IBS stands for irritable bowel syndrome. IBS is a chronic functional disorder of the gastrointestinal system characterized by stomach pain and changes in bowel habits. About 10-15% of adults experience IBS symptoms. The exact cause of IBS remains unknown, however the condition is often treatable with exercise and dietary changes.

To receive an IBS diagnosis, you must meet two criteria:

1. Your abdominal discomfort must occur at least once a week for three months
2. You must also experience at least two of the following conditions: discomfort caused by defecation, change in the frequency of defecation, change in the consistency of your stool

Common symptoms of IBS include:

• Abdominal cramping, bloating or pain related to a bowel movement
• Abdominal pain
• Constipation and/or diarrhea
• Gas/flatulence
• Changes in the frequency and appearance of bowel movements
• Mucus in the stool

One important step is learning which foods to avoid with IBS.

Understanding the Impact of Diet on IBS Symptoms

Consuming certain types of foods may intensify IBS symptoms. Because IBS is different for each person, medical experts cannot draw up universal lists of foods to eat and foods to avoid. That said, people with IBS can improve their quality of life by determining their food triggers and avoiding them.

Dieticians use the acronym FODMAP when they talk about “fermentable oligosaccharides, disaccharides, monosaccharides and polyols.” These are short-chain carbohydrates (sugars) that can be difficult to digest. High-FODMAP foods can worsen IBS symptoms, and doctors often recommend a FODMAP diet, or low-FODMAP diet, for IBS sufferers.

However, not all food triggers are related to FODMAPs. These are the most common foods that cause trouble for people with IBS:

Dairy products

Many people around the globe do not produce sufficient levels of lactase, an intestinal enzyme that is necessary for digesting lactose, which is a sugar found in most dairy products. Without this enzyme, lactose travels through the small intestine undigested and into the colon. Bacteria there interact with lactose, and even people without IBS can experience similar symptoms. Lactose-free milk is a good alternative, but the foods to avoid include:

• Milk
• Cheese
• Ice cream

High-FODMAP Foods

A diet high in FODMAPs, which are not easily absorbed in the bowels, can aggravate IBS symptoms in some individuals. High levels of FODMAPs can be found in a wide range of food types. Here are some examples:

• Onions
• Garlic
• Legumes
• Fruits with high levels of fructose, such as apples, pears, cherries, and watermelon
• Cruciferous vegetables, such as broccoli, cauliflower, cabbage, kale, and brussels sprouts

Fried Foods and Other Fatty Foods

Food that is high in fat can be hard to digest and may lead to IBS symptoms. Foods to avoid include:

• French fries
• Fried pastries
• Fried chicken

Gluten

Gluten is a type of grain found in grains such as wheat, rye, and barley. Gluten also is the key factor in celiac disease and gluten intolerance, which share symptoms with some types of IBS. Foods to avoid include:

• Bread
• Pizza
• Cereal
• Crackers
• Beer

Caffeine and Alcohol

Caffeine has a laxative impact on most individuals, but those with IBS often feel its effects more strongly. Alcohol, too, can cause IBS flare-ups because of the way it’s digested and because it can lead to dehydration.

• Coffee
• Tea
• Cola drinks
• Beer, which also may contain gluten
• Spirits

Other Foods to Avoid With IBS

People with IBS also may have trouble with processed foods, which tend to have high amounts of fat and sugar; hot, spicy foods; and artificial sweeteners, especially those with sugar alcohols, like sorbitol and xylitol.

Tips for Identifying Trigger Foods

One way to identify food triggers is to follow an elimination diet, which is a process for identifying which foods trigger your IBS symptoms. Dieticians may recommend different periods for these stages, but here is a general roadmap for a FODMAP diet:

• Stop eating high-FODMAP foods for two to six weeks.
• Reintroduce high-FODMAP foods one at a time — one every 3 to 7 days.
• Use a diary to record everything you eat and drink.
• Write down any symptoms you notice regarding each food.
• Eliminate all foods that worsen your IBS symptoms.

Creating a Personalized IBS Diet

Your health care providers can help you tailor a diet for IBS that works for you by following a few simple steps.

Alternative Food Options for IBS

As you remove certain foods and drinks that aggravate IBS symptoms from your diet, you will need to replace them with alternatives. These alternatives should come in the form of lean meats, eggs, seafood, nuts, seeds, and low-sugar fruits and vegetables. Some people who suffer from irritable bowel syndrome find relief by eating fermented foods. Yogurt, milk, bananas, rice, oats, and leafy greens are all good alternative food options.

Incorporating Fiber-Rich Foods

Make sure to add high-fiber items to your diet gradually so your body can adjust to the change. If you add too much fiber too quickly, this can worsen IBS symptoms. There are two kinds of fiber to consider. Soluble fiber is more prevalent in beans, fruits, and oat products. Insoluble fiber dominates in whole grain products and vegetables. Soluble fiber is recommended for people with IBS.

Hydration and IBS

Because of the high frequency of bowel movements associated with IBS, sufferers may need to drink higher amounts of water to avoid dehydration.

Dehydration will worsen your IBS symptoms, including cramps, stomach pains, and other abdominal discomfort. IBS sufferers are also likely to experience reduced pain tolerance if they become dehydrated.

Eating Right with IBS

Dietary changes can have a big impact on IBS, but doctors often use other therapies as well. The professionals at Florida Medical Clinic can help you find the right combination of dietary changes, medications and stress management techniques.

Our Gastroenterology Department treats patients with problems with the digestive tract, including the esophagus, stomach, small intestine, and colon. Schedule an appointment with Dr. Gandle right away if you’re interested in getting help for IBS. Through our electronic health records system, our gastroenterologists can instantly share test findings and treatment recommendations with your primary care doctors and other specialists to provide you with the best care possible.

Meet Dr. Cassandra Gandle

Dr. Cassandra Gandle earned a Bachelor of Science in Biology and a Bachelor of Arts in Art History in 2013 at Johns Hopkins University. She completed her medical school at Tulane University School of Medicine and completed residency and gastroenterology fellowship at the Baylor College of Medicine in Houston, Texas.

Dr. Gandle was born and raised in the Tampa area and returned to Florida to become a part of the Florida Medical Clinic’s Gastroenterology team, where she provides evidence-based care to each patient. Outside of her medical career, Dr. Gandle enjoys exercise and spending time with her husband and dog.