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Harvard Medical School
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General Medical Questions
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Q: I suffer from irritable bowel syndrome. I take Prevacid for heartburn. I know what foods to avoid, but I am having trouble finding what foods are good for me. Any recommendations?
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Stephen E. Goldfinger, M.D., is the faculty dean for Continuing Education and a professor of medicine at Harvard Medical School. He is a graduate of Columbia College of Physicians and Surgeons, and his clinical base is at the Massachusetts General Hospital.

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May 22, 2009
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A:

I assume you know the common foods to avoid for heartburn:

  • fried, spicy foods
  • citrus fruits and drinks
  • tomatoes
  • onions
  • garlic
  • chocolate

By the way, many of these items can be brought back into your diet if the Prevacid protects you from their effects.

With irritable bowel syndrome, the foods to avoid are based entirely on which ones trigger the cramps, gas, diarrhea and/or bloating in each person.

Common offenders for irritable bowel syndrome include:

  • fatty foods
  • raw fruits and vegetables
  • nuts
  • caffeinated beverages

It's up to each person to find what foods and drinks cause trouble. Take a close look at lactose-containing dairy products and high fructose foods (fruits, carbonated beverages). What you think is irritable bowel syndrome could be lactose intolerance or sensitivity to fructose.

Once you identify and avoid the foods that bother you, the goal is to eat as healthy a diet as possible. You want a diet high in the fruits and vegetables you can tolerate, as well as ample amounts of protein in the form of fish, skinless poultry products and lean meat. Starches can be found in bread, potatoes and cereals.

What to do about fiber is also an individual choice. Bran is often helpful for people with irritable bowel syndrome whose main symptom is constipation. But bran might not help -- and might even make symptoms worse for -- people whose main symptom is diarrhea. Many people with irritable bowel syndrome have periods of diarrhea and constipation. In these cases, slowly increasing fiber is often worth a try.

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