Management of Irritable Bowel Syndrome with Low-FODMAP Diet

Primary High-FODMAP Foods to Eliminate

The American Gastroenterological Association recommends that patients with severe bloating and abdominal pain avoid wheat, milk products, garlic, onions, apples, pears, and foods containing high-fructose corn syrup, as these high-FODMAP foods are the most common symptom triggers and should be eliminated as part of a supervised low-FODMAP diet 1, 2
Wheat and wheat-based products, such as bread, pasta, and cereals, are specifically identified as "common culprits" and contain fructans that trigger symptoms, according to the Gastroenterology journal 1, 3
Garlic and onions are explicitly listed as primary triggers in the low-FODMAP algorithm, as stated in the Gastroenterology journal 1, 2
Rye and barley products contain high levels of fructans, which can worsen symptoms, as noted in the Praxis Medical Insights journal 3
Milk and high-lactose dairy products, such as regular milk, ice cream, and soft cheeses, are common triggers and should be avoided, according to the Gastroenterology journal 1, 2

Starchy vegetables, including some preparations of potatoes, and certain grains and grain products beyond wheat, should be restricted, as recommended by the Gastroenterology journal 4
Foods made with high-fructose corn syrup should also be limited, as stated in the Gastroenterology journal 4

The low-FODMAP diet must be implemented as second-line therapy only after first-line general dietary advice has failed, and must be supervised by a registered dietitian with GI expertise, as recommended by the Nature Reviews Gastroenterology and Hepatology journal 6, 1, 7, 5
A three-phase approach is required, consisting of a restriction phase, a reintroduction phase, and a personalization phase, as outlined in the Praxis Medical Insights journal 7, 2, 5

Rice, citrus juices, white grape juice, fish, chicken breast, eggs, olive oil, canola oil, and certain vegetables when cooked soft, are considered safe and can be consumed, as recommended by the Gastroenterology journal and Praxis Medical Insights journal 2, 4

The low-FODMAP diet has the strongest evidence base of any dietary intervention for IBS, with a meta-analysis of 11 trials demonstrating reduced risk of remaining symptomatic, as stated in the Praxis Medical Insights journal 2