An elimination diet for irritable bowel syndrome (IBS) aims to identify foods that trigger symptoms and remove them from the diet.
People then gradually reintroduce foods after a period of elimination. If symptoms improve with eliminating a food, it may help to avoid it.
An elimination diet aims to help people identify and eliminate foods that trigger or worsen IBS symptoms. After a period of elimination, people reintroduce the foods one at a time to see if they cause symptoms.
The aim is to create a personalized diet that is as varied and nutritionally dense as possible while avoiding foods that aggravate IBS symptoms.
Learn more about elimination diets.
If someone wants to follow a restrictive elimination diet, such as the low FODMAP diet, they can discuss it with a doctor or dietitian with experience in IBS treatments.
Elimination diets, highly restrictive diets, or the low FODMAP diet may be unsuitable for certain people, such as those with a history of eating disorders or those at risk of nutrient deficiencies or malnutrition.
Read about the low FODMAP diet.
Gluten can occur in wheat, barley, and rye products. Bread, pasta, and cereals may all contain gluten.
People may also want to try a low FODMAP diet. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) are types of carbohydrates that may trigger IBS symptoms in some people, as they can be hard to digest.
A low FODMAP diet restricts foods containing FODMAPS, which includes the following:
- Certain fruits and fruit juices: These includeapples, pears, plums, blackberries, mango, nectarines, cherries, apricots, watermelon, canned fruit, and dried fruit.
- Certain vegetables: These include garlic, onions, cauliflower, lentils, mushrooms, cabbage, asparagus, artichokes, beans, and sugar snap peas.
- Dairy products: These include milk and milk products like yogurt, soft cheeses, ice cream, and custard.
- Wheat, barley, and rye products: Examples include wheat or rye bread, pasta, grains, and cereals.
- Honey and high-fructose corn syrup: These may be found in processed and snack foods, sweets, baked goods, and soft drinks.
- Certain sweeteners: These include xylitol, mannitol, sorbitol, maltitol, and other sweeteners ending in “ol.”
The International Foundation for Gastrointestinal Disorders (IFFGD) recommend that if people are unsure how to begin an elimination diet, they can start by cutting out coffee, chocolate, and nuts.
Read more about foods to avoid with IBS.
The IFFGD recommends people follow a 12-week elimination diet by following these steps:
- Start a food diary to write down all the foods people think may trigger or worsen their IBS symptoms.
- Take one food item from the list and avoid consuming it for 12 weeks.
- Keep track of any IBS symptoms during this time to see if there is an improvement.
- If there is no noticeable improvement from eliminating the food item for 12 weeks, reintroduce the food and move on to the next food item, repeating the steps above.
Alternatively, people may follow a low FODMAP diet. The low FODMAP diet eliminates all foods containing FODMAPs for 2–4 weeks.
If people eliminate one food item at a time over the course of several weeks, they can reintroduce the eliminated food if there is no improvement in symptoms.
If following a low FODMAP diet, people will begin to reintroduce FODMAP foods after 2–4 weeks of the elimination phase.
If eliminating FODMAPs has significantly improved symptoms, people will gradually reintroduce groups of FODMAPs one by one. As people reintroduce foods, they can monitor symptoms to see if any reoccur or worsen.
Once people identify which foods trigger their IBS symptoms, they can avoid them in their diet and return to eating a varied diet of nontriggering foods.
Learn more about treatment options for IBS.
According to a 2019 article, research suggests elimination diets may be beneficial and highly effective for managing IBS symptoms but are unsuitable for people with certain eating disorders.
According to the American College of Gastroenterology (ACG), the low FODMAP diet is the most researched diet for managing IBS symptoms. It may be the most effective elimination diet for IBS.
According to clinical guidelines from the ACG, the low FODMAP diet requires careful monitoring or guidance from a healthcare professional. The low FODMAP diet may be challenging to follow and lead to nutritional deficiencies without proper guidance.
An elimination diet may help people identify foods that trigger their IBS symptoms. Removing the food from their diet may help to improve symptoms.
The low FODMAP diet involves removing all foods containing FODMAPs and monitoring how symptoms change. People reintroduce foods one by one and continue to monitor their symptoms. This helps to identify foods they can eat safely and those to avoid.
Working with a healthcare professional helps prevent an elimination diet from feeling overwhelming and ensures people eat a varied diet with plentiful nutrients.