This elimination diet is extreme and should not be followed for longer than one week. It’s designed to help people who suffer from severe, persistent, diarrhea-predominant IBS determine which foods may be aggravating their condition. It avoids all common IBS trigger foods. This plan is very low in dietary fiber and is based on the few foods I’ve found that people with this type of IBS can tolerate best. Fiber (and nutrition) will be slowly increased as you introduce new foods.
If you’re a candidate for this extreme plan, follow it for one week. Every day, choose one option for each of the three meals &mdash breakfast, lunch, and dinner. Then, once or twice per day, choose from my suggested snacks. Eat slowly, and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage, and try to drink at least 8 cups throughout each day.
After following this plan for one week, you can start experimenting by adding new foods. You should add one new food every two to three days. (It’s best to stick with one portion of a new food per day.) Keep an IBS diary and write down everything you eat and everything you feel. Pay close attention to how you feel after eating each new food, which will help you determine whether that food can be permanently reintroduced into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next food category. You can always retest a problem food at a later date.
At the end of this tough assignment, you will have identified most of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods:
- Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
- Sweet potatoes
- Wheat products: Start with white versions of bread, crackers, and pasta. In the future, when symptoms subside, you can slowly test small amounts of whole wheat varieties.
- Oats and barley
- Brown and wild rice
- Cooked vegetables (noncruciferous)
- Fruit (without tough outer skins, at first)
- Whole grains (whole wheat breads, cereals, pasta; popcorn; quinoa; millet; amaranth; etc.)
- Whole nuts and seeds
- Garlic and onion
- Starchy beans and lentils
- Cooked cruciferous vegetables
- Raw vegetables
- Ketchup, soy sauce, and other condiments (test one at a time)
- Dried fruit and all-fruit jams
- Fruit juice, sugar, and honey
- Coffee or tea
EXTREME ELIMINATION DIET
(300 to 400 calories)
Hot Cereal with Banana Slices
Prepare 11/2 cups cream of rice cereal with water and 1 tablespoon soft tub trans fat–free spread. Enjoy with 1 sliced banana.
Cold Cereal with Soy Milk
Enjoy 2 cups puffed rice cereal with soy milk (or rice or almond milk).
Scrambled Eggs with Rice Cakes
Beat 2 whole eggs with 2 egg whites and scramble in a hot skillet coated with oil spray. Season eggs with preferred herbs. Enjoy with 2 rice cakes, each topped with 1 teaspoon soft tub, trans fat–free spread.
(400 to 500 calories)
Grilled Chicken with Rice
Enjoy 5 ounces grilled chicken (or fish, shellfish, or lean beef) with 1 cup cooked white or yellow rice with preferred seasonings.
Turkey Burger with Baked Potato
Serve a 5-ounce, bunless turkey burger with 1 medium baked potato topped with 2 teaspoons soft tub trans fat–free spread. Do not eat the potato skin.
Turkey and Avocado on Rice Cakes
Divide 4 ounces sliced turkey (or chicken) over 2 plain rice cakes, and top each with 1 thin slice avocado. Enjoy with 1 ounce of baked potato chips.
Dinner Options (500 to 600 calories)
Salmon with Rice
Enjoy 1 serving of Easy! 3-Step Microwave Salmon or 5 ounces grilled salmon (or sole, haddock, cod, or tilapia) seasoned with 1 teaspoon olive oil and a pinch of kosher salt. Serve with 1 cup cooked white or yellow rice with preferred seasonings.
Rosemary Chicken with Baked Potato
Enjoy 5 ounces Rosemary Chicken with 1 medium baked potato topped with 1 tablespoon soft tub trans fat–free spread. Do not eat the potato skin.
Roast Turkey with Mashed Potatoes
Enjoy 6 ounces skinless roast turkey with 1 medium baked potato scooped and mashed with 1 tablespoon soft tub trans fat–free spread (or 1 cup cooked white or yellow rice). Do not eat the potato skin.
100 calories or less
- 2 plain rice cakes
- 1 banana
- 1 hard-boiled egg (or 4 egg whites)
- 1 rice cake topped with 1 teaspoon nut butter
- 8 ounces soy, rice, or almond milk
100 to 200 calories
- 100 to 200 calories’ worth of plain rice crackers
- 1 ounce baked potato chips
- 1/2 baked potato with 1 teaspoon soft tub, trans fat–free spread (or 1 tablespoon guacamole); do not eat the potato skin.
- 2 rice cakes, each topped with 1 teaspoon nut butter
- 2 rice cakes, each topped with 1 tablespoon guacamole