Irritable Bowel Syndrome

Handout File:

Irritable Bowel Syndrome (IBS)

 

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that commonly causes abdominal pain, cramping, bloating, gas, and altered bowel habits. You may have constipation, diarrhea, or urgency.  Symptoms vary from person to person.

 

IBS is the most commonly diagnosed disorder by gastroenterologists and is also seen very often by primary care physicians. It is estimated that approximately 20% of the US population has IBS.

 

The most important thing to remember about nutrition management of IBS is that there is no single diet to help resolve symptoms. Individualization is key. Work with your dietitian to figure out what will work for you.

 

  • There is no cure for IBS. However, individuals may find relief with treatments specific to their symptoms.
  • Symptoms vary from person to person. Each individual experiences different symptoms and tolerates different foods.
  • Food allergies are rarely the culprit in IBS patients. Allergies are caused by an immune response. Most IBS patients with food-related symptoms have food sensitivities or intolerances, which are not caused by an immune response.
  • A few people with IBS symptoms may have specific food-related conditions including lactose intolerance and celiac disease, but these are not common.
  • Life stressors such as employment changes, travel, relocation, uncomfortable social situations, or illness can trigger or worsen symptoms.
  • A number of other factors may also worsen symptoms, such as excessive use of laxatives or antidiarrheal drugs, lack of regular sleep, and inadequate fluid intake.

Diet Modifications for IBS

 

The suggestions in this handout have helped some patients with their IBS symptoms. To determine what does and does not work for you, make only one change at a time.

 

  • Eat smaller, more frequent meals. Large meals can cause cramping, bloating, and diarrhea. If this happens to you, try eating 4-5 small meals a day. At the same time, avoid “grazing,” or snacking all day, as this can also worsen your symptoms.
  • Eat a lower-fat diet. High-fat, greasy, rich foods are typically not well tolerated. Some easy ways to reduce fat intake include:
    • Select lean meats (fish, turkey, chicken) and bake or grill, don’t fry.
    • Choose low-fat or non-fat dairy (cow’s milk, soymilk, yogurt, cheese).
    • Use cooking spray instead of butter or vegetable oil.
  • Reduce the lactose in your diet.  Many people with IBS are lactose-intolerant. Lactose is a sugar found in certain dairy products, such as milk and ice cream. It is also present in smaller quantities in yogurt, cheese, and prepared foods.
  • Try a “bland” diet to reduce aggravation to your intestines. Foods and beverages that seem to be better tolerated include:
    • Plain pasta, plain noodles, white rice. No sauces or gravies.
    • Plain baked or boiled potatoes. No French fries.
    • Breads: French, Italian, whole white, English muffins, white rolls
    • Meats: plain fish, plain chicken, plain turkey, plain ham, eggs
    • Cereals: cornflakes, rice krispies, corn or rice chex, cheerios; dry or with soymilk
    • Vegetables: some lettuce, cooked peas, cooked carrots
  • Reduce the amount of poorly absorbed carbohydrates in your diet. This includes:
    • Fruits such as apples, pears, mangoes, oranges, pineapples, and melons
    • Wheat-based products
    • Sugar alcohols, including sorbitol and mannitol, which are commonly found in gum, candy, and some medications
  • Reduce the amount of gas-producing foods in your diet, including legumes (beans), cabbage, brussels sprouts, cauliflower, and broccoli. Reducing or eliminating these foods is reasonable especially if you suffer from gas and bloating. Some people also have trouble with onions and garlic.
  • Avoid additional trigger foods. You may have identified certain foods that worsen your symptoms. Some common triggers include caffeine (in coffee, tea, and soda), chocolate, and alcohol. You can keep a food and symptom diary to help you identify your triggers.
  • Slowly add fiber to your diet. Soluble fibers (not insoluble) may alleviate some of your symptoms. Some foods rich in soluble fiber include oatmeal, raisin bran, lima beans, sweet potatoes, and collard greens. However, many high-fiber foods may increase gas and abdominal distention. Gradually add one food at a time and track your symptoms.
  • Avoid swallowing excessive amounts of air by chewing and eating slowly in a relaxed environment. Also avoid chewing gum and mints, which increase air swallowing.

 

Lifestyle Suggestions for IBS

 

  • Avoid tobacco products, including cigarettes and e-cigarettes, as nicotine can worsen your symptoms.
  • Exercise regularly. Moderate exercise for 30 min/day may help especially if you suffer from constipation.
  • Reduce stress. Stress and anxiety can worsen IBS in some people. The best approach for reducing stress and anxiety depends upon your situation and the severity of your symptoms. Have an open discussion with your clinician about the possible role that stress and anxiety could be having on your symptoms, and together decide upon the best course of action.

 

Additional Resources

 

 

 

version information:

last update:  
January 2024