Irritable Bowel Syndrome: Your Go-To IBS Diet Plan, Supplements + More
In my telehealth functional medicine clinic, I have witnessed firsthand the debilitating effects that irritable bowel syndrome (IBS) can have on people’s lives. And while this condition affects a staggering 15% of the population worldwide, the exact cause of IBS remains elusive. (1) But there is one thing we do know: diet plays a critical role in managing this condition and alleviating its symptoms. Read on to learn a little bit more about this condition from a functional medicine perspective, and exactly how you can harness the power of food to achieve a healthier gut and manage your symptoms.
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What is IBS?
Irritable Bowel Syndrome, is a multifaceted condition that affects the gastrointestinal system and is characterized by a variety of symptoms including abdominal pain, bloating, irregular bowel movements, and discomfort.
Since everyone is so different, it is no surprise that there is no “one-size-fits-all” even in regards to how a condition will manifest itself in each person - including IBS. Because of this drastic difference in symptoms a person can experience, there are a few different subtypes of irritable bowel syndrome that are based on the predominant bowel habits experienced by people with IBS.
IBS-C: This stands for irritable bowel syndrome with constipation and is the most common subtype of IBS with . People with this type of IBS often experience limited or difficult bowel movements, alongside symptoms like abdominal pain, bloating, and lumpy, hard stools.
IBS-D: This stands for irritable bowel syndrome with diarrhea. People who have this type of IBS experience the opposite side of the coin when it comes to bowel problems with symptoms like loose stools and the urgent, uncomfortable need to have a bowel movement. Symptoms of IBS-D can also include abdominal pain and cramping.
IBS-M: It’s important to note that some people may experience a mix of both constipation and diarrhea. This type of IBS is known as irritable bowel syndrome mixed.
While the cause of IBS is often misunderstood in conventional medicine, functional medicine views IBS as a manifestation of underlying imbalances in the body such as bacterial dysbiosis, food sensitivities, chronic inflammation, and even chronic stress.
How do you know if you have IBS?
There is no standard test to definitively diagnose IBS. Typically, coming to the conclusion of Irritable Bowel Syndrome is based on a process of elimination to rule out similar types of gut dysfunction. This is done by taking a comprehensive look at your health including diet and lifestyle habits, symptoms, and the gut health labs.
To help assist this process the Rome criteria is a set of diagnostic criteria used to help practitioners identify IBS within patients by providing guidelines for identifying patterns and durations of symptoms. Some of these include:
- Recurrent abdominal pain that is present for at least three days per month and is associated with a change in frequency of bowel movements and consistency.
- Changes in bowel habits have been occurring for at least three months with symptoms at least once per week.
- Symptoms should be occurring for a minimum of 6 months.
Just remember, everyone is different so you can still have IBS - or not have IBS - whether or not you meet this criteria so it is important to work alongside a qualified practitioner who understands bioindividuality and can look at your health case from a holistic perspective.
IBS and your diet
Unfortunately, there are a lot of misconceptions about IBS and the best way to manage this condition. In conventional medicine, medication is the typical go-to remedy. However, the research surrounding medication for IBS has shown mixed results in terms of efficacy and effectiveness. Plus, certain medications prescribed for IBS such as antidepressants, laxatives, antispasmodics, and antidiarrheal medications, have their own long list of side effects.
That’s why diet and lifestyle changes are still the biggest part of a person’s treatment plan, even in conventional medicine. We take this a step further in functional medicine by acknowledging that there is still no perfect IBS diet plan that works for everyone. In fact, studies have shown that simply eating more fiber - the often default recommendation for most people with IBS - can actually make symptoms worse for some people.
So when patients ask me “What is the best diet for irritable bowel syndrome?”, my answer is based on their specific health case. While some people do very well on paleo, AIP, and other similar diets, I always take a whole-health approach when considering what foods are going to be best for them as an individual based on their lab work, food sensitivities, and more.
IBS and FODMAPs
When it comes to food sensitivities and how they play a role in IBS, FODMAPs are at the top of the list. This strange sounding acronym stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. In short: fermentable sugars. These short-chain sugars are contained in many different foods and are not fully digested in the gut, which can cause them to be excessively fermented by gut bacteria.
This fermentation releases hydrogen gas that could lead to distension of the intestines, which can cause uncomfortable IBS symptoms in some people, such as pain, gas, bloating, constipation, and diarrhea. This would be considered a FODMAP intolerance, and tends to be common in those with IBS.
The reason a FODMAP intolerance can go years without being discovered is because most high-FODMAP foods are actually considered healthy, food foods like fruits and vegetables.
That’s why an effective IBS diet plan should take into consideration factors like food intolerances to be successful in alleviating symptoms. A low-FODMAP diet that eliminates high-FODMAP foods for a time being can be beneficial for those with IBS. In fact, close to 75% of people with IBS have found relief from their symptoms by following a low-FODMAP diet. (1) This can be short-term or long-term depending on your particular healing journey.
IBS Diet Plan
Again, there is no perfect IBS diet plan for everyone. But with that said, there are certain foods that have been shown to aggravate IBS by increasing inflammation, fueling bacterial dysbiosis, and perpetuating symptoms.
In general, the best diet for IBS is going to consist mostly of clean, whole foods and greatly limit, if not eliminate entirely, pre-packaged, processed foods, sugar, industrialized seed oils, and alcohol.
But to take it a step further, following a low-FODMAP diet is going to be your best bet when starting to heal through food.
What foods will aggravate IBS?
There are certain foods that have been shown to aggravate IBS by increasing inflammation, fueling bacterial dysbiosis, and perpetuating symptoms like in the case of high-FODMAP foods. Ultimately, if you are struggling with IBS symptoms and are already eating a pretty clean diet, these are the foods you should consider limiting next.
1. High-FODMAP vegetables and fruit
FODMAPs were first discovered by Monash University in 2005 and over the years, they have become the ultimate resource for all things FODMAPs. According to their research these fruits and vegetables contain the highest amount of FODMAPs that can irritate people with IBS or other chronic gut dysfunctions.
- Green peas
- Sugar snap peas
- Dried fruit
Not many people know this, but dairy is actually considered high FODMAP! So while that alone is a reason to leave dairy behind, there are many other aspects of dairy that can aggravate IBS. For example, casein - a protein found in animal milk - and lactose are two common food sensitivities that can perpetuate inflammation and symptoms like gas and bloating.
3. High-fiber foods
The type of IBS you struggle with will determine whether or not you do well with eating more fiber. If you have IBS-D it might be best to avoid eating more fiber as this can make symptoms worse.
4. Nuts and seeds
Some people with gut dysfunction can find that nuts and seeds can be irritating on their gut, especially in their whole form. Plus, nuts like cashews and pistachios are considered high-FODMAP. However, people with a nut and seed sensitivity can still usually enjoy low-FODMAP nuts and seeds in other forms like milk and butter.
Foods to eat with IBS
If you are already eating a clean diet, focus on these foods to really up your healing journey.
1. Low-FODMAP vegetables and fruit
If you are wondering what you can eat if you are following a Low-FODMAP diet, Monash University has you covered with their extensive list of high and low-FODMAP foods including: (3)
- Green beans
- Bok choy
- Green bell pepper
- Kiwi fruit
2. High-fiber foods
Again, high fiber foods are on both lists - foods to eat and to avoid - because it all comes down to what type of IBS you struggle with. If you have IBS-C fiber-rich foods could have a positive effect on your symptoms by encouraging regular bowel movements and improving consistency.
Additional lifestyle tips to help with IBS
Thankfully, there are even more ways that you can naturally support healing. These can vary based on your health case, but in general these
Since bacterial dysbiosis can perpetuate IBS symptoms, it’s important to correct any imbalances in your microbiome by ensuring your gut has everything it needs to thrive. A daily probiotic like The Probiotic from my supplement line The Collection, will supply your gut with much-needed beneficial bacteria strains to fight off any overgrowths of bad bacteria.
2. Alleviate stress
Research has found that stress is a major trigger for IBS symptoms. Like this study so eloquently put it, “IBS is a combination of irritable bowel and irritable brain.” (4) Talk about the gut-brain axis at work! Tools like meditation, breathwork, and therapy, can do wonders for helping manage everyday stress in your life. You can learn more about the gut-brain axis and how to restore your gut-feelings connection in my book, Gut Feelings.
Seeking help from a functional medicine expert
At the end of the day, there is no perfect diet for IBS. Even though there are some basic principles about food that reign true across the board, it ultimately all comes back to bioindividuality.
That’s why I strongly encourage you to seek out personalized functional medicine care if you are struggling with IBS. In my telehealth functional medicine clinic, we specialize in uncovering exactly what is going on beneath the surface of your symptoms to tailor a dietary plan specific to you. Remember, you don’t have to face IBS alone!
If you are ready to take the next step, schedule a telehealth functional medicine consultation to learn more about how we can help you reclaim your health.
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- "I Have IBS" Monash University. May 2023. https://www.monashfodmap.com/ibs-central/i-have-ibs/
- Dieterich W, Zopf Y. Gluten and FODMAPS-Sense of a Restriction/When Is Restriction Necessary? Nutrients. 2019 Aug 20;11(8):1957. doi: 10.3390/nu11081957. PMID: 31434299; PMCID: PMC6723650.
- "High and low FODMAP foods" Monash University. May 2023. https://www.monashfodmap.com/about-fodmap-and-ibs/high-and-low-fodmap-foods/
- Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014 Oct 21;20(39):14126-31. doi: 10.3748/wjg.v20.i39.14126. PMID: 25339801; PMCID: PMC4202343.
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BY DR. WILL COLE
Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.
Healing The Shame-Fueled Relationship
Between What You Eat And How You Feel