Nutrition Considerations for the Patient with Irritable Bowel ...

Nutrition Considerations for the Patient with Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is defined as abdominal discomfort associated with altered bowel habits such as
constipation, diarrhea, bloating, or urgency.
IBS Facts:
♦ It is estimated that approximately 10-15% of the population has IBS;
♦ It is the most common disease diagnosed by gastroenterologists; and
♦ The most common disorder seen by primary care physicians.
♦ There is no known cause or cure for IBS; each person experiences different symptoms and will likely
tolerate different foods.
♦ Food allergies are rare and most IBS patients have food sensitivities (symptoms not due to the immune
system)
♦ Some individuals with IBS symptoms may have specific food-related conditions including lactose
intolerance and celiac disease
Keeping a food journal will help you to log the foods you do not tolerate and the symptoms you experience.
The suggestions below are things to consider helping alleviate your IBS symptoms.

Diet Suggestions for IBS:
• Try smaller, frequent meals
• High-fat, greasy, rich foods are typically less tolerated. Try eating a lower-fat diet, selecting baked or
grilled meats, low fat and light foods.
• Try a lactose free diet. Lactose is found in certain dairy products. If symptoms improve and you plan
on continuing this diet long term, it is very important to get calcium and vitamin D from other food
sources or supplements including naturally low lactose dairy products (yoghurt and hard cheeses). The
fat in some dairy products rather than lactose can also be a factor contributing to IBS symptoms.
• These foods can make IBS symptoms worse: caffeine (coffee, tea, soda), chocolate, and alcohol.
• Try reducing the amount of fructose, the sugar found in fruit and honey, or fructans (found in artichoke,
green beans, leeks, onions and wheat).
• Sorbitol is the sugar alcohol used in many sugar-free gums, candy, and medicine (unfortunately, it is not
always listed on the medicine label, so you will have to ask your pharmacist). Sorbitol can increase gas
and bloating.
• Some foods commonly reported to also cause gas and bloating include: beans, onions, celery, carrots,
raisins, bananas, apricots, prunes, brussel sprouts, wheat germ, pretzels, and bagels.
• Fiber supplements that are made from soluble fibers are better tolerated than the insoluble fiber
containing supplements (e.g., Citrucel over Metamucil for example).
• Slowly adding soluble fiber to your diet may alleviate some of your symptoms – examples include: oats,
potatoes, peas, beans, and barley. Attached is a table of foods and the amount of soluble fiber contained
in them. Remember to drink plenty of fluids as you gradually increase the fiber content of your diet.

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Vegetables
Amount
Soluble Fiber
(grams)
Asparagus 2/3
cup 2
Baked potato with skin
1 small
1
Broccoli/carrots ½
cup
1
Brussel sprouts
½ cup
3
Collard greens
1 cup
3
Green beans
½ cup
1
Sweet peas
½ cup
1.5
Sweet potato with skin
1 small
1.5
Fruits
Apple 1
medium 1
Apricots, dried
7 halves
1.1
Apricots, fresh
1 small
1
Banana 1
medium 1
Grapefruit ½
medium
1
Nectarine 1
medium 1
Orange/pear/tangerine 1
medium
2
Peach/Plum 1
medium 1
Legumes


Black/pinto beans
½ cup
2
Black eyed peas
½ cup
1
Garbanzo beans
½ cup
1.5
Kidney beans
½ cup
3
Lima beans
½ cup
3.5
Grains


All bran, buds
1/3 cup
4
Brown rice
½ cup
0.4
Cheerios 1
cup 1
Fiber One
1 cup
1
Oat bran
1-1/4 cups
2
Oatmeal (dry)
1/3 cup
2
Oatmeal (instant)
1 packet
1.5
Raisin bran
1 cup
1.3
Whole-wheat bread
1 slice
0.4
White bread
1 slice
0.2

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Alternative Therapies and IBS:

Alternative therapies are sometimes used by patients with IBS. Some of these common therapies include:
probiotics, hypnosis, and herbals. Kefir and yogurt contain natural probiotics. Below is a list of herbals and
natural therapies. Unfortunately there is no good evidence supporting their benefit.
• Peppermint oil — there is a small amount of evidence supporting a benefit for peppermint oil,
although it is difficult to make definitive conclusions. Peppermint oil can cause or worsen heartburn.
• Acidophilus — there is increasing interest in the possible beneficial effects of so called "healthy"
bacteria in a variety of intestinal diseases including IBS. Whether supplements containing these
bacteria (such as acidophilus with or without fructooligosaccharides “FOS” or Lactobacillus) are of
any benefit is unproven.
• Chamomile tea —Chamomile tea is of unproven benefit in IBS.
• Evening primrose oil — Evening primrose oil, a supplement containing gamma linolenic acid, is of
unproven benefit.
• Fennel seeds — Fennel seeds are of unproven benefit.
• Wormwood — Wormwood is of unproven benefit and may be unsafe. Wormwood oil can cause
damage to the nervous system.
• Comfrey — Comfrey is of unproven benefit and can cause serious liver problems.


Additional Resources:

♦ National Institute of Diabetes, & Digestion, & Kidney Diseases: www.niddk.nih.gov
♦ International Foundation for Functional Gastrointestinal Disorders (IFFGD) Inc: www.iffgd.org
♦ Irritable Bowel Association: www.ibsassociation.org

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