7 Drinks to Avoid
First consider the drinks that are likely to make your IBS symptoms worse.
1. Fructose May Disrupt the Gut
A big trigger can be any beverages containing fructose or high-fructose corn syrup, which are high in FODMAPs, says Ellen Stein, MD, a gastroenterologist with Rutgers Robert Wood Johnson Medical Center in New Brunswick, New Jersey, and a fellow of the American Gastroenterological Association.
High-fructose corn syrup can be found in soft drinks, sweetened tea and coffee, energy drinks, and fruit drinks, among others.
The IBS Network, an organization that supports people with IBS, explains that fructose is absorbed slowly in the small intestine, so amounts can pass on into the colon and partially ferment, causing bloating and diarrhea in sensitive and reactive bowels.
“It’s sort of like what your mom always told you — don't eat too much candy or you're going to get a tummy ache,” says Dr. Stein.
2. Some Fruit Juices May Fuel Discomfort
While fruit juices can be healthy, some can have a very high fructose content, including mangos, apples, pears, and watermelon. That’s according to researchers in the department of gastroenterology at Australia’s Monash University, who developed the concept of a low-FODMAP eating plan and have tested the content of hundreds of items. You have to be diligent about checking labels of fruit drinks for high fructose corn syrup. Odds are you’ll find it on product labels because it’s so widely used by manufacturers.
“It's not that you can never drink a high fructose drink, it’s more that when you have more, you may be more gassy and have more symptoms,” says Stein.
3. Sugar-Free Drinks May Not Be an Alternative
You also want to avoid sugar-free drinks made with artificial sweeteners containing polyols because they're also known to bring on IBS symptoms. Experts, including those at the Cleveland Clinic, warn against sweeteners ending in “-ol,” such as sorbitol, mannitol, maltitol, and xylitol, as well as isomalt.
And results from lab tests published in 2021 in the International Journal of Molecular Sciences showed that the artificial sweeteners aspartame, sucralose, and saccharin may inhibit bacterial communication in the gut, possibly leading to digestive disease and discomfort. Monash University researchers point out that trials in people are needed to confirm that, but they recommend only using these sweeteners occasionally.
4. Vegetable Juices Can Also Bring Trouble
Stein adds that if you make your own vegetable juices, keep in mind that onions and garlic are considered major contributors to IBS, so they’re something to avoid.
You may also want to avoid juices that include other vegetables on Monash University’s list of foods high in FODMAPs, such as:
- Asparagus
- Legumes
- Peas
- Cauliflower
- Mushrooms
- Snow peas
5. Milk May Contribute to Intestinal Distress
Stein cautions that standard cow’s milk is high in FODMAPs due to its content of lactose, which some people have a hard time digesting. Alternatives for those who are especially sensitive to dairy include almond milk, coconut milk, soy milk, hemp milk, and oat milk. Yogurt can be a dairy exception for those with IBS — some people find the live cultures in yogurt help their symptoms.
6. Caffeine Can Aggravate Symptoms
As Johns Hopkins Medicine warns, caffeine can increase diarrhea. It's known to move the bowels for most people, but the effect tends to be worse for those who have IBS.
“People with irritable bowel have more irritable nerves in their guts,” says Stein. “So caffeine may worsen their IBS.”
She recommends, however, that people don’t necessarily eliminate coffee or tea from their diet. According to Stein, moderation is key. One or even two cups a day should be okay. And coffee and tea may have other health benefits, including a reduced risk for certain chronic diseases, according to the Harvard T.H. Chan School of Public Health.
7. Alcohol May Disturb Digestion
Beer, wine, and liquor may contain sugars that people with IBS find hard to digest and may worsen symptoms, according to NYU Langone Health. In a review of several different lab studies published in 2022 in Frontiers in Microbiology, scientists found that alcohol can change the composition of the beneficial microorganisms in the gut, damage protective intestinal mucus, and promote inflammation.
5 Safer Bets for Drinking
After eliminating the big offenders, it may seem like there’s nothing left to drink. Not so. Take a look at all of the beverages on the thumbs up list.
1. Low-FODMAP Fruit Juices
The online nutrition guidance source for individuals with chronic digestive disorders, DietvsDisease.org, says that low-FODMAP fruits include blueberries, grapes, kiwi, lemons, limes, oranges, pineapples, and strawberries. But keep your serving size small. Monash University researchers say even fruits naturally low in FODMAPs may cause you problems if you have a larger portions.
2. Low-FODMAP Vegetable Juices
Monash and the Cleveland Clinic list several vegetables that are low in FODMAPs that you can try juicing with. They include carrots, celery, cucumber, spinach, sweet potatoes, zucchini, and eggplant. And you can spice up your juice with herbs including ginger, mint, and parsley.
Stein advises cleaning all produce before juicing. “People with irritable bowel are sometimes more easily set off by poorly washed or poorly prepared fruits and vegetables that may be contaminated,” she says.
3. Decaffeinated Coffee, Decaf Tea, or Weak Caffeinated Tea
When it comes to coffee or tea, Stein notes that caffeine is probably the primary active ingredient that contributes to IBS symptoms. “So decaffeinated is a nice way to go,” she says. Or you might try a “weak” cup of tea or coffee.
4. Herbal Tea
Herbal tea doesn’t contain caffeine and is a great choice hot or iced. “A lot of my patients get some relief from their lower gut symptoms with peppermint tea,” says Stein.
5. Dairy-Free Milk
Rice milk, soy milk, oat milk, and lactose-free milk are all low in FODMAPs. Stein cautions that some of these products can have a high sugar-content, so check the labels and buy those with zero or low sugar.
Paying attention to how your body responds to different drinks is most important. If you know something bothers you, take it out of your diet. But if you can tolerate drinks that are on the restricted list, it’s okay to indulge.
“In general, you're probably not going to have many symptoms when you stick to a smaller portion size of anything,” Stein says. “I have some patients who are exquisitely sensitive so even a half apple will cause symptoms. You just have to understand your triggers.”
Additional reporting by Don Rauf.
