Finding the Right Diet for IBS
Expert Patsy Catsos, MS, RD, answers questions about eating for IBS.
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 excess flatulence.
Can probiotics or digestive enzymes help reduce symptoms?
The use of probiotic supplements may help reduce symptoms in the long run, but I would encourage using a FODMAPS approach before introducing probiotics into the diet.
Lactase is the name of the enzyme that breaks lactose (milk sugar) down to simpler sugars during digestion. Using milk products that have been pre-treated with this enzyme, or taking an enzyme, are good strategies for reducing symptoms. Naturally fermented foods, such as yogurt and kefir and hard cheeses, contain less lactose than milk and may be better tolerated.
In a nutshell, what are recommended foods for IBS sufferers?
Use lactose-free or reduced-lactose dairy products; small servings of berries and citrus fruits; potatoes, rice, oats and corn products; lean meats, fish and poultry; salad vegetables; and plant-based oils. When it comes to sweeteners, small servings of granulated sugar and maple syrup are usually well-tolerated.
Keep your diet as varied and colorful as you can tolerate. Remember, you can probably tolerate small servings of your favorite high-FODMAPS foods. Even if a whole bowl of grandma’s baked beans is out of the question, a little bite won’t hurt you.