Digestive Health: Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a problem of the large intestine (also known as the colon). IBS is a functional gastrointestinal (GI) disorder, meaning it is a problem caused by changes in how the GI tract works, but the GI tract is not physically damaged. It is believed that most of the symptoms of IBS are caused by painful muscle spasms that occur in the lower part of the colon. The spasms can slow down bowel movements and cause constipation. They may also speed things up and cause diarrhea. Some people find that certain foods bring on an IBS attack. This handout will give you tips that may help. There is no exact food plan that works for everyone. It is always a good idea to work with your doctor and dietitian to find a treatment plan that meets your needs
What can I do to decrease any symptoms of IBS?
• Eat smaller meals, more often. Large meals can trigger symptoms.
• Chew foods slowly and enjoy your meal.
• Reduce intake of sorbitol, mannitol, xylitol (mainly found in “sugarless” gums and candies).
• Lower the fat in your diet to 40-50 g daily and limit fat free products that contain Olestra®.
• Drink plenty of fluid each day (try for 6-8 glasses per day).
• Reduce fructose intake (high-fructose corn syrup, honey, dried fruits)
• Reduce your intake of gas-producing foods.
• Be aware that some medicines and herbals may make your symptoms worse.
• Get regular exercise.
• Keep a food diary to track what foods make you feel bad. Then avoid those foods.
• Learn new ways to decrease any stress or anxiety that you may feel.
Will fiber help me or make me feel worse?
In general, fiber supplements have not been helpful for treating IBS symptoms. One exception is that psyllium may be helpful for people with constipation associated with IBS.
What are examples of foods or pills that might make me feel worse?
Many people find that certain foods or medicines can make their symptoms worse. The list below gives examples of items that often increase problems for people with IBS. Not all people with IBS will have problems with these items.
Milk and milk products
Fatty foods and fat substitutes
Sorbitol® or sugar alcohols
Diuretics (water pills)
Liquid, sweet-tasting medicines
What do you mean by fructose–rich foods?
Fructose is a sugar that occurs in nature. Fructose-rich foods include sugary soft drinks or snacks with High Fructose Corn Syrup (HFCS) as a main ingredient. Honey also contains high amounts of fructose. Some fruits, like dates, oranges, prunes, pears, apples and cherries contain higher amounts of fructose, but shouldn’t be avoided unless you are sure they make your symptoms worse
What is Sorbitol®?
Sorbitol® is a sugar alcohol that is used as a sweetener in foods labeled “diet” or “sugar free.” You will notice this in items like candies, gums and desserts. Sorbitol also occurs naturally in cherries, apples and pears. Other sugar alcohols to avoid include mannitol and xylitol.
So what are the gassy foods?
These foods may increase stomach pressure and gas. The foods listed are common “gassy” foods for many people (even without IBS). If you find that you are able to eat any of these foods without increasing your symptoms, there is no need to limit them in your diet.
Apples, apple juice, apricots, avocado, banana, cantaloupe, honey dew, grapes, prune juice, raisins, and watermelon.
Beans (kidney, lima, navy), broccoli, brussel sprouts, cabbage, carrots, cauliflower, celery, corn, cucumbers, green peppers, leeks, lentils, onions, radishes, scallions, shallots, split peas, and soybeans.
- Cereals and grains
Bran cereals and high fiber foods.
- Wheat , wheat germ and wheat products
Lactose can be found in dairy products. Some people are lactose-intolerant and need to reduce their intake foods with lactose. There are many lactose-free dairy products available in the stores which are usually well-tolerated.
What are FODMAPs?
FODMAP stands for fermentable oligo-, di-, and mono-saccharides and polyols, which are poorly-absorbed carbohydrates found in certain foods. They can trigger abdominal discomfort, distention, bloating, fullness, nausea and/or pain in some people. Refer to the Low FODMAP diet handout for more information.
Do probiotics help?
Probiotics are helpful bacteria that may be useful in the management of certain medical conditions. Probiotics may play a role in relieving IBS symptoms in some individuals, but studies so far do not agree on types or amounts of bacteria or even if there is any benefit.
Is peppermint oil useful in providing relief from discomfort?
In some studies, peppermint oil relaxes intestinal muscles and may improve comfort in people with mild IBS symptoms. If you decide to use peppermint oil, be sure to get enteric-coated pills, rather than a liquid so it does not cause heartburn. Although a standard specific dose has not been determined, an intake of 0.2 to 0.4 mL of peppermint oil up to 3 times per day has been suggested. Avoid peppermint oil if you have gastroesophageal reflux because it can worsen symptoms.
Why should I keep a food diary?
Keeping a record of the food you eat can help you pinpoint foods that may make your IBS symptoms flare up. You will want to include what you eat and how your body was able to handle it. This may help narrow down foods to limit or avoid. If you are very limited in the foods you can eat, talk to your doctor and dietitian about vitamins.
What is the most important thing you learned from this handout?
What changes will you make in your diet/lifestyle, based on what you learned today?
If you have more questions please contact UW Health at one of the phone numbers listed below or visit our website at www.uwhealth.org/nutrition
UW Digestive Health Center
UW Health West Clinic
UW Health East Clinic
UW Medical Foundation
The International Foundation for Functional Gastrointestinal Disorders
National Institute of Diabetesand Digestive and Kidney Diseases (NIDDK), NIH
The American Gastroenterological Association
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/26/2013
Copyright © 07/26/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#390
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