Integrating Nutritional Strategies Into IBS Chronic Care Management


Irritable bowel syndrome (IBS) is a chronic gut disorder that can have a debilitating impact on those living with it. Symptoms—gas, bloating, abdominal pain, diarrhea, constipation—can be sporadic and unpredictable, which can increase anxiety and stress and make symptoms worse. It is estimated that between 10% and 15% of the U.S. population live with the disorder, and it is one of the most frequent disorders that doctors see.

While there is no cure for IBS, making simple lifestyle changes, especially in diet, is one of the most critical aspects of managing the disorder. This blog explores the vital role nutrition plays in managing your IBS and offers guidance on dietary strategies that you can use to help alleviate your symptoms and improve your well-being.

Understanding the Role of Nutrition in IBS

According to the American College of Gastroenterology, IBS is not a problem with the bowel’s lining or structure but with the bowel’s function; it results from “changes in nerves and muscles that control sensation and motility of the bowel”. While the cause of IBS is unknown, it is believed to be related to how the brain and gut communicate.

IBS also affects how gastrointestinal (GI) muscles move food through the GI tract. In those with IBS, muscles tend to contract more, which can cause abdominal cramping and pain. Some individuals with IBS may have more sensitive nerves in their GI tract that increase the sensations of discomfort and pain.

While the types of food that trigger IBS symptoms can vary from person to person, common culprits include dairy, gluten, and food known to cause gas, like beans, cabbage, and carbonated drinks.

Nutritional Strategies for Managing Your IBS

There are four proven steps you can take to alleviate your IBS symptoms. However, it is important to remember that each person is unique, and what works for them may be different than what works for you. The best approach is to work closely with a registered dietitian or nutritionist to help you incorporate each strategy in a way that works best for your personal situation.

Adopt a low FODMAP Diet

FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols.” These are “short-chain carbohydrates (sugars) that the small intestine absorbs poorly.” These forms of sugar can cause digestive issues in some people, which is why a diet low in FODMAP foods can benefit those with IBS.

According to Johns Hopkins Medicine, the first step in implementing a low-FODMAP diet is to eliminate all foods that contain FODMAPs. These include dairy-based milk, yogurt, and ice cream; wheat-based products; beans and lentils; vegetables like artichokes, asparagus, onions, and garlic; and fruits like apples, cherries, pears, and peaches. Your dietician or nutritionist can provide a full list of FODMAP foods to avoid during this portion of the diet.

After all FODMAP foods have been eliminated, they should be reintroduced slowly, one by one, to identify which ones cause symptoms. These are the foods that you may want to permanently eliminate or limit in your diet.

Increase Your Fiber Intake

Fiber is essential for maintaining gut health, but it’s important to choose the type best suited for your particular IBS symptoms. Soluble fiber, which is found in oranges, berries, peas, and oats, removes excess water in the digestive tract to alleviate symptoms like diarrhea. Insoluble fiber, which is found in food like zucchini, broccoli, and leafy green vegetables, can be better for those dealing with constipation and related symptoms. By adding bulk to the stool, insoluble fiber has a laxative effect. Your dietician or nutritionist can help determine which type of fiber you need the best foods and the right amount of those foods to incorporate into your diet.

Take Prebiotics and Probiotics

An individual’s gut contains trillions of bacteria that help promote healthy bowel function. Probiotics are microorganisms that help maintain the presence of good bacteria in the gut, while prebiotics act as food for the probiotics. Together, they help create a healthy, balanced gut microbiome.

Since IBS can be related to an unhealthy microbiome, incorporating prebiotics and probiotics into your diet can help regulate your gut flora and alleviate symptoms. Probiotics are present in fermented foods like sauerkraut and yogurt, while prebiotics are found in foods like bananas, greens, and whole grains. Both are available in supplement form, which can be a convenient option to ensure you get the right amount.

Stay Hydrated

The human body is about 60% water. Without adequate hydration, those who live with IBS can experience worsening symptoms. Drinking an adequate amount of water, at least two liters a day, improves the function of the digestive tract, leading to reduced IBS symptoms. It’s important not to wait until you’re thirsty before drinking water, though; once you feel thirsty, your body has likely already lost two to three percent of its water. Alcohol and caffeine can cause dehydration and should be limited as they can trigger IBS symptoms.

To ensure you’re drinking enough water, the Mayo Clinic suggests the following tips:

  • Flavor water with lemons, limes, cucumbers, or other healthy foods to make it more enjoyable to drink.
  • Create a habit of drinking water after routine activities such as brushing your teeth or using the bathroom.
  • Set a reminder on your smartphone to remind you it’s time to drink.
  • Carry water with you as you go about your day and fill a bottle to take in the car.
  • Switch it up by alternating water with another healthy drink, such as juice.
  • Eat more fruits and vegetables that naturally contain a lot of water, such as cucumbers, lettuce, celery, and melons.

Implementing Strategies and Staying on Track

Putting these strategies into action will take time and patience, but the payoff will be worth it. It’s important to look at these strategies holistically. In other words, they should be treated as part of a larger plan that includes reducing stress, prioritizing mental health, maintaining overall physical health, and seeing your primary care doctor regularly.

One of the best ways to be more successful in implementing your IBS strategies is to work with a registered dietician or nutritionist to create a personalized IBS management plan and help monitor and adjust it as needed.

Putting it all together

Many people assume that IBS symptoms are just something they have to live with, but this is not true. There are proven steps you can take to alleviate symptoms and improve your overall well-being. The first step is to reach out to your GI doctor. If you don’t yet have a GI doctor, the GI Alliance website can help. Along with a searchable database of doctors in your area, the website provides other resources to help you on your IBS journey.