From the Guidelines
For managing Irritable Bowel Syndrome (IBS), the most effective approach is to follow a low-FODMAP diet, as it has been shown to significantly reduce global symptoms of IBS, including abdominal pain and bloating, as supported by recent studies 1.
Key Components of the Low-FODMAP Diet
- The diet consists of three phases: restriction, reintroduction, and personalization, with the restriction phase lasting no more than 4-6 weeks 1.
- During the restriction phase, high-FODMAP foods such as onions, garlic, wheat, certain fruits (apples, pears), dairy products, and legumes should be eliminated from the diet.
- Safe foods that are low in FODMAPs include rice, potatoes, carrots, cucumbers, grapes, oranges, lactose-free dairy, and lean proteins.
Additional Recommendations
- Soluble fiber supplements like psyllium (Metamucil) can help regulate bowel movements, starting with a low dose of 1 teaspoon daily and gradually increasing to 1 tablespoon 1.
- Staying well-hydrated with 8-10 glasses of water daily and eating smaller, more frequent meals can also help manage symptoms.
- Avoiding caffeine, alcohol, and fatty foods, which can worsen symptoms, is also recommended.
Importance of Professional Guidance
- A registered dietitian nutritionist (RDN) with gastrointestinal expertise can assist in implementing the low-FODMAP diet and optimizing outcomes, especially for patients who are motivated and willing to make dietary changes 1.
- Regular follow-up and monitoring are crucial to ensure the diet is effective and to make any necessary adjustments.
From the Research
Food for IBS
- The low FODMAP diet has been shown to be effective in managing irritable bowel syndrome (IBS) symptoms, with up to 86% of patients experiencing improvement in overall gastrointestinal symptoms 2.
- A systematic review and network meta-analysis found that a low FODMAP diet was superior to other interventions in improving global IBS symptoms, abdominal pain, and abdominal bloating or distension 3.
- The low FODMAP diet has been recommended as a first-line therapy for patients with IBS, with studies showing that it is easy to follow and effective in reducing symptoms 4.
- The diet consists of three stages: FODMAP restriction, FODMAP reintroduction, and FODMAP personalisation, which can be implemented with the help of a dietitian 5.
- Probiotics, such as Lactobacillus and Bifidobacterium, have also been shown to be effective in reducing IBS symptoms, and may be used in combination with a low FODMAP diet 6.
Key Components of the Low FODMAP Diet
- Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are restricted in the diet, with the goal of reducing symptoms such as abdominal pain, bloating, and diarrhea 2.
- The diet is typically implemented in three stages, with the first stage involving restriction of high FODMAP foods, followed by reintroduction of these foods to identify triggers, and finally personalisation of the diet to exclude individual triggers 5.
- A dietitian-led approach is recommended, with education and counselling provided to help patients understand and implement the diet effectively 4.
Efficacy of the Low FODMAP Diet
- Studies have consistently shown that the low FODMAP diet is effective in reducing IBS symptoms, with improvements seen in abdominal pain, bloating, and bowel habits 2, 3, 4.
- The diet has been shown to be effective in both short-term and long-term studies, with some studies suggesting that the benefits of the diet can be maintained even after reintroduction of FODMAPs 4.
- Network meta-analyses have found that the low FODMAP diet is superior to other interventions, including standard dietary advice and probiotics, in improving global IBS symptoms and individual symptoms such as abdominal pain and bloating 3, 6.