IBS Treatment: A Guide to Managing Irritable Bowel Syndrome
How is IBS treated?
IBS treatment depends on your symptoms and may include dietary changes, regular physical activity, stress management, psychological therapies, supplements or medications. Healthy eating and lifestyle habits are often a starting point, while approaches such as a low FODMAP diet may help some people when guided by a registered dietitian or healthcare professional. Because IBS symptoms vary from person to person, treatment is often individualized.
What is Irritable Bowel Syndrome (IBS)?
What is Irritable Bowel Syndrome (IBS) affects 13 to 20% of Canadians and 11% of the population worldwide. IBS is more common in women than men and individuals are most often diagnosed before 50 years old.
IBS symptoms often include recurring diarrhea, constipation, abdominal pain, bloating, and/or gas. The pain may be linked to:
- Having a bowel movement
- Changes in how often you have a bowel movement
- Changes in the appearance or consistency of your stool
The exact cause of IBS is unknown, but it may be linked to:
- A sensitive gut
- Food that is digesting too fast or too slow
- Stronger signals between the gut and the brain
- Changes in the bacteria in the gut
IBS impacts quality of life, relationships, productivity and socioeconomic burden on the individual as well as on society at large. So… what are some IBS treatment options? There is no one size fits all treatment approach for IBS, and an individualized approach is often needed because everyone’s symptoms can vary.
IBS Treatment Options
General healthy eating habits
- Small, frequent meals: Aim to eat every 3 to 4 hours to keep your digestive system moving regularly
- Stay hydrated: Aim for 2 to 2.5L (8 to 10 cups) of water everyday
- Limit caffeine, high fat foods, alcohol and spicy foods
Lifestyle habits
- Stay active: Regular physical activity like walking, cycling, or swimming can help stimulate regular bowel movements and reduce bloating
- Manage stress: IBS symptoms can worsen when you are experiencing stress. Try meditation, deep breathing, and mindfulness activities that may help you relax
- Healthy sleeping habits: Build a consistent sleep schedule and get enough sleep to support your digestive system
Dietary Therapies
Low FODMAP diet
The low FODMAP diet may be an IBS treatment option for you if your symptoms are caused by eating fermentable carbohydrates. The low FODMAP diet is not considered a first line therapy for everyone. Initial IBS treatment should include modifications to general healthy eating and lifestyle habits. When these changes do not provide symptom relief, a low FODMAP diet may be recommended with guidance from a registered dietitian or healthcare professional.
What are FODMAPs?
FODMAPs are foods that contain fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These carbohydrates are not fully digested or absorbed into our intestines.
- In the small intestine: FODMAPs can attract water and lead to bloating and diarrhea
- In the large intestine: FODMAPs are fermented by gut bacteria and can produce gas, bloating and discomfort
Why do FODMAPs matter?
FODMAPs are an important part of a nutritious diet, and low FODMAP diets can be restrictive.
Numerous studies have shown that a low FODMAP diet improves overall functional symptoms, but it is important to seek professional advice before restricting or eliminating foods in your diet!
Examples of low FODMAP substitutes for high FODMAP foods
| Food category | High FODMAP (Avoid) | Low FODMAP (Select) |
| Grains | Wheat, rye, pasta, bread | Rice, quinoa, rolled oats, gluten free pasta and bread |
| Vegetables | Onion, garlic, leek | Garlic and onion infused olive oils |
| Fruit | Apple, pear, stone fruits, watermelon | Oranges, mandarins, banana, berries |
| Dairy | Milk and yogurt | Lactose free products or dairy alternatives (oat milk) |
| Meat and Alternatives | Legumes (beans, soybeans) | Meat, extra-firm plain tofu, eggs, chickpeas and lentils |
| Sweeteners | Honey, sugar free products with sorbitol or mannitol | Table sugar, maple syrup |
FODMAPs are found in a wide variety of foods. For more information on low FODMAP foods and serving sizes, check out Understanding the FODMAP diet.
How long is the low FODMAP treatment? Is the low FODMAP diet a lifelong therapy?
The low FODMAP diet should not be a lifelong treatment plan. There are three phases:
- Elimination: Adopt the low FODMAP diet for 2-6 weeks by identifying foods in your diet that are high in FODMAPs and swap with low options from the same food group. Observe if your symptoms improve.
- Reintroduction: After 2-6 weeks of elimination, reintroduce or challenge each individual FODMAP group with a dietitian’s guidance for 6-8 weeks. Select a FODMAP subgroup and a test of food from that group. Consume that food over 3 days with increasing doses. Identity symptoms. After a 2-3 day washout period, try the next subgroup.
- Personalization: Retain well tolerated foods into your diet to reduce restricting your diet while relieving IBS symptoms. This ensures that you are eating the proper nutrients and minimizing unnecessary restrictions in your diet!
If you are unable to meet with a dietitian, the Monash University FODMAP Diet app is an accessible resource for IBS treatment that can help manage symptoms!

Is the low FODMAP diet right for me?
If you are not on restrictive diets, you frequently consume high FODMAP foods and your symptoms line up with FODMAP intolerance, then you may benefit from a low FODMAP diet.
The low FODMAP diet is not recommended for the following people:
- Those with an active eating disorder or history of an eating disorder
- Those who are underweight or malnourished
- Children
- Pregnant women
- Those with cognitive impairment
Modified low FODMAP diet
The modified low FODMAP diet is a more gentle approach that is less restrictive to the traditional low FODMAP diet mentioned above. This IBS treatment option only eliminates frequently eaten foods that are high FODMAP and can cause symptoms in the majority of people. The first option is to swap out the frequently consumed high FODMAP for low FODMAP foods. The second option is to avoid high FODMAP foods for the 2-6 week elimination period.
Low lactose diet
The low lactose diet may be suitable if you are lactose intolerant.
Low fructose/sorbitol diet
Fructose/sorbitol restriction may help manage IBS symptoms if you experience fructose or sugar alcohol malabsorption.
These lines of treatment that include restricting or eliminating certain foods from your diet should be approached alongside a registered dietitian or healthcare professional, to determine if it is a necessary part of your IBS treatment plan.
IBS Treatment Series Reels
Part 1: Healthy Eating & Lifestyle Habits for IBS
Part 2: Is the Low FODMAP Diet Right for You?
Part 3: IBS-Friendly Overnight Oats
Supplements
Probiotics
- Probiotics are live microorganisms that have proven health benefits when taken in the specific amounts.
- The live microorganisms that are found in fermented foods like kombucha, sauerkraut, and kimchi are not always considered probiotics if they do not have the right doses or strains of microorganisms that provide a proven health benefit.
- Work alongside a healthcare provider to choose which probiotic is right for you.
- The Probiotic Guide Canada app provides more information on different probiotics and their different strains of bacteria that may manage your IBS symptoms.
Prebiotics
- Prebiotics are foods that benefit the live microorganisms in our gut to keep our gut healthy!
- Food sources that contain prebiotics include oats, kiwis, chia seeds, flaxseeds, lentils and chickpeas.
Herbal supplements
- Peppermint oil (liquid or capsule): is safe and effective for IBS treatment. It helps relax abdominal muscles and can reduce pain over a 24 hour period.
- Take 30-60 minutes before a meal or 2 hours after your meal
- Start with 1 dose daily and work up to 3 doses daily
- Peppermint tea: less evidence to support its usefulness in IBS treatment, but is commonly used to reduce bloating and gas.
- The menthol properties of peppermint may help relax muscles of the digestive tract and move gas through the digestive tract.
Psychological therapies
Cognitive behavioural therapy (CBT)
CBT may help you identify which of your thoughts, emotions, and behaviours can trigger or worsen IBS symptoms so that you can understand how to manage your symptoms and improve your quality of life.
Gut-directed hypnotherapy
Gut directed hypnotherapy is a form of medical hypnosis that uses guided relaxation and imagery to help you regulate the communication between the brain and the gut to improve management of IBS symptoms.
Medications for IBS
Dietary and lifestyle changes are the first line of IBS treatment. However, medications may be used as a form of IBS treatment to alleviate and manage some of the symptoms if the other options are not working for you. It is important to discuss pharmaceutical options with your doctor or pharmacist, and all medications should be used under the guidance of a healthcare provider.
| Common Medications for IBS Symptoms | |
| Constipation | Laxatives* |
| Diarrhea | Antidiarrheal agents, Antibiotics** |
| Abdominal Pain | Antispasmodics (smooth muscle relaxants, peppermint oil) |
*Consider laxatives such as polyethylene glycol instead of prune juice and lactulose for management of constipation.
**Consider healthcare provider’s instructions prior to taking antibiotics such as rifaximin, as there may be potential side effects.
What about antibiotics?
Healthcare professionals may recommend antibiotics to manage IBS symptoms when diarrhea is a symptom, and there is suspicion of bacterial overgrowth. Antibiotics may reduce symptoms, but they do not provide permanent relief, and symptoms may return after the treatment is stopped. It may also deplete the gut from the different types of healthy bacteria that it contains.
Antibiotics may be a helpful form of IBS treatment for some individuals, but dietary therapy, general healthy eating habits, and lifestyle changes may be a better line of approach for managing IBS symptoms.
Probiotics can help restore healthy bacteria in the gut that the antibiotics may have depleted. Taking probiotic supplements 2 hours after taking antibiotics may help support a healthier gut by restoring the beneficial bacteria that the antibiotics remove.
Fibre and IBS
Canadian women need 25g of fibre per day and men need 38g of fibre per day. But aren’t low FODMAP diets also lower in fibre?
Fibre is a non-digestible carbohydrate that is a part of plant foods, whole grains, legumes, nuts and seeds. Fibre is beneficial in lowering blood glucose levels, cholesterol, increasing satiety, improving laxation, and feeding our gut bacteria to keep our gut lining healthy!
Not eating enough fibre can worsen IBS symptoms such as constipation and abdominal pain. Eating too much fibre can lead to gas build up and uncomfortable feelings of bloating and distension.
Try to incorporate viscous and soluble fibres (fibres that form a gel-like substance to thicken stool, and can dissolve in water) to soften or bulk up stool. Reduce highly fermentable fibres (high FODMAP) that take longer to break down in the large intestine which can contribute to IBS symptoms.
Examples of low FODMAP high fibre foods:
- Chia seeds
- Cooked oats
- Ripe banana or kiwis
Examples of Low FODMAP fibre supplements:
- Metamucil
- Psyllium husk (start with ½ tsp and slowly increase)
For more information about fibre, check out Fibre and Its Benefits.
The future of IBS treatment
Researchers are studying microbiome modulation which include ways to change the bacteria living in the gut to help improve IBS symptoms. While this is promising, more research is needed before these treatments become routine.

Key Takeaways
- There is no one-size-fits-all IBS treatment. Treatment depends on your symptoms and may involve changes to your diet, lifestyle, stress management, supplements, psychological therapies, or medications.
- Healthy eating and lifestyle habits are an important starting point. Regular meals, adequate hydration, physical activity, sleep, and stress management may help manage IBS symptoms.
- A low FODMAP diet can help some people with IBS, but it isn’t intended to be a lifelong diet. It typically involves elimination, reintroduction, and personalization and is best undertaken with guidance from a registered dietitian or healthcare professional.
Frequently Asked Questions
1. How do you know if you have IBS?
IBS is diagnosed based on your symptoms. IBS diagnostic criteria includes:
- Symptoms for at least 6 months
- Abdominal pain on average 3 days per month for the past 3 months and two or more of the following:
- Your pain goes away after a bowel movement
- Your pain is associated with bowel movement frequency
- Your pain is connected to a change in the look or consistency of your stool (eg. Constipation, diarrhea or the presence of mucus)
A healthcare provider can confirm the diagnosis.
2. What is the best breakfast for IBS?
Breakfasts that follow the CFP+B formula (calcium, fibre, protein, boosters) as they include key daily nutrients needed for overall health are a great place to start!
Examples:
- Tofu spinach scramble on sourdough toast
- Quinoa porridge with banana and lactose free yogurt/almond milk
- Rolled oats with banana and peanut butter
3. Can IBS be cured permanently?
There is no permanent cure for IBS, but IBS treatments and modified lifestyle factors can help make IBS manageable.
4. How to relieve IBS pain instantly?
There is no one proven method to relieve IBS pain instantly, however, peppermint oil/liquid capsules or peppermint tea has antispasmodic effects, meaning it can help relax digestive tract muscles, reduce bloating and abdominal discomfort.
Stress management techniques such as deep breathing exercises, gentle physical activity like walking, or the use of a heating pad or warm bath may also reduce bloating, help gas pass, and lessen abdominal pain.
5. What is the best over the counter medicine for IBS?
For constipation, Metamucil will typically help soften stools and promote regular bowel movements.
Have diarrhea? Imodium can aid in controlling diarrhea but will not relieve bloating, gas, or abdominal pain but should only be taken under the guidance of a healthcare provider.
For abdominal discomfort and pain relief, peppermint oil capsules may help as a digestive tract muscle relaxant.
References
- Altobelli, E., Del Negro, V., Angeletti, P. M., & Latella, G. (2019). Low-FODMAP diet improves irritable bowel syndrome symptoms: A meta-analysis. BMC Complementary Medicine and Therapies, 19, Article 21. https://doi.org/10.1186/s12906-018-2409-0
- American College of Gastroenterology Task Force on Irritable Bowel, S., et al., An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol, 2009. 104 Suppl 1: p. S1-35.
- Canadian Society of Intestinal Research. (n.d.). The low FODMAP diet. https://badgut.org/information-centre/health-nutrition/low-fodmap-diet/
- Moore, K., & Senchuk, A. (2026, June 10). Understanding the low FODMAP diet: Foods, phases and tips for managing IBS. Canadian Digestive Health Foundation. https://cdhf.ca/en/understanding-the-fodmap-diet/
- Elsevier. (n.d.). Antispasmodic. In ScienceDirect Topics. https://www.sciencedirect.com/topics/neuroscience/antispasmodic
- Harris, L. A., & Baffy, N. (2017). Modulation of the gut microbiota: A focus on treatments for irritable bowel syndrome. Postgraduate Medicine, 129(8), 872–888. https://doi.org/10.1080/00325481.2017.1383819
- International Foundation for Gastrointestinal Disorders. (n.d.). Dietary fiber. https://aboutibs.org/treatment/ibs-diet/dietary-fiber/
- International Foundation for Gastrointestinal Disorders. (n.d.). Medications for IBS. https://aboutibs.org/treatment/medications-for-ibs/#anticholinergics
- Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., Moshiree, B., & Lembo, A. J. (2021). ACG clinical guideline: Management of irritable bowel syndrome. The American Journal of Gastroenterology, 116(1), 17–44. https://doi.org/10.14309/AJG.0000000000001036
- Monash FODMAP. (n.d.). Get the app. https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/
- Monash University. (n.d.). FODMAP gentle diet.
- Monash University. (n.d.). Module 2 summary factsheet.
- Monash University. (n.d.). Module 1 summary factsheet.
- Ostgaard, H., et al., Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome. Mol Med Rep, 2012. 5(6): p. 1382-90
- Staudacher, H. M., & Whelan, K. (2017). The low FODMAP diet: Recent advances in understanding its mechanisms and efficacy in IBS. Gut, 66(8), 1517–1527. https://doi.org/10.1136/gutjnl-2017-313750
























































































