When you’ve avoided certain foods for a really long time it can be difficult to start eating them again.  Many of my clients really worry about reintroducing foods again. This is really understandable. If you’ve managed to reduce painful or embarrassing digestive symptoms with an elimination diet you definitely don’t want a return of those!

By the way – This article doesn’t cover the FODMAP reintroduction process as that has a very specific protocol. I have written more about the FODMAP diet in a Beginners Guide to the low FODMAP diet and what is the low FODMAP diet?

I’ve added some real life stories at the end so you can see how I approach this with my clients. 

Why do I have to reintroduce foods I’ve excluded?

When we eat a wide and diverse diet we have a bigger chance of getting all the nutrients we need for a healthy body and mind. We need a good balance of fats, proteins and carbohydrates. 

Most of my IBS clients have avoided fibre rich foods for a long time because these are often the foods that cause bloating, gas and diarrhoea. 

The risk with a long term low fibre diet is that you are starving your gut microbes of food, and if they don’t have enough food to eat they won’t hang around in your gut. This means other ‘bad’ bacteria can muscle in and take the place of the good guys, and this can lead to further digestive problems.

Fear of food is one of the biggest challenges I find with my new clients have been on exclusion diets for many years before working with me.

Here are my top tips for reintroducing foods when you have IBS. 

1. Find the right time to reintroduce foods

Firstly start introducing foods when you are in a good place mentally, with some space in your schedule. When your digestion is calm you feel relaxed is a good time, rather than when you’re trying to move house, just about to go on holiday or going through redundancy. 

Times of stress are not a good moment to start playing around with dietary changes because stress itself can have a negative consequence on our digestion. When we are stressed we don’t digest food as well, leading to bloating, gas, fermentation so you don’t want to mix up these kind of symptoms from stress with the food reintroduction.  

2. Be aware some reaction to food reintroduction is normal

I completely understand you might have some anxiety about this process, but it’s really helpful to remember that there may be a mild increase in digestive symptoms when you start changing your diet.

When we change our diet we can sometimes feel a bit of gurgling in the stomach, or a bit more gas escaping from our bodies. This can be down to

• the gut microbes feasting on the fibre they have missed,
• some ‘bad’ bacteria dying off,
• or your body remembering how to digest certain foods again. 

Symptoms like bloating or gas doesn’t always mean it’s not working or that you should stop the trial. You will need to work out what is mild discomfort, what can you tolerate, and what is too much. 

I’d always recommend listening to your body, and stopping the process if it feels too uncomfortable. (And of course if you have a known allergy you shouldn’t eat those foods at all unless under the supervision of a medical professional)

3. Start low and slow

Take very small increases in foods to begin with, at a pace you feel comfortable with. Start with very small amounts of your chosen food and build up. 

My favourite way to bring back fibre for those who have been avoiding a lot of vegetables for a long time is the microbiome mash up. This is a mash of 15-20 different cooked vegetables. You only need to eat 1-2 tbsp a day, the rest can be chilled or frozen.

This is a strategy used by Dr Datis Kharrazian who works with auto-immune patients to reintroduce foods after an elimination diet, but it works very well in those who have avoided vegetables for too long. Think about it like weaning a baby, only you’re reintroducing food back to your gut microbes. 

4. Focus on eating properly

During the food reintroduction phase you may find it helpful to focus on the basics of eating again.  This could include

• chewing your food really well
• sitting upright at a table
• getting into a relaxed state before you eat by deep breathing. 

5. Work with a nutritional therapist

One way to reduce anxiety about food reintroduction is to work with a professional who knows exactly how to do this which foods you can include and which foods to avoid. The order of reintroduction very much depends on why you’ve been avoiding foods, and the action they have in your digestion. 

For example, maybe you’ve been avoiding foods that give you acid reflux. Some acid reflux foods cause heartburn by different means:

• Tomatoes and citrus fruits may increase acid in the stomach
• peppermint, alcohol and coffee may relax the opening to the stomach

It’s helpful to be aware of these kinds of things as you bring them back in, to notice what symptoms you’re getting.

6. Track your symptoms

How are you going to notice the difference in your symptoms?  The best way to monitor this is to use a food diary, and track your symptoms as you reintroduce each food.

Measure how your digestions reacts, but also think about other body signs such as

• Has it affected my sleep?
• What is my skin like during this trial?
• Am I bloated in the morning, or just after the food?
• Is the reaction to this food immediate, or does it appear a few days later?
• Is my mood different?

7. Try to avoid being craving led

When you’re working our which foods to reintroduce try to think about your diet overall, and what your body needs, rather than the foods you’ve been missing the most.

Some examples of food reintroduction in my clients

A recent client had been on a low FODMAP diet for over 2 years avoiding most fermentable fibres to help him manage his abdominal pain, constipation and excessive gas. As part of working together we ran a SIBO (Small Intestinal Bacterial Overgrowth) breath test which identified he probably had hydrogen sulphide gas producing bacteria in his small intestine. 

• To address this kind of SIBO the best approach is to to increase fibre, almost to the point of eating a vegan diet. There is also a low sulphur diet (avoiding onions, garlic, cruciferous vegetables) and a supplement regime. 
• This caused some anxiety in my client understandably after years of avoiding fibre I asked him to completely reverse his approach to eating. 
• To manage the anxiety we talked extensively about how fibre will support gut health and crowd out hydrogen sulphide producing bacteria.
• He was actually very brave and ate a lot of prebiotic foods, including greenish bananas, artichokes and the veggie mash up. He really threw himself into extending diet within his limits of what felt comfortable. 
• Within a few weeks he had expanded his range of foods considerably.

Client example – reintroducing gluten

Another client who also had long term constipation and had been told by a kinesiologist to avoid gluten around 12 years before. She was eating a good range of fruits and vegetables, but eating the same ones day in day out, so there wasn’t quite enough variety. 

• She was worried about gluten because she hadn’t eaten it for so long and we talked about gluten, how it affects the gut, and the place of grains in a healthy balanced diet.
• We started with non-wheat gluten containing foods such as rye, spelt and barley in small amounts. As this didn’t change her symptoms she was able move on to wheat bread, pasta and other foods.
• She was eventually able to eat a balanced amount of gluten containing foods and had lost her fear of eating it. This meant she could eat out more easily with friends, and enjoy a wider variety in her diet.

If you have a huge range of foods you’ve been avoiding, and you want to do something about changing that, then please get in touch to book a call with me. We can talk about what symptoms you have, and I can share how I can help as part of my IBS nutrition package The Gut Reset.