*Last updated Oct 2017*
Irritable Bowel Syndrome (IBS) is a major digestive concern for many Canadians, and for millions of people around the world. Click here to learn more about IBS.
Unfortunately, there is no cure for IBS, and many people experience symptoms long-term. However, there are many simple changes which can help decrease symptoms. For many people, nutrition changes can help with IBS management. I’ve rounded up the most common dietary and lifestyle recommendations for managing IBS symptoms.
Since everyone has a unique experience with IBS, they will also have a unique response to every dietary change. Some of these changes may greatly help you with managing your symptoms, but others may not be helpful for you. You may want to talk with a dietitian one-on-one to get some personalized advice.
Here is the list of 10 dietary and lifestyle changes:
1 – Eat Enough Fibre
Fibre recommendations are 25 g/day for women, and 38 g/day for men. It can be tough to reach the daily fibre recommendations. The best way to eat more fibre is to focus on eating more fruits, vegetables, whole grains, nuts, seeds, and legumes. You can also try high fibre foods such as ground flax seeds, chia seeds, and/or psyllium fibre. Insoluble fibre can be more helpful for managing constipation and soluble fibre can be more helpful for diarrhea. It is important to increase your fibre intake slowly to avoid bloating and cramping. If you are already meeting the recommendations, further increasing your fibre intake is unlikely to be helpful.
2 – Stay Hydrated
Drink water throughout the day to stay hydrated. It is especially important to drink plenty of fluids when increasing your fibre intake, or if you are experiencing symptoms such as constipation or diarrhea. Have a cup of water with each meal and snack, and keep a reusable water bottle with you. If you get bored of water, try adding slices of fruit, such as lemon, lime or orange.
3 – Lower Stress & Anxiety Levels
For many people, stress and anxiety levels are closely related to digestive symptoms. Try to make time to do activities you find relaxing. Meditation and/or yoga can be very helpful. If you are dealing with high anxiety levels or depression, please seek help from your doctor and/or a psychologist.
4 – Exercise Regularly
Regular exercise can help keep your digestive system moving, and is particularly helpful for constipation. Aim to exercise at least 150 minutes per week, spread out in at least 3 sessions. If you don’t enjoy exercise, try pairing it with something you do enjoy, such as spending time with friends, listening to music/podcasts, or watching videos. If your digestive symptoms make you hesitant to exercise in public, you could try starting with exercise videos at home. Exercise may also help with managing stress and anxiety levels.
5 – Swallow Less Air
Swallowing less air can help decrease the amount of gas and bloating you experience. Try to eat slowly in a relaxing atmosphere, and sit upright. Avoid chewing gum, using straws and drinking carbonated beverages.
6 – Have Regular Meals and Snacks
Having a regular meal and snack schedule can help decrease symptoms. Aim for 3 moderate sized meals per day, and 1-3 small snacks. Breakfast is important and can help decrease constipation. Eating extra large meals or grazing on food all day long may trigger symptoms.
7 – Avoid/Decrease Gut Stimulants
Gut stimulants include caffeine, alcohol and tobacco. If you are experiencing loose stools, you may want to decrease the amount of gut stimulants you use, or avoid them all together. If the thought of completely stopping drinking caffeine or alcohol, or smoking cigarettes, makes you want to run away screaming, focus on just slowly decreasing the total amount you drink/smoke. Some people find that caffeine and alcohol affect their gut less when they are consumed with food.
8 – Avoid/Decrease Fatty Foods
Some individuals with IBS (but not all) find that fatty/greasy foods trigger digestive symptoms. Fatty foods include deep fried foods, chips, cookies, and high-fat meats and dairy. Eat fried foods and high fat treats in moderation. Try eating leaner meats, lower fat dairy products, and cooking with less oil.
9 – Avoid/Decrease Lactose (Found in Dairy Products)
Lactose is the sugar naturally found in most dairy products, including milk, yogurt and cheese. The enzyme lactase is needed to break down lactose in our small intestines so it can be absorbed. Lactose intolerance occurs when we do not have enough lactase in our intestines. When lactose is not absorbed it is fermented by bacteria in the large intestine and may cause digestive symptoms.
Some individuals with IBS (but not all) also have lactose intolerance and find that high-lactose foods trigger symptoms. Milk contains high amounts of lactose, and yogurts contain a moderate amount. Hard cheeses and butter are much lower in lactose and usually well tolerated. Click here to learn more about lactose in yogurt. Click here to learn more about lactose in butter and hard cheeses.
If you do not experience symptoms after eating dairy products, there is no need to avoid them. Butter and high fat cheeses may trigger symptoms due to high fat content (see tip #8 about fatty foods). Dairy products may be better tolerated when consumed with other foods and/or in small quantities. Lactose-free versions of milk and yogurts are available now in many grocery stores; these products have the enzyme lactase added and therefore the lactose is broken down and easy to digest. You can also try taking a lactase pill prior to eating a high lactose food. If you choose not to eat dairy products, it is important to eat alternative products (such as soy or almond milk) that are a good source of calcium and vitamin D.
10 – Avoid/Decrease Certain Artificial Sweeteners (Sugar Alcohols)
Sugar alcohols (also called polyols) are artificial sweeteners that can have a laxative effect in anyone when eaten in large quantities. People with IBS may be particularly sensitive to sugar alcohols. Sugar alcohols often end in -ol (e.g., erythritol, glycerol, mannitol, sorbitol, xylitol, etc.). Two sugar alcohols that don’t end in -ol are isomalt and hydrogenated starch hydrolysates. Most commonly sugar alcohols are found in products that are labelled as “sugar-free” such as ice creams, baked goods, candies and gum. They are also often commonly found in liquid or gel-capsule medications and supplements. As previously stated, if these products don’t trigger symptoms, you don’t need to avoid them.
Before making any dietary changes, always speak with your doctor.
These changes are a good place to start with IBS management. However, they are not the only options. Research has found that the Low FODMAP Diet can be effective for managing IBS symptoms and identifying food triggers. Click here for an overview of the Low FODMAP Diet. Please note that this is a medical diet designed to be implemented with the help of a dietitian and is designed to manage lower gastrointestinal symptoms (it is NOT a weight loss diet).
You do not have to struggle with IBS alone! A registered dietitian can help you make changes to manage your symptoms and feel better. In Canada there is a big difference between a dietitian and a nutritionist, click here to learn more.
Are you looking for support with managing digestive symptoms and/or the low FODMAP diet? My nutrition counselling and coaching services are available across Canada (via video messaging or phone). I am a registered dietitian with a Master’s of Public Health in Nutrition who specializes in digestion and practical healthy eating tips. Learn more about my services by clicking here.