From the Guidelines
The most common foods that trigger IBS symptoms are high-FODMAP foods, including wheat, rye, onions, garlic, certain fruits, dairy products, legumes, and artificial sweeteners, and patients may benefit from a low-FODMAP diet under the guidance of a registered dietitian. According to the most recent and highest quality study 1, a low FODMAP diet is the most convincing evidence-based dietary treatment for IBS, involving three phases: FODMAP restriction, reintroduction, and personalization. This approach can help identify personal triggers and improve symptoms.
Some key points to consider when implementing a low-FODMAP diet include:
- Restricting FODMAPs for 4-8 weeks, followed by reintroduction and personalization phases
- Working with a registered dietitian to ensure nutritional needs are met and to guide the elimination and reintroduction process
- Keeping a detailed food and symptom diary to identify personal patterns and triggers
- Being aware of the potential impact on the microbiome and diet quality, and taking steps to mitigate these effects
It's also important to note that a low FODMAP diet may not be suitable for individuals with moderate to severe symptoms of anxiety or depression, and a gentle FODMAP diet or other approaches may be more appropriate in these cases 1. Additionally, other foods that can worsen IBS symptoms include caffeine, alcohol, fatty or fried foods, and spicy dishes, and patients may need to limit or avoid these foods as part of their individualized treatment plan.
From the Research
Common Food Triggers for IBS
The following foods are known to trigger Irritable Bowel Syndrome (IBS) symptoms:
- Foods high in FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, And Polyols) 2, 3
- Lactose-containing products, as some individuals with IBS may experience lactose intolerance 2
- Foods that can cause colonic gas production, potentially inducing pain signaling in the brain 2
Dietary Management of IBS
Dietary modifications are often used as a first-line therapy for managing IBS symptoms:
- A low FODMAP diet has been shown to be effective in reducing global symptoms in IBS patients in the short term 2
- Restricting FODMAPs, followed by reintroduction and personalization, can lead to long-term symptom relief for at least 50% of individuals with IBS 2
- Working with a skilled nutritionist can help ensure nutritional adequacy and compliance with a low FODMAP diet 3
Other Interventions for IBS Management
In addition to dietary modifications, other interventions may be considered for managing IBS symptoms:
- Probiotics have demonstrated efficacy and safety in patients with IBS, although more research is needed to determine the most effective strains and dosing regimens 4
- Psychological therapies, such as cognitive behavioral therapy and hypnotherapy, may also improve IBS symptoms 4
- Pharmacological interventions, including rifaximin, eluxadoline, and alosetron, have been approved for the management of IBS with diarrhea (IBS-D) 4, 5, 6