Diet and IBS - beyond FODMAPs

Food and IBS Symptoms

About 9 in 10 people with IBS report that food makes their symptoms worse, and most people have tried changing their diet to improve their IBS.

Outside of FODMAPs, there are several dietary factors that can be symptom triggers. It's worth being aware of these, so you can experiment with adjusting them if you think you might be sensitive to them.

Remember there’s no one-size fits all approach to managing IBS so it’s a case of exploring what works for you.

1. High-Fat / Rich Foods:

Research suggests foods and meals high in fat (like creamy sauces, chips, pizza and takeaways) may increase symptoms like bloating, tummy pain and loose poo.

If you think fatty foods are a problem for you, you can explore cutting down the amount you eat. For example, avoiding fried foods, opting for leaner meats, going for a tomato-based sauce over a creamy sauce and using smaller amounts of fat in cooking.

Try it: Reduce rich or higher fat foods like chips, pies, batter, cheese, pizza, creamy sauces, spreads and cooking oils, and fatty meats such as burgers and sausages

2. Coffee/Caffeine:

A morning cup of coffee is a daily ritual for lots of us, but studies show 26-40% of people with IBS think that caffeine makes their symptoms worse. It’s true that caffeine and compounds within coffee can increase contractions in the large intestine, triggering an urge to poo.

Coffee may also aggravate acid reflux and heartburn. Given what we know about the impact of coffee on the gut, you’re more likely to benefit from reducing your intake if you have IBS-D, Ioose stools, or heartburn. 

But, if you struggle with constipation, you might find a cup of coffee helpful! If this is you, aim to have your coffee before 12pm so it doesn’t affect your sleep.  

Try it: reduce caffeine-containing drinks to no more than one-two a day. Try to drink least eight cups of fluid per day, especially water and caffeine/coffee-free options. We like rooibos, peppermint or lemon and ginger tea.  

3. Spicy Foods:

While spice adds flavour to meals, it might not sit well if you have IBS. Several studies have linked spicy foods (like curry and chilli) with an increase in IBS-symptoms, including tummy pain, heartburn and loose poo.

This could also be because these dishes usually contain high FODMAP onion and garlic. But there is evidence that people with IBS have more receptors in the gut that are sensitive to the compounds that make spicy foods hot.

If you think you might be sensitive to spicy food, try cutting down for a week or two and see if it makes a difference.

Try it: Swap fresh and dried chillies for warming spices like turmeric, paprika and cinnamon. Avoid spicy condiments like tabasco, chilli sauce, and sriracha. Here at Field Doctor, we’re also a fan of using lots of fresh herbs to flavour food.

4. Alcohol:

Around 30% of people with IBS report that alcohol makes their symptoms worse. Studies show alcohol can aggravate loose stools and acid reflux, and disrupt the gut microbiome in unhelpful ways.

These effects are more common with large intakes of alcohol (several drinks in one go) versus light drinking (1 drink or less per day). If you’ve noticed a link, or you’re currently drinking more than 1-2 units a day (a 175ml glass of wine is 2.3 units) try cutting down.

Try it: limit alcohol to no more than two units per day (a 175ml glass of wine is 2.3 units) and aim for at least two drink free days a week

5. Eating habits:

Several studies have found that people with IBS are more likely to have irregular eating patterns (skipping meals, leaving long periods between meals, or eating late at night) than people without IBS. 

This might be a consequence of trying to manage symptoms, but it’s also true that eating habits can impact digestion. I’m guessing most of us have experienced the discomfort that comes from eating a large, rich meal late at night or feeling full after rushing a meal.

Taking time to eat and having a regular eating pattern can support digestion and are good habits to adopt as part of a healthy lifestyle.

Try it: Aim for a regular eating pattern, including breakfast, lunch, dinner and a snack. Take time to eat your meals (away from your desk or a screen if possible). Whenever possible, avoid eating late at night so that you have time to digest your meal and wind down before you sleep.