An upset stomach is never fun, but people with IBS experience chronic, or frequent, gastrointestinal pain and discomfort. One treatment that has been proven to help reduce the symptoms and identify the trigger foods of IBS is the Low FODMAP Diet.
What is IBS?
Irritable Bowel Syndrome, commonly known as IBS, is a disease in the digestive tract that can cause alterations in bowel habits. This disease can affect up to 15 percent of the population worldwide.
Symptoms of IBS include:
- Gas
- Bloating
- Pain
- Diarrhea
- Constipation
What causes IBS?
There are many factors that may play into the role of IBS. These include:
- Bacterial imbalance (more “bad” gut bacteria than “good” bacteria)
- Gut sensitivity (also known as visceral sensitivity)
- Speed of food moving through the gut
People with IBS often worry that their symptoms may creep up at the wrong time, leaving many to try planning when and what to eat to avoid an emergency trip to the restroom.
Working with a gastroenterologist can help diagnose IBS and rule out other conditions that may have similar symptoms, including celiac disease, Crohn’s disease, ulcerative colitis and small intestinal bacterial overgrowth.
How might diet impact IBS?
Certain foods may trigger your symptoms. If you have confirmed IBS, making changes to your diet may help improve how you feel. Working with a registered dietitian to determine if following an elimination diet such as the low FODMAP diet can be helpful in guiding you in the right direction.
What is the low FODMAP diet?
FODMAP is an acronym for different types of natural sugars found in foods: Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols.
These sugars are not completely digested in our intestines after eating. They can pull water into our small intestines, resulting in common IBS symptoms such as bloating and diarrhea. When these sugars go through the large intestine, bacteria use them for fuel and ferment, creating gas.
The impact of these natural sugars on IBS symptoms have been extensively studied by researchers at Monash University in Australia who went on to develop an elimination diet. By temporarily eliminating foods that contain these natural sugars, the researchers concluded that IBS symptoms improved in three out of four patients. This diet is now one of the first line approaches to managing IBS in diagnosed patients.
How does the Low FODMAP Diet work?
With the guidance of a registered dietitian, you would temporarily eliminate foods that are high in FODMAP sugars from your diet. This elimination period is followed for two to six weeks. It can be helpful to document how you are feeling at the start of the elimination process and record your symptoms throughout this phase to see if eliminating trigger foods has been helpful.
What types of foods are eliminated from the low FODMAP diet?
This is not a complete list, but the most common foods that can trigger IBS and are excluded from the Low FODMAP diet include:
Vegetables including:
- Garlic and onion
- Cauliflower
- Asparagus
- Mushrooms
- Artichokes
Fruits including:
- Apples
- Pears
- Mango
- Dried Fruits
- Cherries
- Peaches
- Pears
- Plums
Dairy foods and certain alternative products including:
- Cow’s milk
- Ice cream
- Soy milk
Protein sources:
- Most beans and legumes
- Certain types of marinades for poultry and beef (containing garlic and onion)
- Select processed meats (containing garlic, onion and sometimes gluten)
Breads and cereals:
- Breads and pasta made with wheat, barley and rye (typically found in gluten-containing products)
- Certain breakfast cereals
- Certain snacks including granola bars, chips, and cookies
- Ingredients added to products including chicory root and inulin
Sugars and sweeteners:
- Foods made with high fructose corn syrup
- No sugar added foods containing sugar alcohols (including sorbitol, xylitol, mannitol)
- Agave syrup
- Honey
Nuts and seeds:
- Cashews
- Pistachios
What can you eat on the low FODMAP diet in the meantime?
Although the above list can seem overwhelming, foods that are generally well tolerated with IBS include:
Vegetables including:
- Lettuce, kale, spinach and arugula
- Broccoli (in small quantities)
- Bell peppers
- Green beans
- Chives
- Cucumbers
- Tomatoes
- Zucchini and squash
- Potatoes
Fruits including:
- Banana (small)
- Blueberries, raspberries, and strawberries
- Cantaloupe
- Oranges and clementines
- Grapes
- Kiwis
- Pineapples
Grains including:
- Oats
- Rice
- Quinoa
- Corn Tortillas
- Gluten free breads and pasta (without FODMAP ingredients)
- Gluten free cereals including those made with corn or rice
Proteins including:
- Beef
- Chicken and turkey
- Fish and shellfish
- Eggs
- Chickpeas (in small quantities)
- Lentils (in small quantities)
Dairy and alternative milk products including:
- Butter
- Naturally aged cheeses with low amounts of lactose including; Cheddar, feta, goat, mozzarella, parmesan, camembert & brie.
- Lactose free products (cow’s milk, yogurt, sour cream and cottage cheese)
- Almond milk and rice milk
An example of one day of eating a low FODMAP menu:
Breakfast: Scrambled eggs with cheddar cheese, spinach and tomatoes with gluten free toast, buttered
Morning Snack: 1 cup mixed blueberries and raspberries with handful of walnuts
Lunch: Grilled chicken over a salad with lettuce, tomatoes, cucumbers drizzled with olive oil, balsamic vinegar with a side of cantaloupe
Afternoon snack: Gluten free pretzels with peanut butter (without high fructose corn syrup)
Dinner: Salmon marinated with olive oil and lemon, rice and green beans
Evening snack: lactose free vanilla yogurt with slivered almonds and strawberries
For Low FODMAP recipe inspiration, Kate Scarlata, RDN, has many great recipes on her blog.
How long should I be on a low FODMAP diet?
This diet is not meant to be followed for an extensive period as it can be restrictive. It is best to work with a registered dietitian as they can guide you with menu planning and include alternatives to your favorite foods, a more extensive overview of the eliminated foods and how to properly re-introduce FODMAPs into your diet.
The Nutrition Counseling team at the Lifespan Lifestyle Medicine Center can guide you on your path to managing your IBS symptoms. Visit us online or call 401-793-7837 to make an appointment.
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