Diet and Irritable Bowel Syndrome (IBS)

Peppermint oil acts on the nerves in the bowel. It can help with general symptoms, especially tummy pain. You can take up to two capsules at a time, up to three times a day. Try a lower dose if it gives you reflux.

The gut is closely linked to the brain. Symptoms can be worse in times of stress or anxiety. If this is the case for you, diet can help but might not fully resolve your symptoms. IBS symptoms can be worse after eating because that is when your gut is most active, but looking after your wellbeing can be even more effective than looking at what you eat.

Try ways to relax and manage stress. If you have a smartphone or tablet you can download mindfulness or meditation apps, or try relaxation podcasts. 

If stress or anxiety are making you feel unwell, or you are feeling low in mood, speak to your GP.

Recent studies show that talking therapies can help IBS symptoms even more than dietary changes.

Vita health group are the local NHS provider of talking therapies. You can self refer at the following website:

Vita Health Bristol, North Somerset, and South Gloucestershire 

Studies show that gut directed hypnotherapy can really help with IBS. Make sure to check your hypnotherapist is registered with the British Association of Clinical and Academic Hypnotherapists.

There are some medicines that can help with symptoms. You can talk to your GP about this.

Exercise and movement can help IBS symptoms, particularly constipation. It can also help you feel less stressed, which can make symptoms better. Try to take regular exercise, such as walking, cycling or swimming.

It is very important to drink enough.

Fluid can help with constipation. It can make poo softer and easier to pass. If you have diarrhoea, you need to drink more to replace the fluid lost. Aim to drink at least 8 drinks each day (1.5 - 3L), especially water and other caffeine free still drinks.

If you drink fizzy drinks regularly, try drinking less of these.

For some people, caffeine can cause symptoms or make them worse. Caffeine is in food and drinks such as tea, coffee, cola, energy drinks and chocolate.

Try to have no more than three caffeinated drinks per day. You could have herbal or fruit teas and decaf tea and coffee instead. 

Coffee can make your bowels open more, even decaff coffee. If you have diarrhoea, try to avoid it. If you have constipation you could try drinking more of it.

Sugar free chewing gum, sweets, mints, and specialist diabetic foods contain artificial sweeteners called polyols. These can cause diarrhoea and bloating. Avoid foods with these in the ingredients list:

• Xylitol.
• Mannitol.
• Isomalt.
• Sorbitol.

If you notice that you have symptoms after having food or drink that contains milk, you may be lactose intolerant. 

• You can ask your doctor to test for this. The test is called a lactase hydrogen breath test. If this is not available, then you can try a low lactose diet.
• If your symptoms are not better after 7 days, lactose is unlikely to be the cause. You should return to your usual diet.

Lactose intolerance is more likely in those with Caribbean, South American, Asian or African ethnic backgrounds.

Sources of lactose include:

• Cow/sheep/goat milk and yoghurts made from these.
• Whey.
• Skimmed milk powder.
• Buttermilk.
• Soft cheese and cottage cheese also contain lactose.

Cream, butter, Greek yoghurt, hard cheddar cheese, parmesan, mozzarella and Swiss cheese are much lower in lactose and may be tolerated.

You can have soya, almond, nut or oat milk alternatives, but make sure you are choosing products that have added calcium.

Cutting down on fat may help IBS symptoms, especially if you get gut pain, indigestion or discomfort around meal times.

Fatty foods include:

• Fatty cuts of meat.
• Cream.
• Butter.
• Fried foods.
• Cakes.
• Chocolate.
• Pastries.

Choose lower fat dairy products and lean meats. Grill or steam food instead of frying or roasting in oil. It can be helpful to measure oil out when cooking using a spoon or spray.

Takeaways are high in fat, and food from pubs, cafés and restaurants can have more fat than food you make at home.

Capsaicin is found in chilli, cayenne pepper and paprika. It can cause gut pain or reflux in some people. If you get symptoms after eating spicy foods try not to eat foods that have chilli, cayenne pepper or paprika in.

Probiotics contain bacteria that may help you. Some people with IBS have a different balance of bacteria (microflora) in the gut than other people.

The scientific studies on probiotics in IBS symptoms show mixed results. The research is promising but it is still very new. Trying a probiotic is not harmful in IBS, so it is something which you may wish to try.

There are lots of different brands available, containing different strains of bacteria in different forms and doses. There is no way to know whether your IBS will respond to probiotics, or which brand or strain will help you the most.

If you are considering trialing probiotics, here are some guidelines to follow.

• Take the probiotic daily and follow the manufacturer’s instructions.
• You need to try it for four weeks before you will know if it works for you.
• If your symptoms don’t get better try a different brand.
• There are strict rules about what products can be called probiotics. Make sure it says the word “probiotic” on the label.
• Look for products stating that the bacteria reaches your gut and it has been tested to remain active, alive or survive through your stomach and gut.
• It should not contain lactose or polyols, which could make symptoms worse.
• Alflorex, Symprove, Yakult and VSL#3 are examples of products that have been proven to help patients with IBS.

If you have constipation, try to eat more high fibre foods. Start with making changes to one meal a day and build up slowly so you don’t make symptoms worse. Drink more to help the fibre go through.

High fibre foods:

• Fruit.
• Vegetables.
• Wholemeal/granary bread.
• Wholemeal pasta.
• Oats.
• Nuts.
• Seeds.
• Basmati and brown rice.
• Potatoes with skins on.
• Beans.
• Pulses.

Studies show that eating a variety of these foods works best. Do not add wheat bran to food as this can make symptoms worse.

• Kiwi fruit are very high in fibre, and don’t tend to cause wind or bloating. You could try having these more often.
• Prune juice can help with constipation but whole prunes can cause bloating.
• You can buy psyllium husk or isphagula husk (Fybogel) powder as a fibre supplement, which can increase bowel action but may lead to wind and bloating.

Some studies have found that linseeds/flaxseeds may help constipation, pain, and bloating. They do not tend to make diarrhoea worse so are helpful if you have a variable bowel pattern.

• Start with one teaspoon daily and build up over 3 weeks to two tablespoons daily.
• Add to breakfast cereal, yogurt, soups and salads.
• Brown, golden, ground and whole linseeds or flaxseeds have all been shown to have a positive effect.
• Drink an extra cup of water (around 150ml) at the same time with each tablespoon of linseeds/ flaxseeds you take.
• It can take three months to see any benefit.

Alcohol can make symptoms worse like loose stools, gut pain and nausea. Try to drink no more than 14 units of alcohol per week. Spread your alcohol over at least three days. A good way to cut down is to have a few alcohol free days each week.

What is a unit?

If nothing else works then a low FODMAP diet might help. It is proven to really help a lot of people with IBS.

We don’t like to try it first because it is a big undertaking:

• It is very restrictive so can be expensive.
• It makes eating out with family very tricky.
• It takes longer to shop for and prep for food.
• It is low in vitamins, minerals, and fibre.

It involves 4 - 8 weeks of removing a long list of foods from your diet. Then you trial set amounts of certain foods and monitor symptoms. The whole process takes 4 - 6 months.

What are FODMAPs?

FODMAPs is an acronym for certain starches and types of sugars: 

• Fermentable
• Oligosaccharides
• Disaccharides
• Monosaccharides
• And
• Polyols

These starches do not get absorbed in your small intestine, instead they travel to your large intestine where there are billions of bacteria. The bacteria ferment FODMAPs which produces gas.

FODMAPs also pull water into the bowel. This is why the diet can help with wind, bloating, loose stools and urgency.

People who follow the diet more strictly are more likely to get better symptoms. 

• It takes a lot of effort to plan and organise the diet and can have an impact on your quality of life.
• The diet could cause some nutrient deficiencies and weight loss.
• It can also affect the gut microflora, which can make symptoms worse in the long term.

This is why we like to try other dietary changes first, and why we advise that you should only try the diet with the support of a dietitian.

If you want to try the low FODMAP diet, contact us and we can talk it through in an appointment.

You can watch a webinar at to learn what the diet involves at:

Patient webinars on Irritable Bowel Syndrome