Finding the Right Diet for IBS
Expert Patsy Catsos, MS, RD, answers questions about eating for IBS.
What's the best diet approach if you suspect you have IBS?
Eating smaller, more frequent meals spread throughout the day instead of
larger meals can lead to less discomfort for some people. What is really
important is to identify the foods that are causing the symptoms.
For individuals with diarrhea, gas, or bloating, or if a high-fiber diet
fails, I suggest a two-week trial FODMAPS elimination diet. (FODMAPS stands for
fermentable oligo-, di-, and monosaccharides and polyols.)
What is the FODMAPS approach?
You'll work with your physician and registered dietitian to eliminate all
foods that contain the five forms of carbohydrates (lactose, fructose,
fructans, sugar alcohols, and galactans) for a trial period of 1-2 weeks.
If FODMAPS carbs are causing the symptoms, relief can occur in just a few
You follow the elimination period with a challenge of reintroducing one of
the FODMAP carbs and observe symptoms. Additional FODMAP carbs are slowly added
back, one at a time. At the end of the reintroduction phase, a final diet
emerges with only those FODMAP carbs that are fairly well
The goal is to find the most liberal and varied diet possible that still
keeps symptoms under control. Most people find they can still include their
favorite foods if they exercise
care. For example, a person who discovers that fructans (found in wheat) cause
a lot of distress might find they can’t tolerate wheat at every meal, but may
be able to tolerate one portion of wheat without a problem.
Is the FODMAPS approach accepted in the medical community?
Health care providers have known for years about the GI impact of select
FODMAPS, such as lactose and sugar alcohols. Fructose and galactan intolerance
are a bit newer. Although it is very well accepted and widely practiced in
Australia, it is a new idea for most health care providers in the U.S.
The FODMAPS approach is unique because it views all of these carbohydrates
as one big system, looking at the forest instead of the trees. Some providers
are concerned that the FODMAPS is too complicated, but many patients are very
motivated and willing to do anything to feel better.
Is a gluten-free diet a good option for IBS sufferers?
Gluten-free diets are very popular right now
for a wide variety of conditions. When you eliminate gluten, you also eliminate
wheat products that contain fructans, one of the FODMAPS carbohydrates.
Why are some carbohydrates more problematic than others?
Eating certain carbohydrates can cause gas, bloating, and watery diarrhea
for some IBS sufferers. Lactose, or milk sugar, is one example many people are
familiar with. If your bowel has difficulty tolerating lactose, when you eat it
-- especially in high doses or when you eat it alone -- bacteria in the large
intestine ferment it, and it can result in gas and painful bloating as well as