What is IBS?
Irritable bowel syndrome (IBS) is a group of symptoms that occur together: repeated pain in your belly and changes in your bowel habits, which may be diarrhea, constipation or both. There is no visible damage or sign of disease in the digestive tract.[1]
IBS is a functional disorder of the digestive system. Today it is counted among the “disorders of gut-brain interaction”, which cover problems with how the brain and the gut work together. It is up to twice as common in women as in men and is more common in people younger than 50.[1]
What should you watch for?
These symptoms may point to a health problem other than IBS. During diagnosis, your doctor will also ask whether anyone in your family has had digestive diseases such as celiac disease, colon cancer or inflammatory bowel disease.[3]
How does the low FODMAP diet work?
FODMAPs are fermentable sugars and carbohydrates that are hard to digest and can trigger IBS symptoms. On a low FODMAP diet, these foods are cut back or removed for a while.[2]
- Step 1, restriction: High FODMAP foods are swapped for low FODMAP options. This phase lasts 2–6 weeks.[5]
- Step 2, reintroduction: FODMAP groups are added back one at a time, in trials that last three days, and your symptoms are recorded. This shows which groups you tolerate and which ones trigger symptoms.[5]
- Step 3, personalization: Foods you tolerate well come back into your diet, only the ones that cause symptoms are limited, and a long-term eating pattern tailored to you is set up.[5]
If your symptoms don't improve during the restriction phase, other treatment options may be needed. Some people can eat certain foods that contain FODMAPs without having symptoms.[2, 5]
- Vegetables
- High FODMAP: artichoke, asparagus, garlic, peas, leeks, mushrooms, onions, red bell pepper
- Low FODMAP: eggplant, green beans, bok choy, green bell pepper, carrots, cucumber, lettuce, potatoes
- Fruits
- High FODMAP: apples, apple juice, cherries, dried fruit, mango, nectarines, peaches, pears, plums, watermelon
- Low FODMAP: cantaloupe, kiwi, mandarins, oranges, pineapple, blueberries
- Dairy
- High FODMAP: cow's milk, yogurt, ice cream, custard, sweetened condensed milk, soy milk made from whole soybeans
- Low FODMAP: lactose-free milk, almond milk, hard cheeses, feta, brie and camembert, soy milk made from soy protein
- Protein
- High FODMAP: most legumes, some marinated meats, poultry and seafood, some processed meats
- Low FODMAP: eggs, firm tofu, tempeh, plainly cooked meats, poultry and seafood
- Bread and grains
- High FODMAP: breads, breakfast cereals, cookies and snack products made from wheat, rye and barley
- Low FODMAP: oats, quinoa flakes, quinoa, rice or corn pasta, plain rice cakes, sourdough spelt bread, breads made without wheat, rye and barley
- Sweeteners
- High FODMAP: honey, high-fructose corn syrup, sugar-free candy
- Low FODMAP: table sugar, maple syrup, rice syrup, dark chocolate
- Nuts and seeds
- High FODMAP: cashews, pistachios
- Low FODMAP: walnuts, peanuts, macadamias, pumpkin seeds
Monash University stresses that you need to talk to a dietitian before starting the FODMAP diet, and that the diet should be followed with the support of a dietitian experienced in IBS and FODMAPs.[5, 6]
Fiber can help with constipation in IBS by making stool softer. But adding a lot of fiber at once can cause gas and trigger symptoms; adding fiber slowly, by 2–3 grams a day, may help prevent gas and bloating. Research suggests that soluble fiber is more helpful for IBS symptoms.[2]
How we work together in counseling
First, we look together at your eating pattern, your symptoms and any test results you have. The IBS diagnosis and treatment plan are your doctor's; our nutrition plan is built as one part that supports that treatment.
We work from a functional medicine perspective, and our priority is supporting your gut health. If it is a good fit for you, we plan the low FODMAP diet together through its restriction, reintroduction and personalization steps and carry out the process with professional follow-up. Our aim is to set up an eating pattern built from foods that agree with you, one that can become part of your lifestyle. We can meet face to face in Çiğli or online.
Common questions
- Is the low FODMAP diet for life?
- No. The restriction phase lasts 2–6 weeks. After that, foods are added back one at a time and you move to a personal eating pattern where only the foods that cause symptoms are limited.[5]
- Can I start the low FODMAP diet on my own?
- Monash University recommends talking to a dietitian before starting the diet and following it with the support of a dietitian experienced in this area. Your doctor may also suggest that you see a dietitian about changes to your diet.[2, 5, 6]
- Is fiber good for IBS?
- Fiber can help with constipation, but increasing it a lot at once can cause gas and bloating. Increasing fiber slowly is recommended; soluble fiber seems to be more helpful for IBS symptoms.[2]
Something on your mind?
This page is general information; it does not diagnose and does not replace your doctor's advice. Let's talk about a plan made for you.
Sources
- 1.National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Definition & Facts for Irritable Bowel Syndrome. www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts
- 2.NIDDK. Eating, Diet, & Nutrition for Irritable Bowel Syndrome. www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/eating-diet-nutrition
- 3.NIDDK. Diagnosis of Irritable Bowel Syndrome. www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/diagnosis
- 4.NHS. Symptoms of IBS (irritable bowel syndrome). www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/
- 5.Monash University. Starting the Low FODMAP Diet. www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/
- 6.Monash University. High and low FODMAP foods. www.monashfodmap.com/about-fodmap-and-ibs/high-and-low-fodmap-foods/