From managing unpredictable flare-ups to navigating dietary restrictions, the daily struggles of living with or supporting someone with irritable bowel syndrome (IBS) can be overwhelming.
While there are various strategies you can use to reduce the risk of IBS complications, one of the most effective is identifying and avoiding trigger foods that intensify symptoms and reduce your quality of life.
So, in this article, we will discuss the mechanism behind IBS, the foods you need to avoid if you have it, foods you can eat instead, how to modify eating habits, and how to eat out with the condition.
Understanding the mechanism of IBS and the need to avoid certain foods
IBS is a disease of the digestive system. While the exact underlying mechanisms behind the disorder remain unclear, several factors are believed to contribute to its development, such as:
- Changes in gut bacteria and motility
- Immune system dysfunction
- Gut inflammation, such as after an infection
- Consuming dairy, cruciferous vegetables, and fried foods
Foods and drinks rich in fructose, lactose, caffeine, alcohol, carbonation, fat, and insoluble fiber can all irritate the gastrointestinal tract, causing bloating, gas, diarrhea, and constipation — the usual symptoms of IBS. However, food triggers vary between individuals and it’s not clear why.
It’s also important to remember that other conditions, such as hemorrhoids or anal cancer, may be confused with IBS. This is why before you think about avoiding certain foods, it’s important to see a doctor who knows how to diagnose IBS.
12 foods to avoid with IBS
While there is no cure for IBS, avoiding the following foods can reduce flare-ups and bring relief.
Dairy products like milk contain lactose, a sugar broken down by the enzyme lactase. Individuals with IBS have low levels of lactase in their gut; this causes lactose to remain undigested.
Undigested lactose is fermented or broken down by gut bacteria into fatty acids, methane, hydrogen, and carbon dioxide. These gasses and acids irritate the gut and cause symptoms like diarrhea and bloating.
Fizzy drinks contain carbonated water and high levels of fructose corn syrup.
Carbonated water can cause gas to accumulate in the gastrointestinal tract, leading to bloating and abdominal discomfort.
Similarly, high-fructose corn syrup (HFCS) is poorly absorbed by some individuals and can trigger symptoms like diarrhea and constipation.
In a recent study involving 3,362 individuals, researchers sought to investigate the potential relationship between caffeine intake and IBS. To gather data, participants were provided with questionnaires that assessed their daily caffeine consumption.
Upon analyzing the responses, researchers found that individuals consuming a minimum of 106.5 mg/day of caffeine had a 47% higher likelihood of having IBS compared to those taking less than 69.4 mg/day.
Moreover, the study also revealed a correlation between high coffee intake and IBS in subgroups like females and individuals with a BMI of ≥25 kg/m2. This suggests it is essential to avoid or reduce your caffeine intake if you have IBS.
Artificial sweeteners contain chemicals that change the composition of the gut microbiota by reducing the levels of beneficial bacteria and promoting the growth of harmful ones. This gut bacteria imbalance can cause gastrointestinal inflammation, leading to IBS.
Moreover, the altered gut microbiota can also increase intestinal wall permeability, allowing harmful substances to escape into the bloodstream and trigger IBS symptoms.
Insoluble fiber, found in wheat bran and whole grains, has been observed to be a common trigger for IBS flare-ups. The rough texture of insoluble fiber can mechanically irritate the sensitive gastrointestinal lining, triggering abdominal pain and discomfort.
Moreover, insoluble fiber can encourage bacterial fermentation, which can cause bloating and constipation.
Fried foods like french fries contain a high amount of fat that slows down digestion and gut motility, causing digestive distress in the form of bloating, stomach pain, and cramps.
Chocolate contains a combination of high levels of dairy, fat, and sugar. These ingredients slow down digestion and are broken into gasses and chemicals that can trigger IBS flare-ups.
Ultra-processed foods contain additives like colors, flavor enhancers, and preservatives that can irritate the sensitive gut lining, triggering IBS symptoms.
Alcohol can damage the cells lining your digestive tract, reducing the intestine’s ability to break down food. This leads to gastrointestinal inflammation. It might also delay stomach emptying, which can cause food to ferment and lead to abdominal pain.
Moreover, alcoholic drinks like cider, beer, and champagne are carbonated and highly likely to cause bloating.
So, people with IBS should decrease their alcohol intake to within safe limits — one drink per day for women and up to two drinks daily for men — and go alcohol-free at least two days a week.
Cruciferous vegetables include broccoli, cabbage, and cauliflower. They contain high amounts of sulforaphane, which causes abdominal pain, bloating, and gas.
Moreover, they have high amounts of fiber, which makes them difficult to digest and highly likely to trigger IBS symptoms.
Beans and legumes
Despite being excellent sources of protein and fiber, beans and legumes contain sugars — called oligosaccharides — that are difficult to digest. This makes them likely to cause IBS flare-ups, so it’s best to reduce their consumption.
All fruits contain fructose. However, fruits like watermelon, apples, and grapes contain high amounts of this sugar.
When you consume too much fructose, it may escape into the colon, where it will be fermented by gut bacteria. The resulting gasses and acids cause diarrhea or constipation, bloating, flatulence, and abdominal pain.
So, individuals with IBS should limit their fructose consumption to prevent flare-ups.
What to eat instead — a low-FODMAP diet
If you have IBS, you may feel discouraged by the restrictions on your diet. However, safer and more beneficial alternatives exist in the form of the low-FODMAP diet.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are carbohydrates — or “sugars” — that can be difficult to digest for IBS patients and potentially cause flare-ups.
The low-FODMAP diet, a key component of the best diet for IBS, involves reducing or eliminating specific types of fruits, vegetables, grains, dairy products, and sweeteners from your diet to alleviate IBS symptoms and regain control over your diet.
Types of low FODMAP foods
Let’s look at different types of low-FODMAP foods:
Lactose-free milk, soy milk, cheese, almond milk, and kefir are low-FODMAP dairy products. They are rich in beneficial nutrients and excellent for individuals with IBS.
Certain fruits and vegetables
Bananas, oranges, and strawberries are low in FODMAPs, contain low levels of fructose, and do not cause IBS symptoms.
Eggs, firm tofu, seafood, and tempeh are some low-FODMAP proteins that will decrease the likelihood of IBS flare-ups.
Unlike insoluble fiber, soluble fiber has the ability to absorb water and form a gel-like substance inside the gut. This slows the passage of food through the gut and alleviates diarrhea.
Moreover, a meta-analysis conducted in 2014 supports the positive impact of soluble fiber on IBS management. It analyzed results from 14 randomized control trials and 906 patients.
The meta-analysis revealed that patients who consumed soluble fiber experienced significant reductions in bloating and overall symptom severity compared to those who didn’t. This suggests soluble fiber can play a valuable role in the treatment of IBS.
Some examples of low-FODMAP soluble fiber foods are potatoes, eggplants, carrots, and almonds.
How to modify eating habits to improve IBS symptoms
To modify eating habits and improve IBS symptoms, you will need to follow a low-FODMAP or “elimination diet,” which involves the removal of high-FODMAP foods. It consists of the following:
In this first phase, you will eliminate FODMAP-containing foods from your diet after consulting your dietitian. The duration of this phase will be four to eight weeks, depending on your progress and health considerations.
Once your body has adjusted to the elimination phase and your symptoms have improved, you will gradually begin reintroducing specific FODMAP-containing foods into your diet. Ideally, you should introduce one food item a week to monitor your body’s response to it.
You should also start with small portions of reintroduced food and gradually increase the quantity if no IBS symptoms arise.
The maintenance phase is about maintaining your new diet. By now, you’ll have understood which foods trigger your IBS symptoms and which are safe for you to consume.
How to eat out with IBS
There is no reason why individuals with IBS can’t eat out. Let’s understand how you can eat out without aggravating your symptoms:
Identify trigger foods
Conduct an elimination diet to find out what foods your body is intolerant to. Once you’ve identified your IBS triggers, you can avoid them when you eat out.
Be careful with your alcohol intake
Maintaining control over alcohol consumption can be challenging when going out. However, moderation is key to controlling IBS flare-ups.
So, if you are drinking, limit yourself to one serving and stick to low-FODMAP drinks like red wine, gluten-free beer, vodka, and whiskey.
Having a backup plan for managing unexpected IBS symptoms is crucial to navigating potential flare-ups. So, before visiting a new place, take a moment to research the availability and proximity of restrooms.
Moreover, select a seat or table close to the restroom, if possible. It’ll offer quick access if you urgently need to use the bathroom. You can also get in touch with groups that provide support for IBS to get IBS-friendly restaurant recommendations.
Frequently asked questions about IBS food triggers
Is rice bad for IBS?
No, rice is a low-FODMAP food recommended for IBS patients.
Is yogurt good for IBS?
Yes. Yogurt contains good bacteria that help break down lactose, reducing IBS flare-ups.
What naturally treats IBS?
While there is no cure for IBS (although new studies may lead to one), there are several natural approaches that can help alleviate symptoms. Some examples include a low-FODMAP diet, regular exercise, peppermint oil, psyllium, chamomile, and probiotics.
What is the best breakfast for IBS?
A breakfast containing low-FODMAP foods is ideal for individuals with IBS. Examples of low-FODMAP breakfast options include an unsweetened oatmeal bowl, a lactose-free yogurt parfait, and a gluten-free bagel sandwich.