Irritable Bowel Syndrome (IBS) affects millions of people worldwide (some prevalence estimates suggest 30% of people living with chronic conditions like Ehler's Danlos Syndrome and lupus also have IBS) and it is often managed through diet changes, lifestyle adjustments, and sometimes medication. If you’re newly diagnosed or suspect you have IBS, it’s common to wonder what dietary approaches actually help—and what sacrifices might be involved.

Common Diets Used to Treat IBS

The most well-researched diet for IBS is the low-FODMAP diet, developed by researchers at Monash University. FODMAPs are certain types of carbohydrates that can ferment in the gut and cause bloating, gas, cramping, and diarrhea or constipation in sensitive individuals.

The low-FODMAP diet has three phases:

1. Elimination – Temporarily removing high-FODMAP foods like onions, garlic, wheat, beans, certain fruits, and dairy.

2. Reintroduction – Gradually testing individual FODMAP groups to identify personal triggers. Food mapping is what this diet therapy is all about and knowing what groups of foods and beverages to avoid or include is a personal decision point.

3. Maintenance – Creating a balanced, personalized diet that avoids only the necessary triggers and includes as much variety as possible (true food freedom) should be the goal.

Other helpful diets include:

• High-fiber diets (for constipation-predominant IBS)

• Low-fat diets

• Gluten-free diets (especially if non-celiac gluten sensitivity is suspected)

Dietitian Recommendations for Getting Started

Registered dietitians usually recommend starting with a food and symptom diary to identify patterns. They may suggest trying the low-FODMAP diet under professional supervision, as it can be restrictive and confusing when done alone. Our dietitians are seasoned at creating pain-less and worry free online tracking methods to help you.

It’s also important to avoid making extreme changes without guidance. Many IBS sufferers benefit from small, consistent adjustments and stress management alongside diet changes.

Do I Need to Give Up Coffee and Alcohol?

Not necessarily. Coffee and alcohol aren’t technically high in FODMAPs, but they can stimulate the gut and worsen symptoms, especially diarrhea or urgency. Many people tolerate moderate amounts (knowing your personal milligram amount of caffeine is key)—tracking personal response to caffeine is helpful.

Can I Eat Fast Food or Dine Out?

Yes, but with caution. Dining out while on a therapeutic diet can be tricky—many fast foods contain hidden FODMAPs like garlic, onion, and wheat. However, planning ahead, asking questions, using technology and trusted food sourcing can make eating out manageable.

Will IBS Resolve on Its Own?

IBS is a chronic condition, meaning it doesn’t typically “go away.” However, many people find that symptoms improve significantly with the right diet, stress management, and sometimes medication.

What Over-the-Counter Options Exist for IBS?

Over-the-counter options include:

• Antispasmodics (e.g., peppermint oil capsules)

• Laxatives (for constipation)

• Anti-diarrheals (like loperamide)

• Fiber supplements (like psyllium husk)

Always consult a provider before starting new treatments.

What to Expect at the Gastroenterologist

A gastroenterologist will take a detailed medical and symptom history, possibly order blood tests, stool tests, or a colonoscopy to rule out other conditions and may often diagnose IBS based on Rome IV criteria, which consider symptom patterns over time

Treatment usually begins with diet and lifestyle advice, sometimes paired with medications.

Managing IBS is highly individual, but with support and experimentation, most people find a combination of strategies that significantly reduce symptoms. Consulting a gastroenterologist is a great first step.