What are the dietary recommendations for IBS-D?

Question

Hello doctor,

I am a 35-year-old woman. I have been struggling with IBS-D (a condition that results in frequent bowel motions, stomach pain, and loose or watery stools) for years. I have tried cutting out certain foods, but I am still getting unpredictable flare-ups, especially after stressful days at work. Could you suggest any specific diets or foods known to help with IBS-D?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Yes, let us understand what IBS (irritable bowel syndrome) is, and yes, I have seen low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diets help along with self-checking on food tolerance. Initially, one can start with a low FODMAP diet that gradually changes in quantity and adds foods of their choice.

Irritable bowel syndrome (IBS) is an uncomfortable disorder characterized by dramatic changes in bowel movements.

Yes, some people experience diarrhea, while others have constipation, cramps, and abdominal pain like diarrhea in your uncle's case.

Dietary Allowances:

Eat more fiber if constipated. Fiber may improve constipation in IBS because it makes stool soft and easier to pass.
Consume soluble fiber like oats, boiled or steamed fruits, and vegetables.
Drink plenty of fluids.
Eat regular meals. Be sure to eat breakfast every day. Do not skip meals.

Here are the things to avoid:

Restrict intake of caffeinated drinks (for example, tea, coffee, or cola).
Avoid skin, pips, and piths from fruit and vegetables.
Avoid foods high in fat, such as chips, fast foods, burgers and sausages, crisps, and cakes.
If you are lactose intolerant, reduce the amount of lactose you consume. Milk and bread are lactose-containing foods.
Try not to have alcohol every day and then have no more than two units a day.
Limit insoluble fiber intake from whole grain breads, bran, cereals, nuts, and seeds (except golden linseeds).
Limit intake of foods high in resistant starches like sweetcorn, green bananas, and muesli that contain bran.

In IBS, every person may respond to different foods differently. It is important to try and test foods (see body's response) and then become liberal with their use in daily routine bit-sharing guidelines.

Low-FODMAP fruits that can be included are:

Blueberries.
Cantaloupe/rockmelon (a half cup).
Coconut-desiccated (a half cup).
Grapes, of all types.
Honeydew melon (a half cup).
Kiwi fruit (two small).
Lemons & limes (including juice).
Mandarins.
Oranges.
Passion fruit.
Pineapple (one cup).
Raspberries.
Strawberries.
Papaya.
Fresh dates.

Low-FODMAP vegetables that can be included are:

Ladies Finger, French beans, carrot, tomato, bottle gourd, ridge gourd, snake gourd, ivy gourd, pumpkin, drumstick, cucumber, and capsicum.
Spices to be used are ginger, turmeric, jeera powder, coriander powder, mint leaves, and coriander leaves.
Avoid green chilly, red chilly, garlic, onion, and shallots.

High-FODMAP fruits that can be avoided are:

Apples.
Apricot.
Avocado (very small quantities may be tolerated).
Bananas, ripe.
Blackberries.
Cherries.
Grapefruit.
Mango.
Nectarine.
Peaches.
Pears.
Plums.
Raisins.
Watermelon.
Dry figs and dates.

Foods to avoid:

Vegetables: Beets, broccoli, Brussels sprouts, corn, lima beans, onions, parsnips, peppers, potato skins, spinach, winter squash, spring onion, and shallots; cauliflower, cabbage, savoy, mushrooms, and peas.
Cereals like brown rice, wild rice, and red rice.
Cereals containing nuts, dried fruit, or seeds
Multi-grain breads or crackers.
Whole-wheat bread and wheat roti.
Barley, bran, couscous, gnocchi, granola, muesli, muffins, rye, semolina, spelled, wheat-based bread, cereal, and pasta.
Pulses: Black chana, rajma, chickpea, lima bean, and urad dal
Nuts: Cashews and pistachio
Milk: Cow milk, goat milk, rice milk, sheep’s milk, and soy milk made with soybeans.
Dairy products: Cream, custard, ice cream, sour cream, cream cheese, and ricotta cheese.
Drinks: Apple juice, pear juice, mango juice, sodas with HFCS, and herbal tea (strong).
Condiments: Jam (mixed berries), pasta sauce (cream-based), relish, and tzatziki dip.
Sweeteners: Agave, high fructose corn syrup (HFCS), honey, inulin, isomalt, maltitol, mannitol, sorbitol, and xylitol.

I hope this helps.

Thank you, and take care.

Regards.