Eating with Irritable Bowel Syndrome

Symptoms, Treatment, and Tips

-- By Becky Hand, Licensed & Registered Dietitian

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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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About The Author

Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. Through her company, An Ounce of Prevention, she makes nutrition principles practical, easy to apply and fun. See all of Becky's articles.

Member Comments

MARMAERT

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. - 4/13/2013 4:06:06 PM
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MARMAERT

my trigger seems to be fatty meats. 80% ground beef, fried foods, and greasy burgers are the biggest culprits. also basil and fancy pepper blends. so I am careful about not eating ground beef but ground chicken or turkey instead, and avoid heavily peppered steaks and mostly stay with chicken and fish. - 4/13/2013 4:04:24 PM
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MIAJOEB

I found a major component in my IBS was eliminating the calcium pills that I had been taking for so many years... I had a bone scan and it was normal so I eliminated the extra calcium over and above what was in my vitamin pills and my food intake.
All of a sudden my constipation was normalized!!! I am still taking konjac root before each meal to supplement fiber. But life is so much better. - 3/30/2013 2:24:14 PM
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ARIES-SC

I found that taking natural Apple Pectin 2 capsules in the morning and 2 capsules in the evening did the trick for my IBS. I tried everything and nothing else worked. I recommend eating turnip greens (better than spinach) and sweeet potatoes for softer output on a regular basis and drink lots of water (at least 64 oz/day). - 9/11/2012 9:31:31 PM
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GRACEMCDOG

Most people who eliminate wheat from their diets find almost immediate and permanent relief. - 4/10/2012 8:50:44 PM
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MIKAELATEACH

VIEVIE63 Be careful with diet foods. They tend to contain artificial sugars which can lead to IBS issues as well as pudding may contain dairy...another trigger for some people. I find that I can't eat ANY diet foods as they all contain artificial sugar which messes me up big time! - 2/7/2012 6:20:32 PM
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JENG829

So true, that what works for one does not work for all. tracking your food is such a help to find your own personal triggers.

After a lot of experimentation and tracking, I found that wheat is the primary cause of my IBS. Other trigger foods for me are skim milk, some corn products, and sometimes brown rice. Luckily no issues with meat or fat for me, as being vegetarian does not agree with me.

I followed similar dietary recommendations That are in this article for many years with no relief... Made it worse for me (especially fiber & whole wheat/grains). It wasn't until I paid attention and really noticed what was happening in my body that I finally kicked this IBS thing! Hope you all can do the same! - 9/28/2011 3:56:10 PM
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PEGGIE57

I've had IBS for 30 years. What works one year may not work another. From 2005-2006, I lost 60 pounds from the big D & IBS. - 5/25/2011 12:40:18 AM
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VIEVIE63

how do i continue to write down all that i eat in the trackers it will alway's tell me that i do not have enough bread or proteins is there a place where i can still write it down and still be within the bread and protein ounces. - 3/17/2011 4:38:19 PM
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VIEVIE63

i just found out that i have ibs and it has been induced from med's and alot of other illnesses now i am having a bit of a hard time with this because i can not eat raw or medium cooked vegetables they give me too much pain, so now i am at a lost as to what i can and can not eat.
i have the same taboo foods as everyone else plus the vege's i am now retreating to eating diet cookies or diet poudding and the such but these things sort of roll around in my mouth . i want to lose the weight but not if i have to not eat at all HELP! - 3/17/2011 4:35:08 PM
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STAREYEZ

I have had IBS for 12 years. After consulting multiple doctors and keeping a food diary my IBS was the same. A friend sent me an article on IBS and being vegan and how it could help. I thought, why not, nothing else has worked! Almost 1 year later and I feel so much better! You are what you eat, and meat and dairy is so full of antibiotics, fillers and items that people with sensitive stomachs shouldn't be eating.
Just my experience. - 2/20/2011 1:47:18 PM
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60SIXTY

Also, be aware that some medications can contribute to IBS for some people. Ask your pharmacist for a list and suggested alternatives to take to your M.D.
Excellent article, Becky. - 8/13/2009 4:32:20 PM
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JIBBIE49

Thanks for this article. I've been reading a lot about LEAKY GUT SYNDROME, so this was of interest to me. - 7/24/2008 12:34:01 AM
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