Irritable bowel syndrome (IBS), also called spastic colon, nervous colon, and mucous colitis, is a gastrointestinal disorder affecting 9%-23% of people worldwide. 
While the exact cause of IBS remains unknown, it can be triggered by processed foods, certain fruits and vegetables, mostsugar alcohols, caffeine, and alcohol — among other things like psychological stress and anxiety. Key IBS symptoms include abdominal bloating, pain, cramping, diarrhea, constipation, and excessive gas. 
Recent studies have shown that gut dysbiosis or the disruption of the gut microbiome and inflammation contributes to the onset of IBS. 
If you’re dealing with IBS and are looking to improve your condition through dietary changes, you might be wondering if the keto diet can help. This article explores the relationship between keto and IBS, what the research says, foods to eat and avoid, and three natural remedies to support your IBS diet.
Keto and IBS: Does a Low-Carb Diet Help?
The keto diet naturally limits your intake of FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) — these are short-chain carbohydrates that are poorly absorbed in your small intestine.
As a result, the answer is yes, going keto can help ease IBS symptoms. In addition, you’ll need to watch out for some sources of FODMAPs that happen to be keto-friendly,such as onions, garlic, and lactose-containing foods and drinks. Overall, however, the keto diet is essentially a low-FODMAP diet, which improves IBS.
Another way that the keto diet may help with IBS is by reducing inflammation, another factor that plays a role in IBS. One study on inflammatory bowel disease (IBD) found that the diet protects the intestinal barrier and reduces the expression of inflammatory cytokines. 
Research Studies on Keto and IBS
Here’s a list of studies suggesting that low-carb diets may be effective for people with IBS:
In a 6-week study, participants (mostly women) with moderate to severe IBS-D (IBS with diarrhea) were given meals with the following macro percentages: 51% fat, 45% protein, and 4% carbs. All participants reported adequate relief from IBS-D symptoms, especially during the last week of the diet.[ref ID = 5]
A randomized, placebo-controlled, double-blind clinical trial found a significant decrease in clinical symptoms of IBS in all groups that followed a low-FODMAP diet. However, five participants who were given gluten supplementation on top of their low-FODMAP diet experienced worsening symptoms.[ref ID = 6] In other words, avoiding gluten (which is found in high-carb foods like bread, cereals, and baked goods) also helps to resolve IBS.
Data from a 2021 study showed that the keto diet was able to reduce the effects of stress on the gut in Wistar rats with IBS. As you may already know, stress can result in the overactivity of the gut, which worsens IBS symptoms. 
Foods for IBS (Low-FODMAP, Gluten-Free, and Keto-Friendly)
This section lists foods helpful for IBS symptom relief that are low in carbohydrates. They’re also low-FODMAP and gluten-free. However, keep in mind that everyone’s body is different; some foods that work for others may not work for you, and vice-versa.
Meats and eggs: top sirloin steak, top or bottom round roast, lamb, veal, pork tenderloin, chicken eggs (unless you have an egg allergy)
Poultry: skinless chicken breast or thighs, turkey, duck, geese
Fish and seafood: tuna, salmon, tilapia, sea bass, shrimps, mussels, and other shellfish
Vegetables: spinach, kale, zucchini, tomatoes, green beans, choy sum, red bell peppers
Fruits: blueberries, strawberries, cantaloupe, lemons, avocado (only in small amounts)
Nuts and seeds: almonds, walnuts, pecans, Brazil nuts, chia seeds, sunflower seeds
Tip: Keep a food journal. It could be a simple notebook or app where you can track what you eat or drink daily. This will allow you to further optimize your keto IBS diet by identifying which foods or ingredients you can tolerate or are more sensitive to.
Foods to Avoid (“Diet Triggers”)
Here’s a list of foods to avoid since they’re likely to worsen gas, bloating, pain, and other IBS symptoms. Note that most items on the list are high in carbs; however, some of them are keto-friendly but should also be removed from your diet if you’re looking to treat IBS.
Grains: wheat, rye, barley, couscous, durum
Dairy: milk, cheese, ice cream with lactose
Foods high in fructose: processed foods, salad dressings, sweetened yogurt, canned fruits, canned soup, fast food items
Vegetables: cruciferous veggies like cauliflower, broccoli, and cabbage
Fruits: sweet fruits like apples, bananas, pears, watermelons, mangoes
Tip: While you’re avoiding these trigger foods, make sure you’re also stocking up with keto and IBS-friendly foods for breakfast, lunch, snacks, and dinner. Also, consider speaking with your healthcare provider about meeting your micronutrient needs — possibly through supplementation — to ensure that you won’t get any vitamin and mineral deficiencies due to eliminating certain foods in your diet.
Natural Remedies to Support Your Keto and IBS Diet
Keto as a dietary change can go a long way toward reducing IBS symptoms, in addition to helping you achieve healthy blood sugar levelsand weight loss. Yet, there are also other interventions to try along with your diet so you can experience optimal relief:
Stress reduction: Mindfulness-based stress reduction, which combines meditation and yoga, greatly improves IBS symptoms.  You can also do deep breathing to calm down. Slow down and remember to take time off for yourself.
Probiotic supplements: These are live microorganisms that prevent the overgrowth of harmful gut bacteria and regulate your bowel movements.  When choosing a probiotic supplement, pick one that’s keto-friendly and designed for your type of IBS (IBS with diarrhea, IBS with constipation, or IBS with mixed bowel habits).
Regular exercise: Working out not only enhances your body’s fat-burning potential and transition to ketosis, but it also reduces IBS symptoms and helps you to feel more in control over the disease.  If you’re new to the keto diet, start slow. Low-intensity workouts such as light jogging, cycling, swimming, and yoga are great options.
Adopting a Keto Lifestyle with IBS
Irritable bowel syndrome or IBS can interfere with your life in many ways, and symptoms can range from mild to severe. The good news is that a healthful diet such as keto can be a good approach for IBS relief, especially if you’ve followed other diet strategies, but they failed.
If you’re trying the keto diet for the first time, consider reducing your carb intake gradually or at a pace you’re comfortable with. This allows you to get properly adapted without causing too much stress physically and mentally, which could aggravate IBS symptoms.
Combining a keto diet with other remedies like exercise, stress management, and taking a probiotic supplement (based on your doctor’s or dietician’s recommendation) could lead to noticeable improvements in your health.
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