Foods to Avoid with IBS: Does a Low-FODMAP Diet Work?
- Foods to avoid with IBS include those containing FODMAPs for many people.
- A low-FODMAP diet can reduce bloating, pain, gas, and diarrhea.
- A low-FODMAP diet can be healthy when done with nutritionist supervision.
- Many foods contain FODMAPs, but there are healthy substitutes for foods to avoid with IBS.
- Studies have found the low-FODMAP diet to be superior to others for treating irritable bowel syndrome.
- Other complementary and alternative therapies may help to relieve symptoms of IBS, particularly when combined with the low-FODMAP diet.
- Bright Belly can help you find a licensed nutritionist or dietitian to guide you through the complexities of a low-FODMAP diet.
Eleven percent of people worldwide are affected by irritable bowel syndrome (IBS). A low-FODMAP diet (LFD) is helpful for most people who have IBS. A dietitian or nutritionist can teach you about foods to avoid with IBS and guide you through this complex dietary approach.
What are FODMAPs?
FODMAPs is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. They are naturally occurring carbohydrates that can increase irritable bowel symptoms.
People who have IBS don’t digest FODMAPs efficiently. If you are sensitive to FODMAPs, you may experience increased pain, bloating, gas, and diarrhea when you eat foods that contain them.
While FODMAPs are classified as simple sugars, foods don’t have to taste sweet to contain FODMAPs. Many healthy plant and dairy foods contain FODMAPs, and processed foods may have hidden FODMAPs.
Why are FODMAPs foods to avoid with IBS?
The intestines contain enzymes that help break down carbohydrates into forms the body can use. The enzymes of people with IBS don’t work as efficiently as they do in people who don’t have IBS.
Here’s what happens when these enzymes don’t work correctly:
- Excess water is drawn into the bowel, increasing the risk of loose stools.
- The body produces more fatty acids than it needs, resulting in inflammation and pain in the digestive tract.
- Carbohydrates don’t get used properly and end up in the large intestine, where they ferment and produce gas.
Individuals who have IBS may develop symptoms within hours or days of eating foods high in FODMAPs.
What does the research say?
Multiple studies have shown that a low-FODMAP diet is an effective treatment for IBS. In a 2020 review, researchers reviewed 10 studies of other nutritional approaches, including generalized healthy eating, Mediterranean and gluten-free diets, and a sham diet.
The study authors also evaluated the effect of probiotics and compared outcomes with the results of the low-FODMAP diet. They concluded that the low-FODMAP diet is superior to the other nutritional approaches studied for treating IBS.
How to begin a low-FODMAP diet
Reducing FODMAPs can be challenging, especially if you eat a plant-based diet. Many foods high in FODMAPs come from plants and dairy foods. Fortunately, there are substitutes for each of the high-FODMAP food categories, which can make it easier to eat a healthy low-FODMAP diet.
Experts recommend eliminating foods that are high in FODMAPs for four to eight weeks. Foods that contain FODMAPs are then reintroduced one by one over six to 12 weeks. Work with a nutritionist or dietitian to ensure a safe, seamless process. Keep a diary of the foods you eat and any symptoms you experience.
Use the following chart as a general guideline when selecting foods. Avoid foods in the red column, as they’re high in FODMAPs. Foods in the green column are better, low-FODMAP choices.
| FOOD TYPE | AVOID High FODMAP foods | ENJOY Low FODMAP foods |
| Fruit | apples, cherries, pears, peaches, watermelon | berries, bananas, cantaloupe, citrus |
| Vegetables | garlic, broccoli, beets, mushrooms, onions, Brussels sprouts, cauliflower | lettuce, carrots, cucumbers, potatoes, peppers, eggplant, sweet potatoes, summer squash |
| Legumes and proteins | lentils, dried beans, chickpeas | tofu, eggs, meat, poultry, seafood |
| Grains | barley, wheat, rye | corn, oats, rice |
| Nuts and seeds | almonds, cashews, pistachios | quinoa, peanuts, pumpkin seeds, walnuts |
| Dairy | milk, soft cheeses, ice cream | hard cheeses, lactose-free milk, almond milk, rice milk |
| Sweeteners | honey, agave, corn syrup, xylitol, sorbitol | Stevia, aspartame, saccharine |
Work with a dietitian or nutritionist for IBS
It is vital that you work with a dietitian or nutritionist for IBS because the low-FODMAP diet is not just an eating plan; it’s a two-stage plan that also works as a diagnostic tool. What’s more, the low-FODMAP diet is a restrictive eating plan. Restrictive diets always carry risk for nutritional deficiencies and potential eating disorders.
A dietitian or nutritionist will provide:
- Professional evaluation. Nutritionists and dietitians monitor the impact of the diet on your overall health. They make sure that you’re eating a well-balanced diet.
- Personalized guidance. A dietitian or nutritionist can recognize links between your intake and symptoms. Identifying patterns will help you identify problem foods faster and allow you to eat a broader array of foods.
- Coaching. Many people find it hard to stick with a low-FODMAP diet. A nutritionist or dietitian will encourage you to stay on track.
- Ideas to make the diet user-friendly. Implementing a low-FODMAP diet is complex and can be expensive. A nutritionist or dietitian can offer simple meal ideas and help you select foods that will help you stay within your budget.
- Other tips for managing IBS. A dietitian or nutritionist can offer solutions for coping with changes in fiber intake. They can also provide you with accurate information about nutritional supplements.
Other integrative, alternative and complementary therapies for IBS
IBS is a challenging condition. Many people find they need a combination of treatments to manage their symptoms and improve their quality of life.
Here are a few complementary therapies that may work well when combined with a low-FODMAP diet:
Hypnotherapy
The low-FODMAP diet reduced gastrointestinal symptoms and anxiety and depression within six weeks in 71% of patients in a 2020 study. The same study found that hypnotherapy offers similar results.
Both therapies provide long-term relief for people who have IBS. Studies suggest that while each treatment is successful, combining them may not offer additional benefits. However, more research is needed to determine this conclusively, so hypnotherapy combined with the low-FODMAP diet may be worth a try for people who haven’t found relief with either therapy alone.
Yoga
Yoga is a safe complementary therapy for IBS. Yoga helps to reduce irritable bowel symptoms and decrease anxiety. It also enhances sleep and quality of life. Again, more studies are needed to determine its effectiveness when combined with the low-FODMAP diet, but for most people, yoga is low risk, and it may provide added symptom relief.
Counseling and lifestyle changes
Several people who have IBS anecdotally report that their symptoms flare when they have periods of high stress. Others note that alcohol and smoking exacerbate their symptoms. It makes sense that any therapies such as counseling, cutting down on alcohol, and quitting smoking would be healthy adjuncts to the low-FODMAP diet.
The low-FODMAP diet is effective for IBS
A low-FODMAP diet is an excellent approach for treating IBS, and many people find that combining the low-FODMAP diet with other complementary and alternative therapies can be helpful.
Because of the complexity of the low-FODMAP diet, however, it’s essential that you approach it with the help of a nutritionist or dietitian. To learn more about nutrition for IBS and other alternative and complementary therapies, follow our blog.
To find a nutritional therapist or dietitian near you, visit our provider directory.
