images/macc_logo.gif(87860 bytes)images/logo_right_space.gif (28465 bytes)

Printer friendly

Controlling your IBD


Diet and Nutrition - Bloating                      


Bloating and excessive wind may be a result of the poor absorption of fructose or lactose sugars.


1. Fructose (fruit sugar) may cause bloating                                

Fructose is fruit sugar which is slowly absorbed in the small intestine. If we take more than can be tolerated, the excess travels along the bowel and is fermented by bacteria. A large amount of wind and 'explosive' diarrhoea may result. Cutting down on the amount of fructose taken at one time (the fructose dose) will limit symptoms.


Fructose is found in large quantities in honey, some fruits, fruit juices and smoothies. The presence of another sugar, glucose, is important. If glucose is present alongside fructose, fructose is better tolerated. When there is more fructose than glucose in a fruit (see below), diarrhoea may result.


Unfavourable foods that have more fructose than glucose 

Fruit: Apple, pear, guava, honeydew melon, nashi fruit, pawpaw/papaya, quince, star fruit, watermelon, unripe (hard) banana, coconut and fruit salad made with these fruits.


Dried fruit: Apple, apricot, currant, date, fig, pear, prune, raisin, sultana.

Dried fruit bars containing dried apple and pear.

Fruit juices and fruit juice concentrates, fruit smoothies; apple and pear juice.

Corn syrup solids and high fructose corn syrup solids (HFCS) found in chutney, relish, sweet & sour sauce, BBQ sauce, marmalade and jams.


Other: golden syrup, honey, fortified wines.

Better choice foods that have fructose approximately equal to, or less than glucose 

Stone fruit: apricot, nectarine, peach, plum.

Berry fruit: blueberry, blackberry, boysenberry, cranberry, raspberry, strawberry.

Citrus fruit: orange, grapefruit, lemon, lime, mandarin.

Other fruits: ripe banana, kiwi fruit, passion fruit, pineapple, rhubarb.


2. Lactose (milk sugar) may cause bloating                                     back to top

Lactose is milk sugar which is digested by an enzyme called lactase found in the small intestine. If lactase is missing, lactose will pass along the bowel where bacteria will use it, producing gas and diarrhoea.


Lactose intolerance related to IBD is usually temporary, but while it is present modest lactose restriction may help symptoms. If you think you may be lactose intolerant, cutting out lactose should improve your symptoms within 48 hours. If your symptoms improve you have two options available:


  1. Continue to cut out lactose


  1. 'Train' your intestine to tolerate lactose


If you feel better on a lactose-free diet then a dietician can help ensure your diet is nutritionally adequate, and also help with a reintroduction regime.


Foods to avoid on a lactose-free diet:


  • Animal milk:*

    • Any animal source (cow, goat or ewe) and foods containing yoghurt,* fromage frais, custard, ice-cream

    • Batters (e.g. Yorkshire pudding, pancake batters)


  • Margarines containing milk solids, milk breads, some deli counter meats


  • Salad dressings, savoury dips, sauces, marinades, some muesli


  • Food ingredients especially whey, whey proteins, casein, caseinates, lactose, milk solids, buttermilk.


*note that a dash of milk in hot drinks, or a small pot of bio-yoghurt, may be tolerated on a lactose-free diet as the 'dose' of lactose is too small to cause symptoms.


Foods to substitute on a lactose-free diet:

  • Lactose-free cow’s milk

  • Plant milks: choose calcium fortified soya milks; oat milks and rice milk do not contain calcium

  • Soya desserts and yoghurts; fruit sorbet

  • Probiotic containing yoghurt

  • Cream cheese and ‘hard’ cheeses such as Cheddar are virtually lactose free


3. Fermentable fibre ('soluble' fibre) may cause bloating             back to top

Soluble fibre is different to the roughage fibre that should be avoided when IBD is active. Soluble fibre forms a soft gel within the bowels and can reduce cholesterol levels and also reduce diarrhoea.


Soluble fibre is food for healthy 'probiotic' bacteria. When bowel bacteria use soluble fibre, they make tiny fats (called 'short chain fatty acids' or SCFAs) that colon cells use for fuel. Healthy colon cells absorb salts and water more effectively, reducing diarrhoea.


SCFAs have another benefit, too. Until used by the cells of the colon they keep bowel contents slightly acidic, favouring growth of other healthy 'probiotic' bacteria and keeping down levels of unhealthy bacteria ('pathogens') such as Clostridium difficile. The only drawback to soluble fibre is that the feeding bacteria produce gas (wind). The link between baked beans and wind is well known, and shows how bacteria use the soluble fibre in baked beans to produce a noticeable amount of wind. Eating foods rich in soluble fibre regularly, though, eventually lessens the amount of gas produced.


Foods rich in soluble fibre: peas, beans, lentils; wheat and wheat products, white or brown (bread, pasta, biscuits); avocado, mango, papaya; green leafy vegetables, broccoli, onions; Psyllium seeds, flaxseeds (linseeds).


Drinks                                                                                                  back to top


It is important to make sure you drink enough to be well-hydrated. If you have diarrhoea you need to increase your intake of fluid; the average daily need is 6-8 cups a day, which doesn't need to be water. Tea, coffee, squash, juice, soup, and milk all count towards your daily fluids.If your diarrhoea is severe you need to include more salty fluids; you could add salt to soups, or take an oral rehydration solution to supplement your fluid intake.


If you have specific symptoms you may need to modify your choice of drinks. Urgency and diarrhoea after drinking may be related to caffeine content. You can reduce your caffeine intake by using decaffeinated tea, coffee, or cola drinks, or naturally caffeine free Rooibos tea and herbal teas. Caffeine is also found in functional drinks and fast-acting pain medications.




 Home    About MACC    Disclaimer    Privacy Policy   Glossary    FAQs    Acknowledgements    Site Map