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IBS Dietary Options
Beyond adjusting when and how you eat, there are several evidence-based diet solutions for IBS.
The Beginning Diet for IBS
Living with IBS can be frustrating, especially when it comes to food. While many people worry that symptom management requires a strict diet, relief often begins with simple, practical changes.
Gentle GI refers to the diet and lifestyle strategies recommended as a first step by leading organizations. This approach is designed to be realistic, flexible, and easier to maintain in everyday life.
More Recommended Diets
While the internet and social media are full of diet options for managing IBS, not all of them are supported by science. Click on the cards to explore more evidence-based diets that have been extensively studied for IBS.
Working with a registered dietitian is the best way to help sort out food triggers and design a diet adapted to individual health goals, lifestyle, and budget.1
Diets with Emerging Evidence
Some diets used to manage IBS are still being studied. The dietary approaches below show promise, but still need more supporting data.
Although some patients with IBS improve with a gluten-free diet, the reality is that other components of grains and patients' beliefs and expectations play a major role in driving IBS symptoms after ingestion of gluten products.
A summary of all available studies showed:1
- Around 1 in 10 adults say they’re sensitive to gluten or wheat, yet true gluten-specific reactions were uncommon and typically mild
- FODMAPs and expectation effects explain most cases
- The symptoms are real - but the mechanisms are often gut–brain related, not gluten-driven
Considering that gluten is not the real problem in the majority of patients with IBS, make sure to optimise diet quality and consider short-term, dietitian-supervised trials rather than lifelong gluten restriction.
References
- Prados A. Why gluten and wheat may not be the dietary villains driving IBS symptoms. European Society of Neurogastroenterology & Motility. Available from: https://www.gutmicrobiotaforhealth.com/why-gluten-and-wheat-may-not-be-the-dietary-villains-driving-ibs-symptoms/
- Spencer M, Chey WD, Eswaran S. Dietary renaissance in IBS: has food replaced medications as a primary treatment strategy? Curr Treat Options Gastroenterol. 2014; 12(4):424-40. doi: 10.1007/s11938-014-0031-x.
Some patients with IBS find relief with a low-carbohydrate diet, which could be explained by a deficiency in sucrase-isomaltase, an enzyme produced by the brush border of the small intestine to metabolize sucrose. This will impact sucrose digestion, but may have a varying impact on starch tolerance.1
A recent study suggests that a low-carbohydrate diet may work as well as following a low FODMAP diet plus healthy eating habits (eat slowly, have regular, small meals, and limit other foods and drinks that could trigger symptoms). What is noteworthy is that both dietary options may offer much greater symptom relief than medications against the main symptom. Participants were given personalized support to follow the diets.2
For instance, the low-carbohydrate, high-fat diet, focuses on foods like beef, pork, chicken, fish, eggs, cheese, yogurt, vegetables, nuts, and berries.
After four weeks, 76% of those in the low-FODMAP group and 71% of those in the low-carbohydrate group reported significant reductions in their IBS symptoms. By contrast, 58 percent of those in the medication group reported significant improvements. At six months, participants in the diet groups still had fewer symptoms than at the start of the trial, even though most did not stick to the diets as closely.2
References
- Chey WD, Cash B, Lembo A, et al. Congenital sucrase-isomaltase deficiency: what, when, and how? Gastroenterology & Hepatology. 2020; 16(10 Suppl 5):1-10. Available from: https://www.gastroenterologyandhepatology.net/supplements/congenital-sucrase-isomaltase-deficiency-what-when-and-how/
- Nybacka S, Törnblom H, Josefsson A, et al. A low FODMAP diet plus traditional dietary advice versus a low-carbohydrate diet versus pharmacological treatment in irritable bowel syndrome (CARIBS): a single-centre, single-blind, randomised controlled trial. Lancet Gastroenterol Hepatol. 2024; 9(6):507-520. doi: 10.1016/S2468-1253(24)00045-1.
Exclusion diets guided by novel diagnostics (e.g., CLE, IgG, and leukocyte activation) aimed at identifying atypical food allergy/immune-mediated reactions have shown positive results for individuals with IBS, but more research is needed before recommending them as an option.
A technique, confocal laser endomicroscopy (CLE), that allows visualization of the small intestine mucosal response to specific food components during standard gastroscopy in real time, has found that some patients with IBS have atypical food allergies, induced by a disruption of the gut barrier, particularly to wheat.1 However, mucosal alterations assessed by CLE are not always associated with increased permeability and immune cell activation, and a diet based on food-induced alterations was not efficacious for improving symptoms in a recent study. Indeed, mucosal alterations occurred in the same percentage of healthy people and did not seem to be IBS-specific, meaning that it is too early to exclude specific food groups based on the results of CLE.2
IgG- Food sensitivities are emerging as a relevant driver of IBS symptoms. However, the role of dietary elimination based on immunoglobulin G testing (an antibody your body produces to fight infections and against certain foods) in improving IBS symptoms remains unclear.
A recent randomized, blinded, sham-controlled trial suggested the potential of an IBS-specific IgG assay to guide personalized diets that exclude specific foods previously identified to elicit IgG antibody responses in patients with IBS but not in healthy individuals. However, 2 of the 3 most commonly eliminated foods in the IgG-based elimination diet were high in FODMAPs (eg, milk, wheat), whereas all 3 most commonly eliminated foods in the sham diet were low in FODMAPs (poultry, rice, and goat cheese). More research is needed before using testing-based strategies for dietary therapies in IBS.3
References
- Fritscher-Ravens A, Pflaum T, Mösinger M, et al. Many patients with irritable bowel syndrome have atypical food allergies not associated with immunoglobulin E. Gastroenterology. 2019; 157(1):109-118.e5. doi: 10.1053/j.gastro.2019.03.046.
- Balsiger LM, Rusticeanu M, Langhorst J, Sina C, Benamouzig R, Huang C, Tack J, Kiesslich R. Review: Food-induced mucosal alterations visualized using endomicroscopy. Neurogastroenterol Motil. 2025 Jan;37(1):e14930. doi: 10.1111/nmo.14930. Epub 2024 Sep 24. PMID: 39314095.
- Singh P, Chey WD, Takakura W, et al. A novel, IBS-specific IgG ELISA-based elimination diet in irritable bowel syndrome: a randomized, sham-controlled trial. Gastroenterology. 2025; 168(6):1128-1136.e4. doi: 10.1053/j.gastro.2025.01.223.
