Advice on diet, particularly restricting caffeine and reducing intake of sorbitol and fructose, may help to alleviate symptoms. Wheat bran can aggravate the condition, but use of oats, ispaghula husk or sterculia as bulk laxatives may be beneficial. Probiotics may help some people and, in those who are interested, a trial of at least four weeks is advised to determine if there are beneficial effects.
Radical dietary restrictions or a low FODMAP (short-chain carbohydrate) diet should only be considered under supervision of a dietitian.
National Institute for Health and Care Excellence (NICE) guidance says that diet and nutrition should be assessed for people with IBS and the following general advice given:
Have regular meals and take time to eat. Avoid missing meals or leaving long gaps between eating
Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks. Restrict tea and coffee to three cups per day and limit alcohol and fizzy drinks
It may be helpful to limit the intake of high-fibre food, such as wholemeal or high-fibre flour, breads and cereals high in bran and wholegrains such as brown rice
Reduce intake of ‘resistant starch’ – starch that resists digestion in the small intestine and reaches the colon intact – which is often found in processed or re-cooked foods
Limit fresh fruit to three portions per day – a portion should be ~80g
People with diarrhoea should avoid sorbitol, an artificial sweetener found in sugar-free drinks and sweets, including chewing gum, and in some diabetic and slimming products
People with wind and bloating may find it helpful to eat oats, such as oat-based breakfast cereals or porridge, and linseeds – up to one tablespoon per day.
Dietary advice