What to eat during an IBS flare up

Diet for managing IBS flare up
Gut Health
Nutrition
Written By:
Kathryn Padva, MS, RD, LDN

One of the most challenging aspects of having irritable bowel syndrome (IBS) is figuring out the foods that cause your IBS symptoms. Finding the right diet and lifestyle changes can help you when IBS symptoms strike. We know that learning to manage IBS triggers can be frustrating on your own. Read on to help eliminate IBS food confusion and to ultimately gain control over your IBS symptoms once and for all. 

What is IBS? 

Irritable bowel syndrome (IBS) is a cluster of symptoms that affects the gastrointestinal tract causing pain and discomfort. Diagnosing IBS can be difficult because symptoms often mimic other gastrointestinal disorders. Some common symptoms include gas, bloating, constipation, diarrhea and GI discomfort.

There are three main types of IBS, which are designated based on symptoms. 

IBS with constipation (IBS -C)

  • Difficulty going to the bathroom
  • Hard stools

IBS with diarrhea (IBS - D)  

  • Frequent loose watery stools 
  • Cramping and abdominal pain
  • Sudden need to use the bathroom 

Mix of both diarrhea and constipation (IBS - M)

Depending on the type of IBS you are experiencing and if you are in a current IBS flare, treatment will vary. 

What is an IBS Flare Up? 

During an IBS flare up also known as an IBS attack, you may experience more gut symptoms than usual. This may include excessive cramping, diarrhea, constipation and pain. These symptoms may last a few hours or up to a few months. In order to reduce the severity and length of time a flare up lasts, it is best to identify your specific trigger foods. 

In addition to diet, IBS flare ups may also be associated with lack of physical activity, stress, and poor sleep habits. It is important to check-in with all aspects of your health in order to help decrease the frequency of IBS attacks.  Some questions to ask yourself: 

  • Do you have stress management techniques?
  • Are you getting at least 7-8 hours of sleep a night? 
  • Are you moving daily? 

Addressing your stress, sleep and movement along with diet can help in decreasing the frequency of your IBS flares. 

Diet for IBS 

IBS can be difficult to treat because every patient responds differently to nutrition. Finding the right foods for managing your IBS symptoms can feel like piecing together a challenging puzzle.

The first step to alleviating your GI discomfort when diagnosed with IBS, is to figure out what your triggers are. Changes in your diet can help treat symptoms of IBS.  The three most common dietary treatments include:

  • Avoiding gluten and lactose 
  • Following a low FODMAP diet
  • Increasing your fiber intake 

Although making certain diet changes will not cure IBS, it can help to prevent IBS flare ups and eliminate GI pain/discomfort. 

Avoid Inflammatory Foods 

One of the first dietary interventions to follow when diagnosed with IBS is to figure out what foods worsen your IBS symptoms. Your dietitian may recommend avoiding foods that contain gluten and lactose, which are often referred to as pro-inflammatory foods. 

Gluten is a protein in wheat, rye and barley that can cause an inflammatory response. Some common gluten foods include:

  • Pastas 
  • Bread
  • Condiments 
  • Baked foods 
  • Flour tortillas 
  • Sauces and gravies 
  • Beer 
  • Crackers 

Lactose is a carbohydrate found in dairy products that has also been linked to inflammation. Some common lactose foods include: 

  • Milk
  • Cheese
  • Yogurt 
  • Ice cream 
  • Baked goods 

When first diagnosed with IBS, It is best practice to eliminate these foods from your diet for 4-6 weeks and see how you feel. 

After eliminating gluten and dairy for 4 - 6 weeks, take note of your symptoms. Begin to introduce gluten and dairy back into your diet one at a time. Keep a journal of your symptoms. If you begin to notice a change in your gastrointestinal symptoms, then this may indicate that you may have a sensitivity to either gluten or dairy which can trigger an IBS attack. 

For best practice, you may need to limit gluten and dairy in your diet indefinitely to avoid future IBS flares. If you are currently having an IBS attack, do a diet recall and assess if you recently had any foods containing either gluten or dairy. 

Avoid High FODMAP foods 

Your doctor may recommend that you try a special diet— called the Low FODMAP diet— to reduce or avoid certain foods that contain carbohydrates which are difficult to digest. These carbohydrates are called FODMAPS. 

FODMAPS are a category of carbohydrate foods that may trigger IBS flares. It stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Many foods you probably eat on a daily basis include FODMAPS such as: 

  • Sweeteners 
  • Vegetables 
  • Fruits 
  • Grains 
  • Dairy products 
  • Sweetened beverages 
  • Garlic 
  • Onion 
  • Legumes

The first step of the low FODMAP diet includes eliminating all foods that contain FODMAPs. A dietitian can help you figure out which foods you need to avoid and which foods are safe to consume. Since this specific diet can be very restrictive and limits the range of nutrients you eat, it is best to seek guidance to optimize your nutrition. 

The goal of the low FODMAP diet is to figure out which type of FODMAPS trigger an IBS attack and which don’t. The FODMAPS that you are able to tolerate should be added back into your diet to give you more food freedom. 

Fiber Foods

Fiber is the non-digestible, carbohydrate component of plant foods that moves intact throughout your gastrointestinal tract. In most cases, not getting enough fiber can cause an IBS attack. Fiber may improve constipation in IBS because it makes stool soft and easier to pass. In addition, eating more fiber can help with bulking up your stool and prevent diarrhea. 

The Dietary Guidelines for Americans, recommends that adults should get 22 to 34 grams of fiber a day. However, overconsuming specific types of fiber can also induce an IBS flare. 

There are two types of fibers that are useful for preventing IBS flares and symptoms. These are: 

  • Soluble: absorbs fluid, can help relieve diarrhea 
  • Insoluble: draws water into your stool, helps relieve constipation

Not eating enough fiber can cause constipation which can lead to an IBS flare. As you increase your fiber intake, it is important to also consume adequate amounts of water to push the non-digestible plant parts through your GI tract. 

If you have IBS and your fiber intake is poor, it is suggested to slowly introduce fiber containing foods into your diet. Start with increasing your fiber intake by 2 -3 grams a day to reduce chances of developing gas and bloating. 

In general, men should aim for about 30 - 38 grams and women 21 - 25 grams of fiber daily. Both soluble and insoluble fiber should be included in your daily intake to decrease the frequency of IBS flares. 

Worst Foods for IBS Flare Ups

IBS treatment is very individualized and difficult to pinpoint which foods to eat versus which foods to exclude. However during an IBS attack, there are a few specific foods that should be avoided overall to help with symptom management. 

Caffeine 

During a flare up, caffeine can aggravate your symptoms and cause diarrhea. Common sources of caffeine include coffee, tea, soda, chocolate and some over the counter pain medications. It is best to completely avoid caffeine during IBS flare ups to help with symptom management.

Carbonated beverages 

Carbonated beverages such as soda and seltzer water may cause bloating and gas which can trigger or worsen an IBS flare up. It is best to stick with plain water when having an IBS attack. 

Alcohol 

Alcohol is a known gut irritant that may cause or worsen an IBS flare. Alcohol has been studied to reduce the absorption of carbohydrates. This can lead to potential irritants staying in your GI tract for an extended period of time leading to an IBS attack. 

Fatty Foods 

Fatty greasy foods such as fast food can cause an IBS flare due to prolonged digestion. High fat foods take the GI tract longer to digest and absorb which can trigger or worsen an IBS flare. It is best to avoid or limit the consumption of fast food, high fat dairy, and fried foods. 

Best Foods for IBS 

The best foods for IBS are the ones that do not cause you any GI discomfort. Generally, these will be foods that are low in FODMAPS, lactose and gluten. 

Protein Foods 

Foods high in protein are generally safe for people with IBS. Fatty meats may cause an IBS flare so focus on consuming poultry, lean meats and seafood. Eggs are also a great source of protein and can be easily digested. 

Omega 3 foods 

Foods high in omega 3 fatty acids have been studied to have an anti-inflammatory effect. Including foods high in omega 3’s such as salmon, walnuts and olive oil can help with reducing IBS flares and alleviate GI discomfort. 

Low FODMAP Fruits/ Vegetables

If you have IBS, instead of eliminating all fruits and vegetables it’s best to focus on consuming those that are low in FODMAPs. Fruits and vegetables provide vitamins, minerals and fiber which are essential for good health. Eggplant, carrots, broccoli, tomatoes, and zucchini are all low fodmap vegetables. Low FODMAP fruits include kiwi, blueberries, oranges, and pineapple. 

Fermented foods

Fermented foods such as kimchi, sauerkraut, kefir, and yogurt may have beneficial effects on gut health. Fermented foods have been linked to providing our gastrointestinal tract with probiotics. These probiotics can be helpful with cultivating an optimal GI tract which can help with preventing IBS attacks. 

IBS Treatment 

Navigating your IBS diagnosis and determining what foods cause IBS flares can be a difficult process. Gain control over your IBS diagnosis by working with a dietitian. 

Why Nourish?

If you’re feeling overwhelmed about where to start, Nourish can help. We connect you with registered dietitians who are leading experts in gut health nutrition. We focus on treating the root cause of your IBS flares. 

Nourish registered dietitians work with you to create an individualized plan. Our dietitians collaborate with your healthcare team to support the multidisciplinary approach.

Our services are covered by insurance and 100% remote. Don’t wait to get help – start with Nourish today.

Sources 

Irritable Bowel Syndrome: A review

https://fg.bmj.com/content/12/4/303