Follow this diet for severe constipation-predominant IBS and as a follow-up to the extreme elimination diet.

This elimination diet is extreme and should not be followed long-term. It’s designed to help people who suffer with persistent constipation-predominant IBS (and other debilitating types of IBS that cause gas, cramping, and pain) finally figure out which foods may be aggravating their condition. It avoids common IBS trigger foods and provides a moderate amount of dietary fiber, with a good amount specifically coming from soluble fiber sources. All foods rich in fiber are marked with an asterisk (*). If you’re feeling gassy or uncomfortably distended, go easy on these foods. Your total fiber intake (and nutrition!) will slowly increase when you start introducing new foods.

If you’re a candidate for this plan, follow it for one week. Every day, choose one option for each of the three meals — breakfast, lunch, and dinner. Then, once or twice per day, choose from my suggested snacks. Eat slowly, and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage and try to drink at least 10 cups throughout each day.

After following this plan for one week, you’re ready to add new foods. You should add one new food every two to three days. (It’s best to stick with one portion of a new food per day.) Keep an IBS diary and write down all the foods you eat, the amounts, and how they affect your constipation. Pay close attention to how you feel after eating each new food and determine if that food can be permanently reintroduced back into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next category. You can always retest a problem food at a later date.

At the end of this tough assignment, you will hopefully have identified all (or most) of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods.

  1. Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
  2. Wheat products (preferably whole wheat bread, pasta, cereal, and more) and other whole grains
  3. Increased portions of daily cooked vegetables (noncruciferous)
  4. More daily fruit
  5. Whole nuts and seeds
  6. Garlic and onion
  7. Starchy beans and lentils
  8. Cooked cruciferous vegetables
  9. Raw vegetables
  10. Ketchup, soy sauce, and other condiments (test one at a time)
  11. Dried fruit and all-fruit jam
  12. Fruit juice, sugar, and honey
  13. Chocolate
  14. Coffee or tea
  15. Alcohol


Breakfast Options

(300 to 400 calories)

Oatmeal with Strawberries and Ground Flaxseed
Prepare 1/2 cup dry *oats with water and top with 1 cup sliced *strawberries and 2 tablespoons ground *flaxseed.

Cold Cereal with Banana and Soy Milk
Mix 11/2 cups puffed rice cereal with 1 cup soy milk (or rice or almond milk) and top with 1 sliced *banana (or 1 cup *berries) and 1 to 2 tablespoons ground *flaxseed.

Banana Almond Muffin with Scrambled Eggs
Beat 2 whole eggs with 2 egg whites and preferred seasonings, and scramble in a hot skillet coated with oil spray. Enjoy with 1 *Banana Almond Muffin or 2 rice cakes, each topped with 1 teaspoon soft tub, trans fat–free spread.

Lunch Options

(400 to 500 calories)

Curried Chicken Salad with Sweet Green Peas and Rice Cakes
Enjoy 1 serving *Curried Chicken Salad with Sweet Green Peas divided over 2 rice cakes. Serve with 1 *orange or 1/2 *grapefruit.

Turkey and Avocado on Rice Cakes
Divide 5 ounces sliced turkey (or chicken) over 2 rice cakes and top each with 1 thin slice *avocado. Serve with 1 cup *berries (blackberries, raspberries, sliced strawberries) or 1 *orange.

Turkey Burger with Sweet Potato
Top a 5-ounce bunless turkey burger with 1/2 cup mushrooms sautéed in oil spray. Serve with 1 plain medium baked *sweet potato.

Dinner Options

(500 to 600 calories)

Salmon with Green Peas and Rice
Enjoy 1 serving Easy! 3-Step Microwave Salmon (page 00; omit the garlic) or 5 ounces grilled salmon, sole, cod, haddock, or tilapia with 1 teaspoon olive oil and other preferred seasonings. Serve with 1/2 cup *green peas mixed with 1/2 cup cooked *brown or wild rice.

Rosemary Chicken with Sautéed Spinach and Sweet Potato
Enjoy 5 ounces grilled Rosemary Chicken, 1 cup *spinach sautéed in 1 teaspoon olive oil with a pinch of kosher salt and pepper, and 1 plain medium baked *sweet potato.

Roast Turkey with Cooked Carrots and Brown Rice
Enjoy 5 ounces roast turkey with 1 cup cooked *carrots and 1 cup cooked brown or wild rice (or 1 plain medium *sweet or *white potato topped with 1 tablespoon soft tub trans fat–free spread).

Snack Options

100 calories or less

  • IBS-friendly fruit rich in soluble fiber: 1 banana or orange; 1 cup berries (sliced strawberries, blackberries, raspberries); 1/2 grapefruit; 2 tangerines or clementines; 20 whole strawberries
  • 1 hard-boiled egg (or 4 egg whites)
  • 1 rice cake topped with 1 teaspoon nut butter

100 to 200 calories

  • 100 to 200 calories’ worth of plain rice crackers
  • 1 ounce baked potato chips
  • 1/2 baked *sweet or *white potato with 1 teaspoon soft tub, trans fat–free spread (or 1 tablespoon guacamole)
  • 2 rice cakes, each topped with 1 teaspoon nut butter
  • 2 rice cakes, each topped with 1 tablespoon guacamole
  • 8 ounces soy, rice, or almond milk
  • *Banana Almond Muffin
  • 1/2 cup *oats prepared with water, topped with 1/2 cup *berries or 1/2 sliced *banana
  • *Strawberry-Banana Smoothie: Combine 1 full cup strawberries (fresh or frozen), 1/2 medium banana, 3/4 cup soy milk (or almond or rice milk), and 3 to 5 ice cubes in a blender and purée until smooth.

Click here to view my list of IBS-safe recipes.
Click here for the Extreme Elimination Diet (With No Fiber).