What Should you Eat When you have IBS?

Foods to Avoid with IBS

Open up a new tab on your internet browser. Type in, “foods to avoid when you have IBS”, and see what pops up. If you do this little exercise you will find lists and lists of various versions of, “Top 10 foods to avoid when you have IBS”. A lot of these lists come from fairly credible sources and some of them provide reasonable explanations for why you should be avoiding those foods. So, should we listen to them? No.

Although you may find that removing these foods from your diet does in fact improve your IBS symptoms, it won’t be the case for everyone. Some people may find their symptoms improve slightly, their symptoms don’t improve at all, their symptoms get worse, or after some time their symptoms start to come back even though they are still avoiding the same foods.

The reason why general advice, like a premade meal plan, a diet, or a list of foods to avoid, won’t help everyone is because what causes your IBS and triggers your symptoms is individual to you.

According to several studies looking at the effectiveness of the low FODMAP diet, which I would argue is the most popular and effective diet for IBS currently available, 50% to 20% of study participants who tried the diet did not find significant improvement to their symptoms, and they were working with a registered dietitian. This point is important as a lot of those foods on the, “Top 10 foods to avoid…” lists are foods you are meant to eliminate on a low FODMAP diet.

So, if the low FODMAP diet is the most successful diet we know of for improving IBS symptoms and the rate of success (according to these specific study results) is not 100%, and that's working with a dietitian, do you really think avoiding 10 of those foods (out of a much larger list) would be helpful for the majority of people living with IBS?

So what should be done instead?

Individualized advice is the alternative. Sitting down in person, or virtually, with a healthcare provider who is well versed in the subject matter (a registered dietitian) and working with them one-on-one to come up with a plan that is individualized to you. Having someone to support you, guide you through the process, and answer your questions is a more effective and efficient way to improve your digestive symptoms.

According to a study published in 2020, working with a registered dietitian as part of a multidisciplinary team improved a patient's self reported symptom improvement by 50% compared to those who worked with a gastroenterologist alone. Now imagine if you weren’t working with any healthcare providers at all.

One last thing to remember, symptoms are not always related to specific foods. There are lots of nonfood triggers that may be present, including going too long without eating, mental illness like anxiety, depression, or an eating disorder, poor sleep, and many others.

Can IBS be Cured?

According to the most recent research on IBS and functional gastrointestinal disorders that I could find, there is no cure. Obviously, that’s not the answer you were hoping to find, but it is important to know. That doesn’t mean there is no hope for finding relief from your symptoms and that your quality of life can’t be improved. What it does mean is that all of those health coaches, “doctors”, and other internet fiends that are claiming their diet, supplement, or treatment plan will cure your IBS are more or less full of shit. That doesn’t mean it won’t potentially help your symptoms, but remember, they are providing general advice and promising a cure because it will make them money a lot quicker than being honest about their product or working with you one-on-one.

What can I Eat for Breakfast when I have IBS?

In the nutrition field there always seems to be questions around breakfast. Should I eat breakfast? When should I eat breakfast? What should I eat for breakfast? Unsurprisingly, this breakfast enigma applies to people with IBS. And I get it. It’s hard to figure out what or how to eat so you won’t trigger symptoms. And with breakfast being the first meal of the day, and possibly the most important, it stands to reason that many people have questions.

To start, it depends on if you are following any kind of elimination diet, like low FODMAP, have allergies or intolerances, are vegan, vegetarian, pescatarian, etc. Due to the fact that individualized advice (!!) is going to be more helpful than general, let’s build a guide for what a good breakfast for anyone could look like.

Breakfast Guide:

1. Carbohydrate - toast, pancakes, oatmeal, breakfast cereal, banana, rice, quinoa, muffin, pastry, potatoes

2. Protein - protein powder, sausage, bacon, tofu, nuts or seeds (whole or as a butter), eggs, fish, tempeh, yogurt, cottage cheese, milk (cow or soy)

3. Fat - nut or seed butter, butter or margarine, full fat yogurt, bacon or sausage, olive oil, MCT or coconut oil, cheese

4. Source of Fibre - fruit, nuts or seeds, whole grains, beans or lentils

5. Foods you Enjoy - if this is difficult to do with your current diet you may want to reconsider it

6. Avoid Known Trigger Foods - if you have any that are currently causing symptoms

7. Coffee (or your preferred morning beverage) - coffee is a must for me

The point here is that your meal is balanced in terms of macronutrients, not in a sense that we are counting our macros, but balanced in a way that the meal will serve you satisfaction and energy for the day. Adding a good source of fibre at breakfast can help with digestive symptoms when done regularly and consistently, this is true for all meals and snacks.

With that in mind, here are a few questions and possible solutions to help you figure out what balanced might look like:

1. Do you find that you are often hungry soon after you eat breakfast?

   • Increase how much you eat

   • Increase your protein intake

   • Try something new, especially if you generally eat the same thing

2. Do you often get digestive symptoms after breakfast (bloating, stomach pain, acid reflux, etc.)?

   • You may need to work on identifying trigger foods

   • Try changing the type of carbohydrate you eat at breakfast (oats, rice, or quinoa, instead of wheat)

   • Decrease the amount of fat, if you think that’s appropriate

   • Eat a smaller amount and then follow up with a snack before your next meal

   • Consider if you slept well the night before

   • Are you nervous for something happening later in the day (presentation at work or school, an exam, starting a new job, having a difficult conversation with someone, an awkward social event)

3. Are you still looking in the fridge or pantry for something else to eat after you finish breakfast?

   • Trying increasing the amount of carbs you eat

   • Make sure you are eating the foods you actually want

4. Do you generally skip breakfast because you don’t find that you are hungry when you wake up?

   • If you’re interested in eating breakfast more regularly, try something small like a glass of milk, one piece of toast, yogurt, or some fruit

   • Notice if you become ravenous later in the day, or are lacking energy in the afternoon, breakfast may help

Below, listed under resources, I've included two links for breakfast recipes if you're looking for something new to try.

What's the Big Deal with Bananas?

Maybe it’s just me, but I’ve been hearing a lot of questions about bananas recently. Can you eat them when you have IBS? Do they cause or cure constipation? Should they be unripe, ripe, or overripe? Should you really use them to make "ice cream"? Okay, that last question is mine to every IG health coach.

The reason that they have become a big question within the IBS community starts with research from Monash University. If that name sounds familiar it’s because Monash University in Australia is where the low FODMAP diet started. In 2017, the FODMAP team at Monash University retested bananas for FODMAP content and found that they contained much higher levels of fructans (a type of FODMAP) then when previously tested.

The researchers explained that the way bananas are bred, grown, and stored before you buy them can increase the level of fructans. Another possible reason for this change in the level found, is that the technology currently being used for testing is more sensitive to FODMAPs then it used to be. Regardless of why, Monash University changed the recommended serving size for ripe bananas for those following a low FODMAP diet.

All of this happened 4 years ago, so why are people asking questions about bananas now? I believe it goes back to our “10 foods to avoid…” lists which now often include bananas and may be causing some confusion. Although eating a whole ripe banana is often not recommended for people with IBS who follow a low FODMAP diet, bananas are currently a popular constipation cure. So if you have IBS but the C (constipation) subcategory, should you eat bananas?

Maybe.

By now I bet you know what I’m going to say, if you tolerate and enjoy bananas then yes eat them, whether you have constipation or not. If bananas trigger symptoms, then don’t eat them, or eat them before they get ripe or in smaller quantities. And if you do have constipation, there are alot of solutions, diet related or otherwise, besides bananas.