Diet
Dietary changes that may be helpful
Several trials report that food sensitivities occur in only a small percentage of people with IBS.1, 2, 3 However, a leading researcher in the field claims at least 3.5 ounces of the offending food need to be consumed at frequent intervals to provoke IBS symptoms,4 and the amount of test foods used in these studies was generally less than this amount. Therefore, inadequate quantities of food may have affected the outcomes of these trials. Other trials have reported that most IBS sufferers have food sensitivities, and that gas production and IBS symptoms diminish when the offending foods are discovered and avoided.5, 6, 7, 8 Some researchers report that problem foods need to be eaten at every meal for at least two days to evaluate the potential of food sensitivity.9
Researchers have found that standard blood tests used to evaluate allergies may not uncover food sensitivities associated with IBS, because IBS food sensitivities may not be true allergies.10, 11 The only practical way to evaluate which foods might trigger IBS symptoms is to avoid the foods and then reintroduce them. Such a procedure requires the guidance of a healthcare practitioner. Attempts to find and avoid problem foods without professional help may fail and may aggravate symptoms.
Preliminary evidence suggests that some people with IBS have greater trouble absorbing the sugars lactose (as found in milk), fructose (as found in high concentration in fruit juice and dried fruit), and sorbitol (as found in some dietetic candy) than do healthy people.12 In this report, restricting intake of these sugars led to reduction in symptoms in 40% of people with IBS.
Limited research has suggested that fiber might help people with IBS.13, 14 However, most studies find that IBS sufferers do not benefit by adding wheat bran to their diets,15, 16, 17, 18 and some people feel worse as a result of wheat bran supplementation.19 The lack of positive response to wheat bran may result from a wheat sensitivity,20 which is one of the most common triggers for food sensitivity in people with IBS.21Rye, brown rice, oatmeal, barley, vegetables, and psyllium husk are good sources of fiber and are less likely to trigger food sensitivities than is wheat bran. Except for psyllium, little is known about the effects of these other fibers in people with IBS.
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