An elimination diet is a tool to use to assess whether specific foods are contributing to your irritable bowel syndrome (IBS) symptoms. This is not a “diet” in the traditional sense, but a way to systematically find out if certain foods are causing symptoms in your body.
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Why Use an Elimination Diet for IBS?
An elimination diet can be a helpful strategy to learn more about your IBS. Reasons people try elimination diets include the following:
Thelow-FODMAP dietis the only dietary treatment approach for IBS that has research supporting its effectiveness.
Before You Start
There are a few things you can do before starting an elimination diet that can help you maximize the benefits of this difficult treatment plan. Consider taking the following steps:
Talk to your healthcare provider about getting tested for celiac disease
Whether you choose to eliminate gluten from your diet because you suspect you have a gluten sensitivity or because you are planning to follow the restrictions of thelow-FODMAPdiet, you should get tested forceliac diseasefirst.
How Celiac Disease Is Diagnosed
It’s important to get tested before starting your diet because the blood test for celiac disease is only accurate if you are still eating gluten at the time of the testing.
The American College of Gastroenterology (ACG) now recommends ruling out celiac disease in anyone with suspected IBS or diarrhea symptoms.
Start a food diary
Whether you use a simple notebook or an online tracking app, it is very helpful to keep a running account of what foods you are eating, what your symptoms are, and any other factors (e.g. stress level, menstrual cycle) that may be contributing to your symptoms.
How to Keep a Food Diary
Decide what foods to eliminate
If you choose to follow the low-FODMAP diet, you will be eliminating—at the very least—all high-FODMAP foods. During the initial elimination phase, many people eliminate the following foods:
High and Low FODMAPs: A Food List
Stock your kitchen
Elimination diets require you to pay close attention to what foods you are eating. You may find it easier to cook and prepare most of your meals at home so that you have full control over the ingredients. You will also want to make sure that you have plenty of options for breakfast, lunch, dinner, and snacks that do not contain the foods or ingredients that you are eliminating.
An Overview of the Gluten-Free Diet
The Elimination Phase
During the first phase of your elimination diet, which will last around two weeks, you will stop eating all high-FODMAP foods (and any other suspected trigger foods). Think of this phase as a cleanse. It gives your digestive system some time to heal and may even help promote a healthy mix of gut bacteria.
During the first phase of the diet, it is important to chart your symptoms in your food diary. If you notice a significant reduction in symptoms, it means the elimination diet is working. Charting your symptoms, or lack thereof, helps you compare how different you feel during this time.
How long you need to stay in the elimination phase will depend on how you are feeling and how old you are. This diet is intended to be temporary. Many of the foods you will exclude are an important part of a healthy diet.
Elimination diets are very restrictive. Talk to your healthcare provider or a registered dietitian about getting the vitamins and minerals your body needs.
Everyone attempting an elimination diet should work with a licensed dietitian to make sure they aren’t harming themselves. Children are particularly vulnerable to malnourishment, so you should never start your child on an elimination diet without first discussing it with their pediatrician.
The Reintroduction Phase
At the end of the elimination period, you will slowly reintroduce foods back into your diet, one at a time. If you are on the low-FODMAP diet, you could introduce foods oneFODMAP typeat a time.
On the first day, eat a small amount of the food or FODMAP type in question. If no symptoms occur, eat twice as much of the same food the next day. If you still have no symptoms, eat twice as much on day three as you did on day two. Pay close attention to any symptoms and document them in your food diary.
After eating a trigger food, it can take up to three days for symptoms to appear.
If you experience symptoms, then you have identified a trigger food that you may want to avoid in the future. If you haven’t experienced symptoms, that food is probably safe. Still, you will need to remove the food from your diet again while you continue testing new foods, one at a time.
If you are following the low-FODMAP diet, after reintroducing and assessing tolerance for the first FODMAP type, you would then reintroduce other FODMAP types, one at a time.
The Goal of an Elimination Diet
Elimination diets are to be used as a tool for identifying foods that contribute to your IBS symptoms. The ultimate goal is to use this information to create a diet including as wide a variety of foods as possible without experiencing excessive symptoms. This will ensure that you are maximizing your intake of essential nutrients.
As you gather more information about your body’s reactivity or tolerance to certain foods or FODMAP types, you may want to play around with portion size. You may find that your body can tolerate certain foods in small portions, but has more trouble with larger portions. This information will not only expand the variety of foods you can consume but may allow you to enjoy some of your old food favorites.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mckenzie YA, Bowyer RK, Leach H, et al.British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update).J Hum Nutr Diet.2016;29(5):549-75. doi:10.1111/jhn.12385Domżał-Magrowska D, Kowalski MK, Szcześniak P, Bulska M, Orszulak-Michalak D, Małecka-Panas E.The prevalence of celiac disease in patients with irritable bowel syndrome and its subtypes.Prz Gastroenterol.2016;11(4):276-281. doi:10.5114/pg.2016.57941Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Spiller R.Impact of diet on symptoms of the irritable bowel syndrome.Nutrients. 2021;13(2):575. doi:10.3390/nu13020575Arscott, SA. University of Wisconsin Integrative Health.Elimination diet.University of Michigan. Michigan Medicine.The low FODMAP diet: A ‘liberating’ route to IBS relief.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mckenzie YA, Bowyer RK, Leach H, et al.British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update).J Hum Nutr Diet.2016;29(5):549-75. doi:10.1111/jhn.12385Domżał-Magrowska D, Kowalski MK, Szcześniak P, Bulska M, Orszulak-Michalak D, Małecka-Panas E.The prevalence of celiac disease in patients with irritable bowel syndrome and its subtypes.Prz Gastroenterol.2016;11(4):276-281. doi:10.5114/pg.2016.57941Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Spiller R.Impact of diet on symptoms of the irritable bowel syndrome.Nutrients. 2021;13(2):575. doi:10.3390/nu13020575Arscott, SA. University of Wisconsin Integrative Health.Elimination diet.University of Michigan. Michigan Medicine.The low FODMAP diet: A ‘liberating’ route to IBS relief.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mckenzie YA, Bowyer RK, Leach H, et al.British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update).J Hum Nutr Diet.2016;29(5):549-75. doi:10.1111/jhn.12385Domżał-Magrowska D, Kowalski MK, Szcześniak P, Bulska M, Orszulak-Michalak D, Małecka-Panas E.The prevalence of celiac disease in patients with irritable bowel syndrome and its subtypes.Prz Gastroenterol.2016;11(4):276-281. doi:10.5114/pg.2016.57941Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Spiller R.Impact of diet on symptoms of the irritable bowel syndrome.Nutrients. 2021;13(2):575. doi:10.3390/nu13020575Arscott, SA. University of Wisconsin Integrative Health.Elimination diet.University of Michigan. Michigan Medicine.The low FODMAP diet: A ‘liberating’ route to IBS relief.
Mckenzie YA, Bowyer RK, Leach H, et al.British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update).J Hum Nutr Diet.2016;29(5):549-75. doi:10.1111/jhn.12385
Domżał-Magrowska D, Kowalski MK, Szcześniak P, Bulska M, Orszulak-Michalak D, Małecka-Panas E.The prevalence of celiac disease in patients with irritable bowel syndrome and its subtypes.Prz Gastroenterol.2016;11(4):276-281. doi:10.5114/pg.2016.57941
Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036
Spiller R.Impact of diet on symptoms of the irritable bowel syndrome.Nutrients. 2021;13(2):575. doi:10.3390/nu13020575
Arscott, SA. University of Wisconsin Integrative Health.Elimination diet.
University of Michigan. Michigan Medicine.The low FODMAP diet: A ‘liberating’ route to IBS relief.
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