Best and Worst Foods for IBS

dish of brocolli and chick peas

If you have irritable bowel syndrome (IBS), knowing what to eat can feel like the holy grail. For some patients, the right diet, along with attention to exercise, can control symptoms without medication.

For my patients, I often recommend a special diet of easily digestible food, called a low-FODMAP diet, which is detailed in this chart.

FODMAP stands for “fermentable oligo-, di-, and monosaccharides and polyols” – a mouthful to say, but in more common terms, FODMAPs are carbohydrates that may not be digested or absorbed well.  Undigested carbohydrates are then metabolized by intestinal bacterial to produce excess gas, which leads to abdominal pain, diarrhea and/or constipation.

What foods to limit (and good substitutes)

Here’s a breakdown of what foods to *limit* when you’re following a low-FODMAP diet, as well as some suggested substitutes:

  • Lactose is found in milk and other soft dairy products like cottage cheese, cream cheese, ice cream and sour cream. Anyone can handle a very small amount of lactose, but if you eat more than your intestine can handle, you will get gas and abdominal pain. About half the population is born with low levels of lactase, which metabolized dietary lactose.
    What to eat instead: Try lactose-free milk, oat milk, rice milk or soy milk as good alternatives to cow’s milk, as well as lactose-free yogurt. For cheese, try any of these three: hard cheeses, brie and camembert. Need butter? Go for olive oil instead.
  • Fruits contain the sugar fructose, which can cause issues for IBS sufferers. Fructose is particularly high in apples and pears, and somewhat high in watermelon, concentrated fruit, dried fruit and fruit juice. Fruits with lower levels of fructose include bananas, citrus, grapes and berries.
    What to eat instead: Eat fruits that are lower in fructose, such as banana, blueberry, boysenberry, cantaloupe, cranberry, grape, orange, lemon, lime, kiwi and strawberry.
  • Certain vegetables cause gas and abnormal bowel habits.  Avoid cruciferous vegetables such as broccoli, cauliflower, cabbage, coleslaw and sauerkraut. Also, limit artichoke, brussels sprouts, onions, shallots, leeks, and asparagus.
    What to eat instead: Vegetables that are good to eat include eggplant, green beans, celery, carrots, spinach, sweet potato, yam, zucchini, and squash. For more good options, see this chart. You can enhance flavors of these veggies with herbs. On the safe list, you’ll find: basil, chili, coriander, ginger, lemongrass, marjoram, mint, oregano, parsley, rosemary and thyme.
  • Legumes, or beans, are often called the “musical fruit” because they contain indigestible saccharides. Baked beans, chickpeas, lentils and soybeans have high amounts, and IBS patients should avoid them, or eat them in very small quantities.
    What to eat instead: While not exactly a substitute for beans, you can enjoy rice, oats, polenta, millet, quinoa and tapioca. Also, as long as you do not have Celiac disease, you can eat gluten on a low-FODMAP diet, which is an inaccuracy of the chart.
  • Polyols, sugar substitutes found in sugarless gum and candy, also can cause problems. Avoid them, including sorbitol, mannitol, isomalt, maltitol and xylitol.
    What to eat instead: It is perfectly fine to eat (in moderation, of course) good old-fashioned sugars; other artificial sweeteners that do not end in “ol,” such as NutriSweet®; Splenda®; and honey substitutes such as maple syrup, molasses and golden syrup.

The best treatment for IBS

Sometimes IBS is treated with medications, but a change in diet is the first thing we try. A healthy lifestyle — with a low-fat diet, exercise and avoidance of alcohol and cigarette smoking — often makes a great difference. For people who still need help, special diets, such as a low-FODMAP diet, can provide relief.

The good news is that a low-FODMAP diet is not a terribly restrictive diet. When you study the FODMAP chart, you will find there are plenty of good foods you can eat.

Your doctor may find that medication is also necessary to keep your symptoms at bay.  These therapies include anticholinergic medicines, which calm the spasms, and antidepressants to reduce stress.

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Bret Lashner, MD

Bret Lashner, MD, is a gastroenterologist, Director of the Center for Inflammatory Bowel Disease and a Professor of Medicine at Cleveland Clinic.
  • Bob

    Oats do not contain gluten.

    • Taylor

      Oats should not contain gluten, but most unfortunately do. This is caused by the vast majority of oats are grown near gluten containing plants or, thus contaminating oats. Most of us celiacs avoid oats for that matter and buy gluten-free oats (products like bob’s red mill are great)

      • Lance

        I think it has more to do with oats being processed in the same plant as wheat. Cross contamination.

      • Susan

        I have not had problems with Quaker Oats, so far. I was diagnosed with Celiac disease about six years ago.

        • Debra

          I was always informed by medical professionals that damage can be cumulative, so over time you may pay for any gluten ingested. I take no chances with oats and stick to GF even though they may cost a bit more.

  • Timea

    What if you have ZERO symptoms? What are the long term implications of a regular diet?

    • KatMo

      ^^^Untreated celiac disease can lead to dangerous complications including but not limited to: stomach cancer, bone density loss, diabetes, iron deficiency, malnutrition, the list goes on. :-(

  • Suzanne

    Cleveland Clinic … really?! There are a quite a few symptoms of celiac disease beyond those you list. Here’s a more complete symptomatic compendium for readers: http://www.gluten.net/docs/default-source/educational-bulletins/could-you-have-06-2011.pdf?sfvrsn=2 … … And do you not tell your patients about non-celiac gluten sensitivity, which — for some, especially if its effects are neurological — can be very serious if not treated with a GF diet? Further, although the numbers are far fewer than for celiac and non-celiac gluten intolerance, some people also have an out-and-out allergic response to gluten. The big picture of the many faces of gluten problems can be seen here: http://www.gluten.net/docs/default-source/educational-bulletins/allergies-and-intol-06-2011.pdf?sfvrsn=2 || It’s just that your article asks, should one “go gluten free?” yet you only provide one of the reasons some people might live healthier lives on a GF diet. Granted: there are many out there who go on a GF diet for no good reason at all, and have no reason to be on one, other than wanting to be trendy. But I think your article stops way short of why there are many who benefit from a gluten free life.

    • rich

      Thank you Suzanne for comment and additional info. Celiac Disease seems to be Diagnosed more and more. There are numerous GI diseases and disorders that are strictly related to diet. My big question is what is the rate of diagnosis in relation to the amount of GMO intake and production in the US. Is there and increase in Sx and Dx with the increase GMO’s in our foods? In my eyes it does not take a scientists to see what our diet is doing to us!!

  • Debra

    Cleveland Clinic saved my life when I was forced to change hospitals and they had to remove 60% of my small bowel. I had no particular symptoms until I unknowingly reached “critical mass.” At that point, I could not get off the pot or eat without losing most of it. Going gluten-free was my only choice, and 5 years later I am living proof of its benefits.

  • Lance

    I disagree with the part about “highly restrictive diet with no bread or pasta”. The gluten free breads and pasta are very good. In fact, I would say gf pasta is better than regular.

    • Debra

      I am sure the statement was in reference to regular breads and pastas made with wheat or other gluten-containing grains. No fair splitting hairs.

  • Ketty_Pearson

    Food is one important part of our life which we should be taking so that it would be more helpful and people are more interested for gluten free food. More people will definitely helpful but this is more helpful and more interested in the gluten food but sometimes it is important that gluten is not always important for the people.

    http://goarticles.com/article/Fish-Fertilizer-An-Important-Organic-Fertilizer/7699653/