IBS Guidance

Medical disclaimer

This resource is for educational and informational purposes only. The content on this page — including dietary guidelines, supplement recommendations, and symptom management strategies — does not constitute medical advice, diagnosis, or treatment. It is intended to support qualified nutrition and health coaching professionals as a general reference tool, and should not be used as a substitute for personalised advice from a registered dietitian, gastroenterologist, or other licensed healthcare provider.

If you or your client are experiencing symptoms that may be consistent with Irritable Bowel Syndrome (IBS) or any other gastrointestinal condition, always seek a formal medical diagnosis before implementing any dietary intervention. Red flag symptoms (listed below) require immediate referral to a GP or clinician. Individual responses to dietary changes vary — what works for one person may not work for another. Coaches should operate strictly within their scope of practice at all times. (NICE, 2015)

IBS symptom quick-action guide

Select a symptom below — see immediate steps, things to consider, and what to avoid

Always first: Regular meal timing 8 cups fluid/day Max 3 cups caffeine/day Food diary Reduce fizzy drinks Limit alcohol

Second-line intervention

Low FODMAP diet guide

Only introduce when general dietary advice has been unsuccessful. Always deliver with professional supervision. (NICE, 2015; Staudacher et al., 2011)

Important: A low FODMAP diet may reduce beneficial bifidobacteria, increase dysbiosis-associated bacteria, and risk disordered eating behaviours. It is restrictive and should not be used as a first-line approach. (Hill et al., 2017; Vandeputte & Joossens, 2020; Satherley et al., 2015)
F ermentable
·
O ligosaccharides  (Fructans + Galactans)
·
D isaccharides  (Lactose)
·
M onosaccharides  (Fructose)
·
A nd
·
P olyols  (Sugar alcohols)
F Fructans Oligosaccharides
Bread & pasta
Bulgar wheat & couscous
Garlic & onion
Leeks & shallots
Asparagus
Artichoke
Beetroot
Broccoli
Savoy cabbage
Inulin (fibre additive)
D Lactose Disaccharides
Cow, goat & sheep milk
Ice cream
Whey protein concentrate
Soft cheeses (ricotta, cottage)
Custard
Natural yoghurt*
*Greek yoghurt lower in lactose — may be tolerated in small amounts
M Excess Fructose Monosaccharides
Apples & apple juice
Cherries & mangoes
Pears & peaches
Watermelon & prunes
Dried fruit
Honey
HFCS (corn syrup)
Fructose sweetener
Tinned fruit in juice
O Galactans Oligosaccharides
Baked beans
Berlotti beans
Broad & butter beans
Chickpeas
Haricot beans
Kidney beans
Lentils
Lima & pinto beans
Soy beans
P Polyols Sugar alcohols
Apples & apricots
Avocado
Blackberries
Nectarines & peaches
Watermelon & plums
Cauliflower & mushrooms
Green peppers & sweetcorn
Sweet potato
Sorbitol, xylitol, mannitol
Fructans
Bread, pasta, noodles
Bulgar wheat, couscous
Garlic & garlic powder
Onion & onion powder
Shallots & leeks
Asparagus, artichoke
Beetroot, broccoli
Savoy cabbage
Inulin in sports products
Rye & barley products
Lactose
Cow, goat & sheep milk
Ice cream & custard
Whey protein concentrate
Natural & flavoured yoghurt
Cream cheese & ricotta
Cottage cheese
Soft cream cheese
Milk powder
Excess Fructose
Apples & apple juice
Cherries, mangoes
Pears & pear juice
Peaches & prunes
Watermelon & dried fruit
Honey
High fructose corn syrup
Fructose sweetener
Tinned fruit in juice
Galactans
Baked & berlotti beans
Broad & butter beans
Chickpeas
Haricot & kidney beans
Lentils (all types)
Lima & pinto beans
Soy beans & edamame
Soy milk (regular)
Polyols
Apples, apricots, avocado
Blackberries
Nectarines, peaches, pears
Watermelon & plums
Cauliflower & mushrooms
Green peppers & sweetcorn
Sweet potato
Sugar-free gum & sweets
Sorbitol, xylitol, mannitol

Note: Bowel habit subtypes should be classified only on days with abnormal bowel movements. Portion size matters — some high-FODMAP foods may be tolerated in small amounts. Use a validated FODMAP app (e.g. Monash University) to check serving sizes. (Nanayakkara et al., 2016; Halmos et al., 2014)

Fruit
Bananas (ripe)
Blueberries
Cranberries
Grapes
Kiwi
Oranges, lemons, limes
Passionfruit
Pineapple
Raspberries & strawberries
Rhubarb
Melon (honeydew, cantaloupe)
Vegetables
Aubergine (eggplant)
Carrot & parsnip
Celery & cucumber
Courgette (zucchini)
Ginger
Green beans & peas (small)
Kale, lettuce & spinach
Olives
Red & yellow peppers
Swede & turnip
Tomatoes & herbs
Dairy & alternatives
Butter
Lactose-free milk*
Lactose-free yoghurt*
Brie & camembert
Cheddar & parmesan
Feta & mozzarella
Cream
*Lactose-free ≠ dairy-free
Carbohydrates
Oats (rolled & porridge)
Potato & yam
Quinoa
Rice (all types)
Rice cakes & oat cakes
Gluten-free bread/pasta
Corn tortillas
Sourdough (wheat — small portions may be tolerated)
Protein & sports foods
Meat, fish & poultry
Eggs
Tofu (firm, drained)
Whey protein isolate
Glucose & maltodextrin
Peanuts & walnuts (small)
Pumpkin seeds
Condiments & drinks
Maple syrup & golden syrup
Sucralose (sweetener)
Soy sauce (small amounts)
Olive oil & butter
Water, tea (weak), coffee
Rice milk (plain)
Almond milk (unsweetened)

Portion size matters even for low-FODMAP foods. Some foods become high-FODMAP in large quantities. Always use the Monash University FODMAP app as the gold-standard reference for current, validated portion sizes. (Adapted from Nanayakkara et al., 2016)

How to run the low FODMAP protocol

The 3-phase process

1

Elimination phase

Strictly eliminate all high-FODMAP foods for 4–8 weeks. Monitor symptom response using a food and symptom diary. Do not extend beyond 8 weeks.

  • Assess baseline symptoms first
  • Check for nutritional adequacy
  • Ensure adequate protein and fibre
2

Reintroduction phase

Systematically reintroduce one FODMAP category at a time over 8–10 weeks. Test each group with 3-day washout periods between challenges.

  • Reintroduce one FODMAP type at a time
  • Start with small portions
  • Track symptoms for 3 days per food
3

Personalisation phase

Build a sustainable, personalised long-term diet that includes all tolerated foods and avoids only confirmed trigger FODMAPs.

  • Reintroduce tolerated foods freely
  • Aim for maximum dietary variety
  • Reassess triggers periodically
Red flags — refer immediately to GP / clinician
Rectal bleeding Unexplained weight loss Nocturnal symptoms (waking from sleep) Difficulty swallowing Anaemia Persistent fever Family history of bowel/ovarian cancer New onset age 50+

These symptoms are not consistent with IBS alone. Rule out IBD, Coeliac Disease and colorectal cancer before any dietary intervention begins. (NICE, 2015)