How to choose the best diet for IBS?

Is there a best diet for IBS? The answer is that it depends.

The actual cause of IBS, short for irritable bowel syndrome, is unknown. However, numerous factors have been associated with it, including food sensitivities, epigenetics, nutritional deficiencies, genetics and psychological stress. (1)

In my clinical experience, there is no single cause for a condition. It is always a blend of factors.

The food we eat can often be a common constituent of this blend, but deciding which foods are triggering your IBS symptoms can be confusing.

Read on to learn about the most clinically and scientifically valid diets for IBS and how to work out the best diet for you.

Diets for IBS

Various diets have been shown, either clinically or through scientific research, to help with IBS symptoms. This next section will briefly outline each diet, beginning with the simplest.

A Gluten Free Diet

Gluten is a protein found in the protective casing around all grains. The most well-known and most toxic glutens include:

• Wheat gluten.
• Barley gluten.
• Rye gluten.

Other less well-known but potentially harmful glutens are found in Spelt, Kamut, farro and durum.

If you suspect that gluten may be triggering your IBS symptoms, it is crucial that when following a gluten-free diet, you exclude all the above grains.

It is a well-known scientific fact that gluten is associated with IBS. (2) A gluten-free diet has also been shown to help with IBS symptoms. (3)

A Low FODMAP Diet

FODMAP is an acronym for a group of carbohydrates, which stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These carbohydrates are found in various foods and alcohols, including:

• Oligosaccharides –Fructans and galacto-oligosaccharides found in wheat, rye, barley, onions, leek, shallots, garlic, legumes, lentils, artichokes, and chicory.
• Disaccharides – Lactose found in dairy products.
• Monosaccharides – Fructose found in honey, mango, watermelon, apples, pears, and high fructose corn syrup.
• Polyols – Alcohols in Apples, pears, apricots, nectarines, plums, cauliflower, and products (e.g., gums & confectionery) sweetened with artificial sweeteners such as sorbitol known as polyols.

To download a more comprehensive list of FODMAP foods, please click here.

The low FODMAP diet has been shown to significantly help IBS symptoms in several high-level clinical trials. (4, 5)

FODMAPs are broken down by our friendly bacteria that usually reside in our large bowel.

In many people with IBS, these bacteria overgrow into the small intestine, known as small intestinal bacterial overgrowth or SIBO.

When the bacteria break down FODMAPs in the small intestine, they produce excess gases. These gases cause the symptoms of bloating and altered bowel function.

The diet is thought to help symptoms by starving the bacteria of FODMAPs.

It is important to see this diet as a short-term measure to get symptoms under control since there are concerns about the future health of the bacteria in the large bowel.

A Low Histamine Diet

Histamine is a compound your immune system produces when it encounters an allergen.

Histamine Intolerance occurs when there is an excess production of histamine. Histamine intolerance has been associated with the development and severity of IBS. (6)

Histamine is found naturally in various foods and food additives.

In my clinical experience, I have observed IBS symptoms improve when clients have followed a diet low in histamine foods. At present, there are no clinical trials to show that a low histamine diet helps with IBS.

A brief list of high histamine foods includes:

• Leftover meats and fish
• Processed or smoked meats
• Fermented foods such as sauerkraut and kefir
• Aged Cheeses and meats
• Tomatoes and Avocados

To download a more comprehensive list of high-histamine foods, please click here.

How to choose the best diet for IBS

If you suffer from IBS and are confused about which of the above diets to follow, I suggest taking a simple step-by-step approach.

Begin by going on a gluten-free diet for at least two weeks. If your symptoms totally disappear, you have your answer.

If your symptoms only partially improve, I suggest starting the low FODMAP and following that for another two weeks.

If your symptoms significantly improve, this strongly suggests that you may have SIBO. In such a case, I recommend that you seek out a health professional, such as a Functional Medicine Practitioner or Naturopathic Doctor, who has experience diagnosing and treating SIBO.

If your symptoms only partially improve, I suggest moving to a low histamine-free FODMAP diet for another two weeks. If your symptoms significantly improve, this also strongly indicates SIBO.

To download a more comprehensive list of Low FODMAP Histamine Diets, please click here.

If your symptoms do not improve on the Low FODMAP Histamine diet, I strongly recommend you go to your doctor and ask to be referred to a GI specialist for further investigation, including a colonoscopy.

Disclaimer

This article is not intended to provide medical advice, diagnosis or treatment.

Now I’d like to hear from you.

Do you suffer from IBS?

Have you been confused about what diet to try?

Do you have any other suggestions that have worked well for you? Let us know in the comments below.