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IBS: What's in Your Cup?
Figuring out what you can drink when you have IBS may feel like a losing battle, but you'll be surprised by how many drinks you can have that won't cause you GI distress.
By Marie Suszynski
Medically Reviewed by Farrokh Sohrabi, MD
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A bout of gas, bloating, cramps, and diarrhea or constipation may make you re-evaluate your meals to find out where you went wrong. But if you have IBS, the culprit could be in your cup.
Irritable bowel syndrome (IBS) happens when the nerves and muscles in the intestine become oversensitive and don’t function properly, leading to diarrhea, constipation, or both.
While most people without IBS will use the bathroom 30 to 60 minutes after eating, some people with IBS will have to go sooner and will feel pain and may have diarrhea.
Research has found that choosing foods and beverages low in "FODMAPs," or fermentable sugars in foods such as fructose, lactose, sorbitol, and frutans, and avoiding foods high in FODMAPs helps relieve IBS symptoms.
In a 2013 study by researchers from New Zealand and Amsterdam, 90 people with IBS reported significant improvement in symptoms such as abdominal pain, bloating, flatulence, and diarrhea after following a low FODMAP diet.
That’s good news, but because the sugars in high FODMAP foods are in so many drinks — and other drinks such as coffee and alcohol are also considered no-nos when you have IBS — it might leave you wondering what you can drink.
The good news? The choices are probably greater than you think.
IBS: Drinks to Stay Away From
First consider the drinks that are likely to make your IBS symptoms worse. One big culprit is any beverages containing fructose or high-fructose corn syrup, says Rebecca Solomon, RD, clinical nutrition coordinator for the department of clinical nutrition at Mount Sinai Medical Center in New York City.
That’s because some people with IBS are intolerant to fructose. In a 2008 study published in the Journal of Clinical Gastroenterology, researchers tested 80 people with IBS and found that about one third were fructose intolerant. For them, restricting fructose helped their symptoms.
It’s a good idea to avoid juices made from fruits with a high fructose content, including apples, mangos, pears, and watermelon, Solomon says. It also means you’ll have to be diligent about checking labels of other drinks such as teas, juices, and sodas for high fructose corn syrup. Odds are you’ll find it on product labels because it’s so widely used by manufacturers.
Also avoid sugar-free drinks made with artificial sweeteners containing polyols because they're also known to bring on IBS symptoms. Those include any sweeteners ending in “-ol,” such as sorbitol, mannitol, maltitol, and xylitol, as well as isomalt. You’re likely to find them in diet sodas, sugar-free juices, and sugar-free teas.
If you make your own vegetable juices, keep in mind that onions and garlic are considered major contributors to IBS, so they’re something to avoid, Solomon says. Also pass on juices made from other vegetables high in FODMAPs, such as beets, cabbage, fennel, legumes, peas, avocados, cauliflower, mushrooms, and snow peas.
As for caffeine, it's known to move the bowel for most people, but the effect tends to be worse for those who have IBS. It’s a good idea to eliminate or limit the caffeine you drink in coffee, tea, and other drinks.
And for the most part, alcohol, especially heavy drinking, can cause IBS symptoms. In a 2013 study, researchers compared the gastrointestinal symptoms of women with IBS to women who didn’t have IBS after drinking alcohol. When the women who had IBS reported having more than four alcoholic drinks in a day, they were also more likely to experience diarrhea, nausea, stomach pain, and indigestion compared to women who didn’t have IBS.
IBS: What to Drink
After eliminating the big offenders, it may seem like there’s nothing left to drink. Not so. Take a look at all of the beverages on the thumbs up list.
Fruit juices.It’s perfectly appropriate to drink juices made from cranberries, bananas, grapefruits, lemons, grapes, and pineapples as long as they don’t contain corn syrup. It’s best when the juice is made fresh from organic fruits without added sugar, Solomon says. But if you do want to sweeten it up, choose a small amount of white sugar or the sweeteners Stevia or Splenda if you can tolerate them. (Those sweeteners bring on IBS symptoms for some people, but are safe for most, she said.)
Vegetable juices.There are several vegetables that are low in FODMAPs that are perfect for juicing. Make a tasty juice using carrots, celery, chives, broccoli, cucumber, ginger, parsley, pumpkin, spinach, the green part of scallions, tomatoes, zucchini, yams, turnips, taro, squash, and eggplant. (Eggplant and squash cause problems for some people with IBS, so skip those if that’s the case for you.)
Decaffeinated coffee, decaf tea, or weak caffeinated tea.Choosing decaf coffee or tea shouldn’t be a problem, Solomon says. Or try caffeinated tea but make it weak.
Herbal tea.Herbal tea doesn’t contain caffeine and is a great choice hot or iced.
Ginger drinks.Ginger teas, punches, or beers are on the safe list as long as they don’t contain high fructose corn syrup, honey, or other sweeteners on the high FODMAP list.
Dairy-free milk.Rice milk, soy milk, oat milk, and lactose-free milk are all low in FODMAPs.
Paying attention to how your body responds to different drinks is most important. If you know something bothers you, take it out of your diet. But if you can tolerate drinks that are on the restricted list, it’s okay to indulge.
“My philosophy is to enjoy as many foods and drinks as you can tolerate,” Solomon said.
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