Nutritionist for IBS: The Best Way to Make Dietary Changes

A nutritionist for IBS may be the best tool you can use to improve your health if you have irritable bowel syndrome. Here’s what you should know about IBS, diet, and how nutritional therapy for IBS can help you manage symptoms. 

How much does diet impact irritable bowel syndrome?

Unsurprisingly for something that involves the gut, what you eat directly affects your symptoms. Yet, how it does that is an open question.

Because IBS is a functional disorder, meaning there’s no known biochemical cause or defect in the gut that explains it, the right treatment approach for one individual may not help another. For some people, changing their diet is the primary way they manage their IBS, while for others, it may only offer limited relief. 

That said, the secondary impact of diet is worth considering. Diets low in fat and high in soluble fiber, fresh vegetables, and lean proteins are positive for your health overall. 

One important caveat, however, is that eating for irritable bowel syndrome is not the same as eating to lose weight. There’s little correlation between IBS and weight. There is some evidence that careful weight intervention in very obese people can help with IBS, but in general, a diet designed for weight loss may not be the best one for IBS.

What are the best dietary changes for IBS?

Regardless of your diet and type of IBS, there are a few dietary changes that consistently help and that your nutritionist may recommend. When eating for IBS, however, it’s important to keep in mind that identifying the foods that trigger your attacks can take a lot of trial and error. 

• Reducing caffeine intake: Regardless of your type of IBS, caffeine can irritate even the healthiest gut. Nutritionists will likely recommend trimming back caffeine, such as drinking tea instead of coffee and drinking no more than three cups per day. 
• Limiting alcohol consumption: There’s evidence that some patterns of drinking can aggravate IBS symptoms, so you may need to limit yourself to a glass of wine with dinner.
• Avoid carbonated drinks. The carbonation in soda and carbonated water can cause gas and bloating. 
• Eating less fat: While the exact relation between types of fats and IBS is still being studied, people living with IBS tend to report more gas and abdominal pain when eating fatty, heavy meals. This could be due to a feeling of fullness after a fatty meal as much as a reaction to the food itself, but either way, expect to eat lighter.
• Eating more soluble fiber: Soluble fiber, either added through diet changes or taken in supplement form, has been shown in a systematic review to help IBS, regardless of type. 
• Avoiding certain types of spicy food: While you won’t need to eat a bland diet, you’ll probably have to set aside foods that contain capsaicin, for example. This oily substance gives hot peppers their fire, and it’s bad for your gut. One study found it caused pain up and down the GI tract. 
• Limiting processed food: While the connection isn’t considered concrete, processed foods can be a source of gastric issues. Phasing them out may pay dividends.
• Eating smaller, more frequent meals. Instead of eating two or three large meals a day, try eating smaller meals five or six times a day.
• Sticking to a meal schedule: A regular meal routine at the same time every day will help you track what you’re eating. It also ensures that you set aside time to eat at a leisurely pace. Eating quickly has been associated with dyspepsia, among other digestive symptoms, so taking your time will help.

When should I consider a nutritionist for IBS?

Your doctor likely recommended you make changes to your diet as a first step for IBS, and in most cases, the sooner the better. Dietary changes are a common intervention for IBS because they’re low-risk, easy to do, and noninvasive.

You should consider a nutritional therapist in any of these situations:

• You’re not seeing results. If you’ve made the above changes and you’re not getting the symptom reduction you want, a nutritionist can help.

• You have other chronic conditions. Managing diet can be tricky, especially if you have a condition such as diabetes or heart disease. Your doctor will likely recommend you get some dietary help.

• You would benefit from stress management. Designing and managing a therapeutic diet takes work, and not all of us have the time or energy to sit down and plan out our menus. Remember, stress is also an IBS trigger, and you should try to limit it. Working with a nutritionist can help with planning what to eat and not to eat while also reducing the stress in your life.

• You’re undergoing a major medical change. If you’re planning to become pregnant, are having surgery, or making another big medical decision, seeing a nutritionist is a good idea. They can help you navigate the complex needs the body can have with any significant medical change.
• Your diet has become too restrictive. A nutritional therapist can help you narrow down foods that may be causing your digestive issues. You probably don’t need to eliminate all of the foods in the list above — if you can just figure out which ones are causing the problems. A nutritionist or dietitian can help you do that so you can add other foods back into your diet more quickly.

What should I expect when working with a nutritionist?

When you first visit a nutritionist, they will probably ask about: 

• Your overall schedule
• Your current dietary restrictions
• What you prefer to eat
• Any health conditions, food allergies, or other nutritional concerns you might have 
• What your goals are with IBS
• Any other goals you might have, such as weight loss or weight gain

Depending on their practice, they may also perform a bioimpedance analysis (BIA). This technique uses a weak electric current to measure your overall body composition, mostly body fat and muscle mass. Because the body stores water mainly in the muscle, the less fat a person has, the more easily electricity flows through them.

This is a more useful measurement than the body mass index, or BMI, especially if you’re managing other medical conditions.

From that session, you’ll develop a plan with your nutritionist and regularly check in on your progress. You’ll talk about any attacks you’ve experienced, what you ate beforehand, and any other factors that might have set them off.

How strict will my IBS diet be? 

That will depend on your lifestyle, your goals, and your overall needs. Outside of urgent medical need, it’s rare that a nutritionist will immediately place you on a strict diet and require you to stay on it. Instead, their recommendations will be driven by one of two approaches, both based on the process of elimination:

• Eliminate many foods at once. With this approach, you cut a group of foods (like FODMAPs, dairy products, fatty foods, or those containing gluten) from your diet temporarily, then add foods back in one by one to see how they affect your system. Many nutritionists will start there if there’s no indication of a particular food that causes symptoms.
• Eliminate common suspects. If you use this method, you will remove specific foods, such as common allergens and foods that are known to be hard on the digestive system, and observe the effects.

Keep in mind that for any diet to be effective, it needs to be realistic. What your nutritionist will suggest will likely be based on what is workable for you.

What diets might my nutritionist recommend for IBS?

While elimination diets are helpful for identifying specific triggers, many people with IBS find that they feel better with a maintenance diet. Here are several that nutritionists and dietitians often recommend for irritable bowel syndrome and other gastrointestinal disorders:

Low-FODMAP diet for IBS

FODMAP is short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are “short-chain” carbohydrates that are difficult for the body to digest, so they tend to absorb water and break down, building up gas and taking water away from stool. 

FODMAPs are so common that in many cases, a perceived gluten intolerance may actually be a FODMAP sensitivity.

Managing FODMAP consumption is difficult, as they’re found in almost every food group. For that reason, a low-FODMAP diet can be complex and hard to stick with. A nutritional therapist can guide you to choices that limit FODMAPs without being so restrictive that your diet becomes unhealthy.

Low-gluten diet for IBS

While gluten, as we noted above, isn’t necessarily the problem it’s been hyped to be, there’s still substantial evidence that limiting your gluten intake may be helpful for IBS. This is especially true if you have other dietary concerns around gluten.

Mediterranean diet for IBS

The Mediterranean diet has been named the best overall diet for four consecutive years by U.S. News and World Report. Research suggests that it may be a good eating plan for overall gut health and for IBS. 

Three types of food make up the foundation of the Mediterranean diet:

• Fish and other lean proteins
• A high proportion of vegetables
• Fats largely drawn from vegetable sources, such as olive oil and avocado.

The Mediterranean diet is a well-balanced diet and one of the easier diets to adapt to, especially for busy people, so it may well be a starting point for your nutritionist.

Vegetarian diet for IBS

The connection between vegetarianism and IBS is controversial. Some studies indicate that vegetarianism may aggravate certain types of IBS. However, going vegetarian may increase the amount of soluble fiber in your diet, which is generally seen as helpful for digestive symptoms. Because no two bodies are alike, talk to a nutritionist if you’re considering switching to a vegetarian diet. 

Let us help

Nutrition for IBS can be a complicated topic, and you need information you can trust. 

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