According to a clinical review published in the Journal of the American Medical Association, irritable bowel syndrome (IBS) affects between 7 percent to 21 percent of the general population. (1) The amount of people who now struggle with some form of IBS is estimated to be a shocking 60 million people in the U.S. alone (roughly 20 percent of all Americans).
If you want to overcome digestive symptoms that may include diarrhea, constipation, bloating and gas, then following an IBS diet and adhering to an IBS treatment plan is essential. Many randomized clinical trials have found that dietary, lifestyle, medical and behavioral interventions can be very effective at managing IBS symptoms.
What should you eat if you have IBS? As you’ll much more about below, an IBS diet plan includes a variety of unprocessed, whole foods that provide fiber, vitamins and minerals — such as vegetables, fruits, clean proteins and bone broth. Avoiding inflammatory and FODMAP foods, using certain supplements, exercising, and managing stress can also play an important role in IBS treatment.
What Is IBS?
Irritable bowel syndrome (IBS) is a very common disorder that affects digestion, especially by interfering with normal functions of the large intestine. IBS is not a single disease but rather a “symptom cluster resulting from diverse pathologies.” This means that each person with IBS can struggle with different symptoms and have their own unique triggers.
What are symptoms of an IBS flare up? IBS symptoms can include: (2)
■ Bloating and gas
■ Cramping and abdominal pain
■ Diarrhea or constipation, or both
■ Changes in poop color and appearance, including having loose stools or mucus in stools
There are many different causes of IBS, ranging from food intolerances to stress. Experts believe that factors that contribute to the development of IBS include: alterations in the gut microbiome, intestinal permeability (aka leaky gut syndrome), impaired gut-immune function, problems with motility, gut-brain interactions and psychological disturbances. Some common underlying causes and triggers of IBS can include: (3)
■ Eating a highly-processed, usually low fiber diet
■ Food allergies or intolerances/sensitivies
■ Inflammation and free radical damage/oxidative stress that can damage the intestines
■ Nutritional deficiencies
■ Leaky gut
■ Use of certain medications that can cause constipation or diarrhea
■ And poor lifestyle choices such as drug use, smoking, and high caffeine and alcohol consumption
■ SIBO, gastroenteritis, or infections of the digestive system
■ Hormonal changes, such as menopause or shifts during the menstrual cycle
■ Sedentary lifestyle
You’re more likely to have IBS if you’re under the age of 50, you’re female, other people in your family have had IBS, or if you suffer from stress and mood-related issues like anxiety and depression.
Inflammatory bowel diseases (IBD) are generally more severe than IBS and also more difficult to treat. IBD tends to cause severe symptoms such as frequent diarrhea, bloody stools, malabsorption of nutrients and ulceration of the digestive tract. This illness can often be related to a number of other health conditions, including ulcerative colitis, Crohn’s disease and leaky gut syndrome.
To diagnose someone with IBS, first other conditions must be ruled out. Tests that can aid in diagnosis include blood cell count, C-reactive protein or fecal calprotectin, testing for celiac disease and colorectal cancer screening in older adults.
If it’s clear that the patient is not suffering from an autoimmune condition, cancer or an allergy — which can cause symptoms that mimic those of IBS — then it will probably be concluded that the patient has IBS. IBS will not be diagnosed if certain serious symptoms are being experienced, such as unexplained weight loss, gastrointestinal blood loss or unexplained iron-deficiency anemia.
In order to be diagnosed with IBS, the following criteria must be met: (4)
1. Onset of symptoms at least six months before diagnosis
2. Recurrent abdominal pain or discomfort for more than three days per month during the previous three months
3. Having at least two of the following features
■ Improvement of symptoms following a bowel movement
■ Association with a change in stool frequency
■ Association with a change in stool form
There are several types of IBS, which are categorized according to the predominant symptom that’s being experienced. The different types include:
■ IBS with predominately diarrhea
■ IBS with predominately constipation
■ or mixed IBS, in which both occur
IBS treatment is typically tailored to each individual’s needs, depending on the underlying causes of the condition (food allergies/intolerances, chronic stress, low motility, etc.). Treatment usually involves dietary changes and sometimes the use of medication and/or counseling.
If emotional/psychological stress is believed to be a major contributing factor, then stress-relieving activities may be recommended like: psychotherapy, biofeedback training to learn how to relax certain muscles, deep breathing and progressive relaxation exercises, and meditation/mindfulness training.
Lifestyle and dietary changes are typically first line treatments for IBS. If these are not helpful enough, some doctors may prescribe medications to control symptoms. Examples of medications that be used to treat IBS include: (5)
■ Anti-diarrhea medications
■ Gut antispasmodics
■ Anticholinergic medications such as dicyclomine (Bentyl) to relieve painful bowel spasms
■ Stool softeners or laxatives
■ Fiber supplements
■ Nerve pain medications
■ Antibiotics such as rifaximin (Xifaxan) to treat infections
■ Antidepressants to reduce stress-related GI issues
■ Dietary supplements to treat nutrient deficiencies
The IBS Diet Plan
IBS Diet Food List:
What are the best foods to eat when you have irritable bowel syndrome? Here are the top IBS diet foods that are recommended, considering they are unprocessed and easy to breakdown:
Raw cultured dairy – Probiotic foods like kefir, amasai and yogurt can help heal the gut and balance your microflora. Also, when buying dairy, look for raw, organic goat milk products or dairy that doesn’t contain A1 casein.
Clean lean protein – Protein deficiency is common in people with bowel disease, therefore try to eat at least 3–4 ounces of protein per meal.
Fresh vegetable juice – As long as the vegetable juice does not worsen the diarrhea, vegetables can help provide critical electrolytes.
Steamed vegetables – Non-starchy vegetables that are cooked or steamed are easy to digest and are an essential part of the IBS diet.
Healthy fats – Consuming healthy fats in moderation like egg yolks, salmon, avocados, ghee and coconut oil are easy on the gut and promote healing.
Fruit – Consuming fruit in moderation, about one serving early in the day, is usually okay for those who struggle with IBS. If IBS is severe, you may want to try steaming apples and pears to make homemade apple sauce.
What can you drink if you have irritable bowel syndrome? First and foremost, prioritize drinking enough water. Hydration is critical to keep the digestive system lubricated and healthy, so try to drink about eight ounces of fluids every two hours, or even more if you’re thirsty. Avoid having too much caffeine (or any), since caffeine can stimulate the digestive tract and worsen diarrhea or cramping.
IBS Trigger Foods to Avoid:
Conventional dairy – Pasteurized dairy can be hard to digest and can make digestive symptoms worse.
Gluten – A gluten-free diet can help improve the symptoms of bowel disease. If you suspect gluten contributes to your symptoms, avoid all foods made with or containing wheat, barley and rye grains.
Grains (if you can’t tolerate them) – Any type of whole grain will contain phytic acid and starch which can irritate the intestinal lining causing gut issues.
Sugar and refined flour – Bacteria love to eat sugar and sugar reduces immune system functioning.
Any potential allergen – Diarrhea can result from food allergies; common culprits include gluten, nuts, shellfish and dairy.
Spicy foods – Hot and spicy foods may can cause heartburn/acid reflux and IBS symptoms to become worse.
Foods that cause gas — Carbonated and alcoholic beverages, caffeine, raw fruit, dairy and certain vegetables, such as cabbage, broccoli and cauliflower may make gas worse.
Low FODMAPs for IBS:
What is a FODMAP food, and how does a low FODMAP diet plan benefit people with IBS?
FODMAPs is an acronym for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols.” These are specific types of sugars — such as fructose, lactose, fructans and galactans — that are found in carbohydrate foods such as certain vegetables, fruits, grains and dairy milk. FODMAPs are short-chained carbohydrates that are fermentable and can be poorly absorbed in the gut.
For a high percentage of people with IBS, reducing consumption of FODMAPs has been shown to help take the burden off the digestive system and improve symptoms. (6) Along with a low FODMAP diet, there are several other diets that are designed to restrict food sources (primarily carbohydrates) that feed harmful bacteria in the gut.
Examples of diet plans that have been shown to help people with IBS include the Specific Carbohydrate Diet (SCD), the Gut and Psychology Syndrome Diet (Gaps Diet), and a combination of these diets (such as SCD + low FODMAP diet). (7)
Keep in mind that you may need to customize your diet depending on which IBS symptoms (diarrhea or constipation, or both) you deal with most. An IBS constipation diet will include plenty of fiber, but not too much that it worsens constipation. An IBS diarrhea diet will include lots of hydrating foods, some fiber and some “binding foods” that can bulk up stool.
When you have diarrhea, try incorporating binding foods like: bananas, rice, mashed potatoes, simply cooked chicken or meat, yogurt and oatmeal. If you’re constipated, have berries and fried fruit, vegetable juices, chia and flax seeds, cooked leafy greens, artichokes, sweet potatoes and squash.
Complementary IBS Supplements & Essential Oils:
Probiotics (50–100 billion units daily) — Probiotics can help re-colonize the gut with healthy bacteria.
Digestive enzymes (2 before each meal) — These enzymes will help you break down foods that you eat and facilitate nutrient absorption.
L-glutamine powder (5 grams twice daily) — Glutamine is an amino acid that helps repair the digestive tract, which is especially important for people with chronic diarrhea.
Aloe vera juice (1/2 cup 3 times daily)— Aloe is healing to the digestive system and can act as a natural laxative for those with constipation.
Fish oil (1000 mg daily) — The EPA/DHA in fish oil can help reduce inflammation in the GI tract.
Herbal remedies — Slippery elm, ginger, peppermint oil and licorice root can all help soothe intestinal inflammation.
Psyllium husks or senna leaf tea — These can be used occasionally to treat constipation.
Chia and flax seeds soaked in water to relieve constipation
Essential oils for IBS — Essential oils including ginger, peppermint, lavender and fennel may be able to help reduce IBS symptoms. Add 1 drop of oil to water 3 times daily, or rub a few drops mixed with a carrier oil over your abdomen twice daily. You can also inhale the oils to relax or diffuse them in your home. Peppermint capsules are also used to soothe the digestive system.
Additionally, there are certain lifestyle changes and habits that can help manage IBS symptoms, especially exercise, getting enough sleep and stress management. If you have IBS, you may notice that times of stress and sleep deprivation will flare up your condition.
Keep stress levels low by scheduling rest during the week, fun activities, social events, and time for hobbies you enjoy. Try to get regular exercise to help keep inflammation levels low and stimulate bowel movements if constipation is an issue. Overall aim to tackle IBS with with a holistic approach that incorporates diet, lifestyle and psychological changes.
Always visit a doctor if you start experiencing severe and unexplained symptoms, such as:
■ Sudden unexplained weight loss
■ Diarrhea or constipation that lasts more then several days
■ Rectal bleeding
■ Signs of iron deficiency anemia, including fatigue and weakness
■ Unexplained vomiting
■ Difficulty swallowing
■ Persistent pain
Discuss any history of allergies you may have, any lifestyle changes you’ve recently made, and whether GI issues run in your family. Your doctor or a dietician/nutritionist may decide to put you on an elimination diet to help pinpoint which foods are most problematic. You can also talk about whether counseling, changing your medications or other interventions may be necessary.
■ Irritable bowel syndrome (IBS) is a very common disorder that affects digestion, especially by interfering with normal functions of the large intestine.
■ IBS symptoms typically include: constipation, diarrhea, gas, bloating and abdominal pains.
■ Causes of IBS can include: poor quality diet, lack of fiber, stress, infections, hormonal changes, low motility, digestive issues like SIBO or food allergies, and genetics.
■ The best IBS diet is one that includes whole, unprocessed foods — including enough fiber, tolerated fruits and vegetables, clean proteins, healthy fats, and water. If you have IBS, your diet needs to be customized depending on your symptoms and triggers. It’s important to remove inflammatory and allergenic foods to help your GI tract heal. You may also need to remove caffeine, alcohol, gluten, dairy, spicy foods and certain types of carbohydrates.
■ Research suggests that many people suffering from IBS can benefit from following a low FODMAP diet. A low FODMAP diet plan removes certain carbohydrate foods that can ferment in the GI tract and cause bloating, gas and other symptoms.