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The Mediterranean diet—one of the most popular healthy eating patterns out there—might be good for more than just lowering your risk of heart attack, stroke, and dementia. A new study suggests it could ease symptoms of irritable bowel syndrome (IBS), too.
The research, published in Neurogastroenterology & Motility in April, suggests that the Mediterranean diet could be an alternative strategy for dealing with the abdominal pain, bloating, diarrhea, and constipation that often come with IBS.
Currently, patients looking to manage their IBS are often encouraged to follow the low FODMAP diet—it’s effective but extremely restrictive, making it hard for some people to follow.
“If you cannot tolerate the low FODMAP diet and you’re still interested in dietary therapies, there are still a few options that can work,” said study author Prashant Singh, MBBS, assistant professor of internal medicine at the University of Michigan Medical School.
IBS is incredibly common—it’s estimated that as many as 15% of adults in the United States have the condition, though only about half have a diagnosis.
And diet plays a huge role. IBS can stem from issues with the gut microbiome, or the trillions of organisms that live in your gut and help it function properly. When someone has IBS, these microbes become unbalanced, leading to painful gastrointestinal symptoms and bowel movement issues.
Diet is one of the primary determinants of the composition of the gut microbiome, so as a result, dietary choices could ease symptoms of IBS by creating an environment where healthy bacteria can grow.
The Low FODMAP Diet
The low FODMAP diet is a type of temporary elimination diet that is used to treat IBS. FODMAP is an acronym that stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are found in many fruits, vegetables, wheat, and dairy products.
The diet involves three steps:
- Elimination. Foods high in FODMAPs are taken out of the diet for two to six weeks.
- Reintroduction. High FODMAP foods are reintroduced one by one while monitoring symptoms, which helps patients determine which food they’re sensitive to.
- Maintenance. After the triggers are identified, people can avoid or limit these foods and return to a nutritious, varied diet.
Essentially, the low FODMAP diet leads to “reduced microbial fermentation in the colon,” and in turn creates less gas production to improve IBS symptoms, Helen Burton-Murray, PhD, director of the Gastrointestinal Behavioral Health Program at Massachusetts General Hospital, told Health.
The Mediterranean Diet
The Mediterranean diet is a healthy way of eating, incorporating the foods inspired by the traditional cuisine of people living in Mediterranean countries. The diet involves eating many anti-inflammatory foods that have a positive effect on gut bacteria. This includes:
- Eating a lot of vegetables, fruits, whole grains, beans, and legumes
- Including low-fat or fat-free dairy, fish, poultry, vegetable oils, and nuts
- Limiting added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats
The Mediterranean diet is much less restrictive than the low FODMAP diet, and may be easier to implement as a result.
To see if the Mediterranean diet could be helpful for IBS patients, Singh and the other researchers ran a small study randomizing 26 participants to receive either a low FODMAP diet or a Mediterranean diet for four weeks.
In total, 11 participants did the low FODMAP diet and 10 finished the study, while 15 people did the Mediterranean diet and 10 finished the study.
The researchers’ main goal was to see whether the Mediterranean diet could reduce participants’ IBS-related abdominal pain. They found that eight out of 11 people in the Mediterranean diet group and nine out of 11 people in the low FODMAP group showed at least a 30% reduction in their abdominal pain for two weeks.
The researchers also broke down the percentages of patients in each diet group who saw improvements in specific symptoms.
| Improved stool consistency | Less abdominal pain | Less bloating | Adequate symptom relief | Improved IBS severity score | |
| Mediterranean diet | 0% | 70% | 50% | 30% | 50% |
| Low FODMAP diet | 20% | 100% | 80% | 60% | 90% |
Though people in the low FODMAP diet group had slightly better results, “both diets led to improvement in symptoms,” Singh told Health.
Though the study’s results are interesting, we still don’t have a clear understanding of just how the Mediterranean diet could be used for IBS management, or how exactly it compares to the low FODMAP diet.
This is only the second clinical trial testing whether the Mediterranean diet could benefit IBS patients. The first study, published in 2023, also showed positive results, but only as compared to a normal diet.
“We were not powered to show that one diet was better than the other,” said Singh. Future studies with more participants—measuring the long-term effects of these diets—are needed to determine who benefits the most from each one.
In addition, the diets might not work as well outside of this trial setting, where meals were prepared for all of the participants.
“In the real world, patients will receive dietary advice and then it is up to them to go and look up recipes, plan a grocery list, shop, prep, and cook meals to follow the [dietitian’s] recommendations,” Amy Bragagnini, RD, spokesperson for the Academy of Nutrition and Dietetics and registered dietitian at Trinity Health Lacks Cancer Center, told Health.
There are many ways to treat symptoms associated with IBS. But if you’re looking to modify your diet, it’s important that the approach is personalized—now, doctors could have another dietary therapy in their arsenal.
“The Mediterranean diet is a traditional diet that is much easier to follow with less risk of malnutrition and may be more amenable to routine [gastrointestinal] practice than the low FODMAP diet, which really should only be undergone with the guidance of a dietitian,” said Burton-Murray.
Doctors can present their patients with research about the different dietary options for treating IBS symptoms, Singh said—including a modified low FODMAP diet, a Mediterranean diet, or an individualized food sensitivities diet—so they can make an informed decision about what best fits their lifestyle.
“If someone is juggling a family, work, household, and does not have a lot of time, the Mediterranean diet may be a better choice,” said Bragagnini. “Paying attention to symptoms and making some diet changes can absolutely benefit your digestive system and lessen symptoms.”
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