and work toward leading a healthy life.
Fiber adds bulk to your stools, which helps aid in movement. The average adult should eat 20 to 35 grams of fiber per day. While this seems simple enough, the nationalinstitute of diabetes and digestive and kindey disease estimates that most people only eat 5 to 14 grams per day.
Fiber-rich foods, such as fruits, vegetables, and whole grains, are nutritious and help prevent constipation. However, if you experience bloating from increased fiber intake, try focusing solely on soluble fiber found in fruits and vegetables instead of grains.
While fiber can help some people with IBS, increasing fiber intake can worsen symptoms if you frequently have gas and diarrhea. Before you completely eliminate fiber from your diet, concentrate on sources of soluble fiber found in produce items, such as apples, berries, carrots, and oatmeal.
Soluble fiber dissolves in water instead of adding extra bulk associated with insoluble fiber. Common sources of insoluble fiber include whole grains, nuts, tomatoes, raisins, broccoli, and cabbage.
You may also consider taking anti-diarrheal medicines 30 minutes before eating fiber to reduce the effects. This method is especially helpful when eating in restaurants and on the go. However, you shouldn’t make a habit of it.
Gluten is a protein found in grain products such as bread and pasta. The protein can damage the intestines in people who are gluten-intolerant. Some people with a sensitivity or intolerance to gluten also experience IBS. In such cases, a gluten-free diet may reduce symptoms.
Eliminate barley, rye, and wheat from your diet to see if gastrointestinal problems improve. If you’re a bread and pasta fanatic, there’s still hope. You can find gluten-free versions of your favorite products in health foods stores and many grocery stores.
An elimination diet focuses on avoiding certain foods for an extended period of time to see if your IBS symptoms improve. the international foundation for functional gastrional disorders recommends cutting out these four common culprits:
- insoluble fiber
However, you should forgo any food you find suspect. Completely eliminate one food from your diet for 12 weeks at a time. Note any differences in your IBS symptoms and move on to the next food on your list.
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Chronic consumption of high-fat foods is a known contributor to a variety of health issues, such as obesity. However, it can be especially hard on those with IBS by worsening symptoms.
High-fat foods are generally low in fiber, which can be problematic for IBS-related constipation. According to the cleveland clinic, fatty foods are particularly bad for people with mixed IBS, which is characterized by a combination of constipation and diarrhea. Embarking on a low-fat diet is good for your heart and may improve uncomfortable bowel symptoms.
Instead of eating fried foods and animal fats, focus on lean meats, fruits, vegetables, grains and low-fat dairy products.
FODMAps are carbohydrates that are difficult for the intestines to digest. Since these carbs pull more water into the bowel, people with IBS may experience more gas, bloating, and diarrhea after eating these foods.
The acronym stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” Temporarily restricting or limiting your intake of high FODMAps for six to eight weeks may improve your symptoms of IBS.
It’s important to note that not all carbohydrates are FODMAPs. For the best outcome, you have to remove the right kinds of foods. Foods to avoid include:
- lactose (milk, ice cream, cheese, yogurt)
- certain fruits (peaches, watermelon, pears, mangoes, apples, plums, nectarines)
- high-fructose corn syrup
- wheat-based bread, cereals, and pasta
- cashews and pistachios
- certain vegetables (artichoke, asparagus, broccoli, onions, brussels sprouts, cauliflower, mushrooms)
Keep in mind that while this diet eliminates some fruits, nuts, vegetables, and dairy, it doesn’t eliminate all foods from these categories. If you drink milk, choose lactose-free milk or other alternatives such as rice or soy milk.
To avoid overly restrictive meals, speak with a dietician before beginning this diet.
Certain foods can help IBS, but everyone is different. Examine your symptoms and talk to your doctor before starting a new diet. Stay in tune with how your body reacts to certain diets, as you may need to tweak the foods you eat.