This elimination diet is extreme and should not be followed for longer than one week. It’s designed to help people who suffer from severe, persistent diarrhea-predominant IBS determine which foods may be aggravating their condition. (If you have occasional symptoms from IBS, the elimination diet plan is not appropriate or warranted. Search the rest of the IBS section for helpful information on managing milder cases.)
My Extreme Elimination Diet avoids all common IBS trigger foods. This plan is very low in dietary fiber and is based on the few foods I’ve found that people with this type of IBS can tolerate best. Fiber (and nutrition) will be slowly increased as you introduce new foods.
If you’re a candidate for this plan, follow it for one week. Every day, choose one option for each of the three meals: breakfast, lunch, and dinner. Then, one or two times per day, choose from a variety of my suggested snacks. Eat slowly and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage, and try to drink at least 8 cups throughout each day.
After following this plan for one week, you can start experimenting by adding new foods. You should add one new food every two to three days (it’s best to stick with one portion of a new food per day). Keep an IBS diary and write down everything you eat — and everything you feel. Pay close attention to how you feel after eating each new food, which will help you determine if it can be permanently reintroduced into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next food category. You can always retest a problem food at a later date.
At the end of this tough assignment, you will have identified most of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods:
- Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
- Sweet potatoes
- Wheat products: Start with white versions of bread, crackers, and pasta. In the future, you can slowly test small amounts of whole wheat varieties.
- Oats, oatmeal, and barley
- Brown and wild rice
- Cooked vegetables (non-cruciferous)
- Fruit (peel fruits with tough outer skins at first)
- Whole nuts and seeds
- Garlic and onion
- Starchy beans and lentils
- Cooked cruciferous vegetables
- Raw vegetables
- Ketchup, soy sauce, and other condiments (test one at a time)
- Dried fruit and all-fruit jams
- Fruit juice, sugar, and honey
- Coffee or tea