Figuring out what foods won’t trigger uncomfortable symptoms is one of the hardest parts of having IBS. Looking at every ingredient in a meal is also time consuming and frustrating.
For those newly diagnosed with IBS, “Can I still have milk?” is a common question since it's such a prevalent ingredient in the western diet. The “sugar” in milk — lactose — is high FODMAP, which is why it can irritate the gut for most people with IBS. Milk fat also affects gut motility, exacerbating abdominal pain, diarrhea, bloating, and gas.
The good news is, there are now a lot of new alternatives for milk. These plant-based alternatives have been growing in popularity as consumers began seeking new ways to consume their favorite drinks.
Since the average IBS consumer is not familiar with different types of milk alternatives, the editors at IBS Life sat down with Renee Clerkin, RD, to talk about the new choices. Clerkin has a virtual practice and is based in Carmel, Ind. She specializes in helping patients with IBS.
According to Clerkin, every individual is different so choosing the right type of milk alternative may depend on the patient. For example, oat milk, is high in sugar and in FODMAP. Coconut milk contains mostly saturated fat. Rice milk is high in carbohydrates and it’s not a great choice for someone with diabetes. It’s also not a good source of protein.
“In my practice, I like to start by figuring out what someone’s individual triggers are,” said Clerkin. “If milk isn’t a trigger, then we don’t remove it from the diet. If milk is a trigger, I start recommending milk alternatives.”
So, what’s a good milk choice for IBS sufferers? Clerkin recommends these four milk substitutes.
Lactose-Free, Fat Free Milk. While lactose-free milk is still technically cow’s milk, it is perfectly fine for those with IBS gut sensitivities. An enzyme is added that helps digestion, making it easier for sensitive guts to absorb. Importantly, this milk still contains many of the nutrients the body needs, such as calcium, protein and vitamins. It’s a great replacement for cow’s milk.
Soy Milk Made from Soy Protein. Not all soy milk is the same. Some are high in sugars; others don’t contain a certain type of soy. Soy milk made from soybeans are high FODMAP. But, according to Clerkin, soy milk made from soy protein are easier for the gut to digest because this type of soy is low FODMAP. Be sure to look on the label to make sure that the milk contains soy protein.
Unsweetened Almond Milk. Unsweetened almond milk has a watery consistency and is made by blending water with almonds. Previously it was thought that almond milk was high FODMAP, but this “milk” contains less than 2% of almonds. It’s low in protein so those who choose to drink this milk alternative should be sure to supplement their diet with more protein-rich foods.
Hemp Milk. This dairy alternative is made by blending water with hemp seeds. It also is a great alternative for those who are allergic to nuts. It’s naturally low FODMAP on its own.
One thing to look out for in these milk alternatives is the additives. Be sure to check for high-FODMAP items, such as inulin, agave syrup, honey, molasses, and high fructose corn syrup.
For those worried about whether or not they can still use their favorite coffee creamer, fear not. Clerkin says, “Coffee creamer is used in such small quantities that most people with IBS shouldn’t worry about it triggering their symptoms”. But she does recommend avoiding cooking or baking with milk.
It’s important to emphasize that having an IBS diagnosis doesn’t mean that one’s whole life has to change. It just means figuring out which foods will trigger IBS symptoms and choosing to either avoid them or reduce the amount consumed. If regular dairy milk isn’t a trigger, then keep it in diet. But if it is causing IBS symptoms, consider trying a milk alternative, like those listed above. Be sure to consult with a physician or dietitian/nutritionist before making any major dietary changes.