Many of my clients have digestive conditions such as IBS, SIBO and IBD. They may have uncomfortable symptoms like gas, bloating, acid reflux, abdominal pain, diarrhea, constipation or a mix of both.
Some clients have just a few of these symptoms and others have them all. Ugh! I know what you’re going through. Been there, done that myself. If you are experiencing one or more of these symptoms on a regular basis, then a gut-healing diet may help.
But which one is the “right” gut-healing diet? This seems to be a huge source of confusion. Why?
- There’s a lot of conflicting information – I hear this A LOT
- Doctors may recommend a low-FODMAP diet but provide zero direction on how to implement it (yep, this happened to me years ago)
- A presumed authority on IBS, SIBO or IBD is adamant that only one diet is the best approach
- Your friend swears a Paleo diet helped her and it will help you, too
What is a Gut-Healing Diet & How Does It Work?
Simply put, a gut-healing diet helps to alleviate symptoms and creates the right environment for healing.
It can help reduce inflammation and restore proper GI function. It can be as simple as removing a known trigger, like dairy, if you know that ice cream sends you to the bathroom. Or it can be as complex as removing multiple types of foods.
A gut-healing diet plays a major role in the 5-R protocol for healing digestive conditions.
1. Remove – remove foods that could be causing symptoms
2. Replace – replace with food that promotes proper digestive function
3. Reinoculate – a more varied diet with probiotics foods and prebiotic fiber can help rebalance good gut bacteria
4. Repair – flood the body with nutrients that heal in order to restore proper function
5. Rebalance – improve response to stress, get more sleep, move more (or less)
Types of Gut-Healing Diets
I am diet agnostic, meaning I don’t have an allegiance to one type of gut-healing diet. I am not concerned with trends or fads. What I am concerned with is results.
With that being said, I do want to be mindful of a few things:
- Does the approach have scientific merit? I’m looking at you celery juice diet!
- The diet is not overly restrictive. Eating only 5 foods is not a gut-healing diet. Your body needs a flood of vitamins and minerals in order to heal.
- It must be a balanced diet. The same nutrition principles apply as they would for any other diet in that you need enough food to meet your energy needs. You need enough protein, carbs and fat to stay satisfied, maintain weight, and keep your blood sugar steady.
- Is it doable? You’re the one who needs to actually implement and follow the diet, so it needs to fit with your lifestyle, your food preferences, your cooking abilities, and your budget.
- This is not a forever diet. Gut-healing diets are tools to create a healing environment for the digestive system and to identify triggers to symptoms. For most people, we may be on the diet for 3 – 8 weeks before we start reintroducing food.
So where do we start?
Lower Fiber Diets
If you have been diagnosed with IBS, SIBO or IBD, then you may have problems digesting fiber and certain types of carbohydrates that are likely to be fermented by your gut bacteria.
Many diets for IBS, SIBO and IBD are lower fiber diets. The low-FODMAP diet is one of the most studied diets for IBS. Scientific studies have shown that a low-FODMAP diet can alleviate symptoms in up to 2/3 of participants.
Many of the SIBO diets such as the SIBO-Specific Diet, the Fast Tract Diet and the Bi-Phasic Diet are based on the low-FODMAP approach. While they vary in the level of restriction of higher carbohydrate foods, they are all variations on the same theme.
The Specific Carbohydrate Diet is another type of lower fiber diet and its variations have been studied for Inflammatory Bowel Disease. The diet can be effective at controlling symptoms during a flare as well as keeping the disease in remission.
Paleo Diet or Whole 30 Diet
Honestly, I could care less what our hunter-gatherer ancestors ate on a regular basis. Again, all I care about is what is upsetting your stomach and how we can get your symptoms under control.
The Paleo and Whole 30 diets are cleverly marketed elimination type diets. Elimination diets have been studied for numerous digestive and related conditions such as IBS, IBD, celiac disease, gastritis, migraines, autoimmune disease and more.
A Paleo type of diet removes all processed food, as well as grains, diary, sugar (including artificial sweeteners), legumes and certain types of oils.
The Whole 30 diet is similar and is a good option for those with sugar addiction. It removes everything in Paleo plus it prohibits alcohol and sugar in all forms (no maple syrup, honey, agave, etc.). The “rules” also prohibit creating baked goods or treats using approved foods. So Paleo pancakes and cauliflower pizza are off limits.
Why? These types of foods may cause digestive symptoms and inflammation across the body. If you noticed that it’s hard to digest these types of food, then perhaps a Paleo or Whole 30 type of diet may be an appropriate approach.
Customizing the Gut-Healing Diet
We may use a lower carbohydrate diet or Paleo diet but keep in mind that they are starting points and will need to be customized for your particular case. In fact, every single client I have is on a customized protocol based on their preferences and tolerances. Here are some examples:
- A client is on the low-FODMAP diet but is gluten & dairy free
- A client is on Paleo but can tolerate rice
- A client is on Paleo but with low-FODMAP fruits, vegetables, nuts & seeds
- A client followed the Whole 30 diet but ate fast food for lunch daily because that fit his lifestyle
Broadening the Diet is Important
Remember, gut-healing diets are not long-term diets. As symptoms improve, we broaden the diet by reintroducing foods in a systematic manner. By keeping a food diary, it is easier to understand which foods are still causing symptoms.
Essentially, I want my clients to be on the broadest diet possible with the fewest symptoms. More food in the diet means more nutrient density. Plus, it’s easier & more enjoyable. Choosing a gut-healing diet is not about being overly restrictive or following all of the “rules”. It’s about getting the most effective results in the shortest amount of time.
Comment below and let me know which approach works best for you to help minimize digestive distress.
Paleo for a year but liver could handle the fats. No sugar dried fruit. No fruit for a year but now have it for breakfast. Have lots of vegetabkes and can have rice. Try oats sometimes. Mostly improving and lots of prebiotics and natural probiotics. Still have aching joints
Trish – As you realized, the Paleo diet is not for everyone. So glad you finding what works best for your body. Hope you continue to feel better 🙂
Thank you so much for putting the plethora of gut-healing diets in perspective. Even my gastroenterologis did not provide any guidance for how to proceed after diagnosing IBS (which is not covered by insurance,) and only referred me back to my primary care physician. Your article provides a structure by which I can ask my PCP questions about how to proceed. My constant abdominal pain is a debilitating 7-9.
Roger, sorry to hear about your experience with your doctor. Unfortunately, it’s a very common experience. I hope you can find some relief soon!
Thank you – your approach is so sensible . I am breathing a big sigh of relief. I have CFS/ME and IBD and when I went onto a strict paleo – keto diet to try to get rid of the ME/CFS I went into a dreadful IBD flare up. Low fodmap helps the IBD but combining it with paleo keto leaves practically nothing. introducing different foods gradually now.
Hi Ruth, we ultimately want our clients to be on the broadest diet possible with the fewest symptoms. Diversity is so important, especially with IBD. You may want to look into the U Mass AID IBD diet, as this has been studied and is being used clinically.
Do you know which form of a diet works best for GERD/reflux? I have tried Whole 30, but did not have the symptom resolution I was hoping for.
Hi Joelene, it’s important to understand WHY you are refluxing. We have seen numerous causes such as SIBO, allergies, food sensitivities and physical issues such as hiatal hernias and more. Once you understand why you have reflux, then you can choose the appropriate approach. You can learn more about causes of reflux in this blog post. https://sarakahnnutrition.com/tips/2021/06/11/conquering-the-root-cause-of-acid-reflux/
you have given me hopoe your approach is so sensible i am 67 and have suffered digestiuve problems for years had numerous tests all for nothing have limited my foods to hardly anything as i am reacting to so many things i am gluten dairy free have a severe nut allergy and coconut
Hi Dawn, we hope you are feeling better soon! Let us know how we can help.