5 Levels Of Diet For IBS

Use these levels to find the diet that works for you

1st Level

High Fiber Diet

The high fiber diet has shown success in research especially for those suffering from IBS-C (IBS with constipation).  Along with gut health and better motility, fiber helps regulate blood sugar, cholesterol levels, and weight. [1]

The Institute of Medicine recommends daily intake to include:

38g  for men 50 years or younger        30g for men 51 years or older

 25g  for women 50 years or younger       21g for women 51 years or older

The easiest way to add fiber to your diet is to switch out processed, packaged snacks and side dishes with plant based foods.  Dietary fiber is found in plants. Fruits, vegetables, grains, nuts and seeds, and beans are loaded with fiber.  Whole, natural foods when eaten in normal amounts as part of the diet, tend to help digestion and boost health.  Processed foods, with fiber added, sometimes make IBS symptoms worse.  Bloating, abdominal pain, and gassiness can occur.

A registered dietitian can help guide you if you find adding fiber to your diet difficult.

Here are some examples of high fiber foods:


  • Avocado 10.5 g fiber per cup – sliced
  • Berries –raspberries 8g fiber per cup, blackberries 7.6g fiber per cup, blueberries 3.6f fiber per cup, strawberries 2.9g fiber per cup
  • Pear 4.3 g fiber per cup – sliced
  • Figs 14.6 g fiber per cup – dried
  • Coconut 7.2 g fiber per cup


  • Chickpeas 8 g per cup
  • Black beans 12.2 g per cup
  • Lentils 10.4 g per cup
  • Split peas 16.3 g per cup
  • Lima beans 13.2 g per cup
  • Pinto beans 30 g per cup


  • Peas 8.6g cooked per cup
  • Okra 8.2  g cooked per cup
  • Brussels Sprouts 7.6 g per cup
  • Turnips 9.6 g per cup
  • Acorn Squash 9 g per cup
  • Artichokes 10.3 g per medium artichoke


  • 6 almonds = 0.6 g fiber
  • 1 oz walnuts = 1.9 g fiber
  • 1 tablespoon flax seed = 3 g fiber
  • 1 tablespoon chia seed = 5.5 g fiber
  • 1 cup quinoa = 5 g fiber

By adding these foods in and removing processed foods, fiber content goes up and GI health improves

Check in with your health care professional if conditions become worse or new symptoms appear. Fiber supplements have shown to be effective in some, but can aggravate symptoms in others.  Increasing fiber intake naturally through food is recommended.  Many people, even those who don’t have IBS, find health benefits in switching to a diet rich in high fiber foods.  Start by switching out low fiber for higher fiber foods.  Do this gradually and give your body time to adjust.  Drink lots of clean, fresh water.  Water helps keep the added fiber bulk moving and keeps the GI tract working.

Here are some examples of high fiber recipes from the MayoClinic

2nd Level

Gluten Free Eating

The gluten free diet has shown some success in research especially for those suffering from non celiac gluten sensitivity.  The gluten free diet excludes all foods containing the protein gluten.  Gluten is found in wheat, barley, and rye grains. Non celiac gluten sensitive individuals have symptoms including bloating, digestive issues, fatigue, but also, many report migraines, mood swings, depression, joint pain, acne, enlarged red blood cells, irritability, and nausea. [2] It is important to rule out celiac disease before going gluten-free.  If there is a chance that you may have celiac, removing gluten from your diet will keep certain antibodies from being produced which are crucial to diagnosis. [3]


In studies, individuals find relief from these symptoms with the removal of gluten from the diet.  Symptoms return when reexposed to gluten.  Medical tests show no markers associated with celiac disease and no allergy markers. [4][5] There are no tests to determine gluten sensitivity, diagnosis is a process of elimination. Patients test negative for celiac disease and wheat allergy, and show benefits removing gluten from their diet. It is estimated that about 6% of Americans have true gluten sensitivity.  That’s 18 million people! [6]

A registered dietitian can help guide you if you find removing gluten from your diet difficult.

Switch out gluten foods for gluten free foods to allow the GI tract to heal and recover.  Eventually you can add some gluten back into the diet to see if sensitivity is still an issue.

Check in with your health care professional if conditions become worse or new symptoms appear. The gluten-free diet has shown to be effective for some, others do not experience much benefit or the benefits are short-lived.

Here are some resources for gluten free eating:

Mayoclinic               Celiac.org               Gicare.com

3rd Level


The Paleo diet has been around for several years, but has experienced growing popularity in the last 4 years. So far, research is lacking on the effects of the auto-immune Paleo diet and managing IBS symptoms. Many educated authors are giving this diet credit for lowering inflammation, balancing bacterial flora in the GI tract, and helping ease allergy symptoms. Research has shown that IBS can be associated with both inflammation and allergy. [7]

The Paleo diet – sometimes called Auto-immune Paleo (AIP) – is based on the idea that our processed food has evolved past the evolution of humans and the GI tract giving us trouble digesting modern food. In the Paleolithic Era, agriculture did not exist. This diet eliminates foods that have only been around since man began to farm foods, especially processed foods and cereal products. [7][8]

The Paleo diet is based on whole, clean, organic foods. Grains, beans, and dairy are removed while clean proteins, plenty of fruits and vegetables, and healthy fats are included. The diet has shown success in case studies and I will be watching for upcoming research as this way of eating promotes good bacteria in the gut, high amounts of natural fiber, and intake of healthy fats. Small studies have shown very good results in managing IBS symptoms and improvement of nutrient absorption. [8]


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Because eating Paleo means removing grain and beans from the diet, some doctors warn that fiber, vitamin, and mineral intake should be monitored and made up by incorporating other foods with these nutrients. Although preliminary results seem positive, focusing on a clean, whole, diet may be the reason people are seeing promising results. More research is needed to examine long term use of this diet and why some people see such impressive results when following this way of eating.

A registered dietitian can help guide you if you need help following a Paleo-style diet.

Check in with your health care professional if conditions become worse or new symptoms appear.

Here are some resources for the Paleo diet:

Paleoleap.com                  Mayoclinic.org

4th Level


The Low FODMAP diet has shown real success in research. FODMAP is an acronym for fermentable oligo-, di-, monosaccharides and polyols. FODMAPS are sugars that are found naturally and synthetically in foods. The problem with FODMAPS is they are difficult for the intestines to digest and can be fermented by bacteria that live in the gut. Fermentation causes abdominal pain, changes in motility, and bloating. The diet involves identifying a threshold of where symptoms begin based on the amount of FODMAPS eaten. Studies have shown that test participants saw relief of symptoms in as little as 48 hours. About 74% of test participants saw improvement of all IBS symptoms. [9][10][11][12] The low FODMAP diet excludes high FODMAP foods and switches them for low FODMAP foods for 2 to 6 weeks. Diet benefits have been proven in children and adolescents also. [13] Once symptoms disappear, high FODMAP foods are reintroduced slowly to identify a tolerable level.

 Dietary FODMAPs are:
food chart

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Fructose – fruits, honey, high fructose corn syrup (HFCS), etc.

Lactose – Dairy

Fructans – wheat, garlic, onion, inulin, etc.

Galactans – legumes (beans, soybeans, etc.)

Polyols – sweeteners containing isomalt, mannitol, sorbitol, xylitol, stonefruits (avocados, apricots, cherries, nectarines, peaches, plums, etc.)


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5th Level

Elimination Diet

The elimination diet is the most restrictive and time-consuming diet. Because this diet requires careful documentation and tracking, it is recommended that you seek a registered nutritionist’s help. Common foods linked to food allergies and sensitivities are removed from the diet. After 2 or 3 weeks, a single food is reintroduced into the diet and given a few days to check for any adverse reactions. As harmful foods are identified, they are removed from the diet and tracked. Some foods are reintroduced to confirm a negative reaction. [14] Negative reactions include headaches, skin rash, joint pain, digestive problems, diarrhea, constipation, fatigue, anxiety, bloating, insomnia, sinus congestion or runny nose, flushing or itching. [15] Some individuals find that keeping an eating diary is also very helpful.

Foodallergy.org    Drdeborahmd.com    Aboutibs.org    Beyondmthfr.com    Harpersvillefamilymedicine.com

A registered nutritionist is recommended to monitor nutrition and avoid an imbalanced diet.

Some suggestions for generally safe foods include:

Brown Rice

Cooked or Dried Fruits – Sulfite-Free

No Citrus, Apples, Bananas, Peaches, or Tomatoes

Cooked Green, Yellow, and Orange Vegetables

Filtered Water – No Teas

Sea Salt, Maple Syrup, Honey, Molasses, and Vanilla Extract

Chicken, Turkey, Lamb, Cold-water Fish (Salmon, Mackerel, Halibut)

Organic Oils – Extra Virgin Olive Oil and Coconut

Try To Stay Away From All Processed Foods [16]



Heizer, W., Southern, S., & McGovern, S. (2009). The role of diet in symptoms of Irritable Bowel Syndrome in adults: A Narrative Review. Journal of the American Dietetic Association, 109(7), 1204-1214. doi:10.1016/j.jada.2009.04.012.


Erlichman, J., Hall, A., Dean, A., Godwin, B., & Mascarenhas, M. (2015). Integrative nutrition for pediatrics. Current Problems in Pediatric and Adolescent Health Care. doi:10.1016/j.cppeds.2015.12.007




Shahbazkhani, B., Sadeghi, A., Malekzadeh, R., Khatavi, F., Etemadi, M., Kalantri, E., . . . Rostami, K. (2015). Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: a double-blind randomized placebo-controlled trial. Nutrients, 7, 4542-4554. doi:10.3390/nu7064542.


El-Salhy, M., & Gundersen, D. (2015). Diet in irritable bowel syndrome. Nutrition Journal, 14(36), 1-11. DOI: 10.1186/s12937-015-0022-3.


What is Gluten Sensitivity?


Fardet, A. (2015). Wheat-based foods and non celiac gluten/wheat sensitivity: Is drastic processing the main key issue? Medical Hypotheses, 85, 934-939.doi:10.1016/j.mehy.2015.09.007.


Knight-Sepulveda, K., Kais, S., Santaollala, R., & Abreu, M. (2015). Diet and inflammatory Bowel Disease. Clinical Gastroenterology and Hepatology, 11(8), 511-520.


Mansueto, P., Seidita, A., D’Alcamo, A., & Carroccio, A. (2015). Role of FODMAPs in patients with Irritable Bowel Syndrome: A review. Nutrition in Clinical Practice, 20(100), 1-18. doi:10.1177/0884533615569886


Iacovou, M., Tan, V., Muir, J., & Gibson, P. (2015). The Low FODMAP Diet and its application in East and Southeast Asia. Neurogastroenterology And Motility: The Official Journal Of The European Gastrointestinal Motility, 21(4), 459-470. doi:10.5056/jnm15111


Marsh, A., Eslick, E., & Eslick, G. (2015). Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. European Journal of Nutrition, 1-10. doi:DOI 10.1007/s00394-015-0922-1


Halmos, E., Power, V., Shepherd, S., Gibson, P., & Muir, J. (2014). A diet low in FODMAPs reduces symptoms of Irritable Bowel Syndrome. Gastroenterology, 146(1), 67-75. DOI: 0.1053/j.gastro.2013.09.046.


Chumpitazi, B., Cope, J., Hollister, E., Tsai, C., McMeans, A., Luna, R., . . . Shulman, R. (2015). Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 42(4), 418-427. DOI: 10.1111/apt.13286


Heizer, W., Southern, S., & McGovern, S. (2009). The role of diet in symptoms of Irritable Bowel Syndrome in adults: A Narrative Review. Journal of the American Dietetic Association, 109(7), 1204-1214. doi:10.1016/j.jada.2009.04.012.





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