How to Do A Food Elimination Diet for IBS

Table in breakfast nook with breakfast food

Have you heard of an elimination diet?

At this time it's considered the "gold standard" for identifying foods that may be causing digestive and/or general body symptoms. Digestive systems such as nausea, stomachache, heartburn, diarrhea, constipation, bloating or gas. General body systems being skin rashes, brain fog, fatigue, or itching. It's one option that I have in my list of treatments for IBS and something that I use quite often with my patients.

An elimination/challenge diet consists of removing specific foods from you diet for 4-6 weeks and then reintroducing the foods one at a time. During this therapeutic diet, you will eliminate a set list of foods and then reintroduce them, one at a time, and watch for symptoms.

The usual suspects on an elimination diet are cow's milk dairy products, eggs, wheat, soy, and corn. When working with patients we may choose to eliminate that whole list, or a few to start. Or we may choose all of the foods on the previous list plus some other common allergens such as shellfish, peanuts, and tree nuts.

A second option with an elimination diet is to order a food sensitivity testing panel such as this one (I happen to use this one with my patients). The elimination diet is then followed using the reactive foods shown on your personal food panel.

The challenge part is the reintroduction of the food or foods. You introduce one new food every 3 days and then check for reactions. Reactions could include digestive upset, headaches, rashes, congestion.

On the day you reintroduce the chosen food, you want to aim to eat a fair amount of the food that you are introducing. A serving at every meal - then remove from the diet again for 2 days to watch for reactions.

It's important to note that the body can react to particular foods within a food group in different ways. You will want to introduce these separately. Examples include whole eggs vs egg yolks, lactose free/low lactose dairy (hard cheese, 24 hour fermented yogurt, ghee, lactaid milk) vs lactose-containing dairy (milk, ice cream, soft cheeses).

If you react to the food at any time in the 3 day window, continue to eliminate it from your diet. If you do not react to the food, you will add it back in, but don’t add the food back until you have tested all the other foods on your list.

When deciding to start an elimination/challenge diet it is best to choose a time where it will cause the least amount of disruption in your life. Don't start it the week before Thanksgiving, or Christmas or another food-centric holiday. Don't start one if you're planning a vacation during the elimination or challenge phase. Pick a time frame when you'll have the least amount of social or holiday activities.

Have you done an elimination diet before? How was it for you? Let me know in the comments before if you've done one or would like to do one.