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Eating with Irritable Bowel Syndrome

Symptoms, Treatment, and Tips

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Imagine experiencing severe abdominal pain, along with alternating bouts of both constipation and diarrhea. Even worse, your doctor can find no physical explanation or effective treatment for you, despite these very real symptoms. Unfortunately, this is a very real scenario for people with Irritable Bowel Syndrome (IBS).

Symptoms & Diagnosis
Common symptoms of IBS include abdominal pain, feeling bloated, flatulence or gas, diarrhea and/or constipation, and mucus in the stool.

When you have IBS, diagnostic tests typically reveal no physical abnormalities in the colon that might explain your symptoms. So, IBS is usually diagnosed by a process of elimination. A diagnosis is made after symptoms have been continuous or recurrent for at least 3 months and other diseases (such as Crohn’s disease and ulcerative colitis) have been ruled out.

Treatment
When managing IBS, experts have seen much greater treatment success when the "team approach", which includes a physician, dietitian, and psychiatrist/psychologist, is implemented.

Because food, eating, and cooking habits can be very complex, SparkPeople strongly suggests that you see a qualified dietitian for both nutrition and diet therapy. Making different food choices and changing eating habits can help with symptom relief, but it's important to determine what works for each individual.

Therefore, keeping a diary is vital. Use it to record when symptoms occur, what you ate around the time of the occurrence, as well as activities and emotional feelings. This diary will help everyone—you, the dietitian, and other health professionals together—to both identify specific concerns and also to develop an appropriate plan.

General Eating Tips
  • Consume meals and snacks on a regular, consistent schedule. Avoid skipping meals. Try 5-6 smaller meals daily. The stomach is more sensitive when it is empty.
  • Chew thoroughly and eat at a leisurely pace. If you must eat in a hurry, serve yourself half portions.
  • Avoid swallowing excess air because this may trigger symptoms. Sip—don't gulp—your beverages, don't drink through a straw, don't talk while chewing, and eat with your mouth closed.
  • Drink 8 cups of water daily.
  • Ask your physician if she recommends taking Metamucil or Citrucel daily. Do NOT use the sugar free varieties, which may contain ingredients (artificial sweeteners, sugar alcohols, etc.) that aggravate IBS symptoms.
  • Carry Fibercon capsules when you have to unexpectedly wait too long between meals or wait at a restaurant.
  • Peppermint may help to relieve spasms. Try Altoids, hot mint tea, or peppermint oil capsules.
Tips for Eating Fiber
  • Slowly increase fiber in your diet to 25-35 grams per day. Include a variety of grains such as wheat, rye, barley, oat, farro, kamut, couscous, soy, and quinoa.  To learn more, read Figuring Out the Facts on Fiber.
  • Always eat soluble fiber first, whenever your stomach is empty. Make soluble fiber foods the largest component of every meal and snack. Foods rich in soluble fiber include: oatmeal, pasta, rice, potatoes, French bread, sourdough bread, soy products, barley, and oat bran. Nuts, beans, and lentils are also a good source of soluble fiber. However, nuts also include fat and lentils also contain some insoluble fiber.
  • Never eat insoluble fiber on an empty stomach, in large quantities at one sitting, or without soluble fiber. Foods rich in insoluble fiber include: wheat bran, whole grain products, and whole wheat products.
  • Limit fat intake to 25% of your total daily calories. Never eat high-fat foods on an empty stomach or without soluble fiber.

Possible Trigger Foods
The following foods are sometimes bothersome to those with IBS. It is a good idea to monitor your tolerance for these foods (not to eliminate all of the foods listed). You may want to pick one food below that you eat frequently, remove it from your menu for 2 weeks and see if there is a difference in symptoms. Then reintroduce the food and see what happens. You should experiment with only one food at a time and in small portion sizes.
  • Legumes, lentils and beans, such as kidney, lima, navy, pinto, black, chickpeas, mung, and garbanzo.
  • Caffeine found in coffee, tea, carbonated beverages
  • Herbs such as guarana, mate, and kola nut
  • Carbonated beverages
  • Alcohol
  • Melons
  • Broccoli, cauliflower, cabbage, Brussels sprouts, kohlrabi, and other gas-producing vegetables in the cabbage family
  • Other gas producing foods such as beets, corn, cucumbers, leeks, and onions
  • Sugar alcohols such as sorbitol, mannitol, xylitol, which are found in sugar-free gums, candies, mints, and jams, as well as some liquid medications
  • High-fat or fried foods, such as fried meat, fried potatoes, fried vegetables, doughnuts, pastries, cream sauces, and oily sauces
  • Lactose, found in dairy products. Read more about Lactose Intolerance and a Healthy Diet.
  • Cereals such as bran, wheat, oat, and cornmeal
Other Healthy Habits
  • Try to find a treatment option that includes the team approach of a physician, dietitian and psychiatrist/psychologist.
  • Try to get 30-60 minutes of moderate exercise each day.
  • Introduce a daily practice of yoga, meditation, or Tai Chi to significantly reduce stress-related attacks.
  • Make sleep a priority. Sleep loss decreases you ability to handle stress and can make you more susceptible to attacks.
  • Do not smoke.
  • Make sure dentures fit properly.

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Member Comments

  • I wish they would have the FODMAPS foods listed in the article. The foods listed that are high in fiber tend to make IBS symptoms flare up. Wheat, barley, rye, some oats, spelt, etc, all flare IBS symptoms.
  • Wow. So I'm now gonna have to revamp what I eat again. Thanks for info.
  • I too have IBS, I have primarily been using fitness, diet, and nutrition to help reduce/eliminate symptoms for almost eight years. Tracking foods has helped immensely in understanding triggers, and working with a dietician has been a pivotal piece in bringing relief. My doctor has me taking gasX on days when I am really uncomfortable, and I too have found that sugar alcohols and artificial sweeteners are huge culprits. Best of luck to all who suffer from IBS, may you find what brings relief and works for you.
  • Most of the time IBS is related to "bad" bacteria in the gut, leading to SIBO, Candida, or both. Those can lead to Leaky Gut. So recommending refined starches (such as pasta and bread) is not a good thing, as it feeds the bacteria. As some mentioned, Paleo or Autoimmune Paleo options, as well as other FODMAPS or SCD type diet changes helps immensely!
  • I've been dealing with IBS-D for about 6 years now. Went to every possible doctor, tried elimination diets (FODMAP elimination kind of helped, but not enough improvement given how impossible it is to follow that regiment), and nothing was working. Then I started eating a paleo diet, getting more exercise, and limiting my meal portions (and snaking a bit throughout the day). I would say my symptoms are 95% gone and results were more or less immediate. It might be a fad, but the paleo lifestyle is working for me!
  • Funny, grains and dairy should have been first on the list to avoid.
  • FOXGLOVE999
    Pretty much, high fiber is my main problem, especially whole grains and raw vegetables. The whole grains are relatively easy to avoid, except my occasional popcorn. Raw vegetables has proven to be more difficult for me, I eat some, but I try to cook most of my vegetables. And they have to be very cooked, no crisp/tender for me.
  • I suffered with IBS (dumping syndrome) for over 12 years. I was afraid to eat anything anywhere but home. Then about 4 years ago, I broke my big toe and when it wasn't healing the way it should, the doctor told me to take a high dose of calcium. It wasn't long before I realized that the IBS episodes were decreasing but I didn't make the connection until one of the women in my knitting group complained about not being able to take calcium as it caused constipation. Bingo!! I take 1000 mg of calcium every morning and while I still have an occasional session they are rare.
  • COOPERREID
    Thanks for the information it was helpful.
  • LOVE2000AMGLAM
    My number one trigger by far is stress.
    I tried cutting out various veggies, but one long weekend when I was by myself I just couldn't resist them any more. I ate many of the things I was avoiding, and then nothing happened. I figured it was because I could actually relax and not worry about work stuff. After that I just ate whatever veggies I wanted and worked on reducing stress instead.
  • Had a very serious case of diverticulitis which cost me 2-4 feet of my lower intestine. I can't eat too much fiber (even though diets want you to). Most of what you're supposed to eat i don't like. I have cut down on the amount of meat eaten, eat less dairy and eat few veggies/fruit. Am finding losing weight virtually impossible. Ideas anyone?
  • Too much fiber is a trigger for me. I started a new diet that calls for a lot more fruit/veg. All of a sudden, my IBS is back. Mine goes back and forth between the D & C symptoms. I try to up my yogurt intake and limit fiber when I am having a flare up.
  • Thanks for good info about IBS. Just got diagnosed with diverticulosis after a cat scan.Have had intermittent IBS for over 30 yrs. I'm pretty much sensitive to everything right now. Hard to exercise because of pain but I keep trying! I keep eating less but crave soft carbs because my brain thinks they won't hurt in the digestion process. My blood sugars don' t like this. This is like a bad chemistry experiment! I was better at Biology!
  • I don't have IBS but I know that if I eat anything with artificial sweeteners, I have terrible tummy problems. I have learned to read labels carefully because that stuff (especially Sucralose) can be lurking in the most unexpected places.
  • also, I have found that eating 2 tablespoons of coconut each day helps control some of the gas that I deal with after every meal. coconut macaroons would work, but coconut milk does not. so I add coconut to my mix of banana and oranges.

About The Author

Becky Hand Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. A certified health coach through the Cooper Institute with a master's degree in health education, she makes nutrition principles practical, easy-to-apply and fun. See all of Becky's articles.

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