Elimination Diets – Everything You Need to Know

If you’ve been diagnosed with IBS, your doctor may have recommended an elimination diet. You may have been advised to eliminate dairy, gluten, fructose, FODMAPs, or other food categories.

Typically, the rational behind this is it to identify which foods trigger your symptoms. For example, you may notice that you get bloated every time you go to your favourite restaurant and order the pasta. So you may have assumed it was the cheese. But when you have cheese at home and you feel fine.

There are few important things to remember about elimination diets to make them a whole lot less frustrating.

Here are my top 5:

1. It’s a trial, not a life sentence. Your heart might sink at the very prospect of a day without a latte. Just remember – when your doctor suggests an elimination diet, the idea is to eliminate the food 100%, but just for a      week or two to see if your symptoms are better or not without it. So it’s not a lifetime commitment to a dairy-free or gluten-free or whatever-free diet – it’s just a short trial to see how you do. Let’s say you feel exactly the same? Well then clearly that food isn’t causing your symptoms, so go back to eating it! Now lets say you feel a lot better. Here’s where things can get tricky – see #3.
2. Neither your gut nor your cheeseburger read the textbook on IBS. So this can be frustrating. But food intolerance isn’t black and white. So what causes bad symptoms on one day may not cause bad symptoms the next day. The idea is to identify foods that tend to cause your symptoms, most of the time.
3. The treatment shouldn’t be worse than the symptoms. Once you’ve identified which foods trigger your symptoms, the next step is decided whether or not you want to avoid them. Remember – unless you’ve been diagnosed with an actual food allergy, or you have celiac disease, what we are talking about are food intolerances. This means that when you eat your trigger food, you may get your symptoms, whatever those are (bloating, diarrhea, indigestion, etc). Unlike, say, an anaphylactic allergy to peanuts, food intolerances are not life-threatening and won’t have any impact on your overall long-term health. The purpose of identifying your triggers isn’t to sentence you to life without them, but rather to give you some control over your symptoms. One the one hand, your symptoms may be so bad that you welcome a life without, say, dairy, because the trade off in terms of how much better you feel is worth it. On the other hand, if your symptoms aren’t severe, you may chose to consume your trigger foods every now and then, but at least you can know what to expect after. So you may not have ice cream on your wedding day, or bread on a long flight overseas…
4. Buy a knockoff! I don’t mean a Chanel bag. That’s illegal. I mean a gluten-free cookie, or dairy free ice-cream. When I was nursing my son Max, I was advised to eliminate soy and dairy because of severe eczema (this is controversial, but that’s another story. I found a local cupcake shop that made soy and dairy free cupcakes, and guess what – I liked them better than the real thing. Go figure.
5. Ok, I don’t have a 5th thing. But a top 4 list seemed silly.

Talia Zenlea, MD

Talia Zenlea, MD is the founder of bellyblog.ca. She is a board-certified internist and gastroenterologist, and mother of 3 rambunctious boys and a well-behaved Labradoodle. She is passionate about good food, good friends, good weather, and empowering women to take charge of their own health and well being. See all of Talia's articles.

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