9 Drinks to Avoid or Limit With IBS

Alcoholic drinks, caffeinated coffee and apple or pear juice are three drinks to limit or avoid if they trigger your IBS symptoms. Other drinks may also contribute to diarrhea, bloating or abdominal discomfort, but triggers vary from person to person. See the best drinks for IBS for alternatives.

Which 9 drinks can make IBS symptoms worse?

You do not need to eliminate all nine drinks simply because you have IBS. The explanations below describe plausible triggers, but we found no drink-specific IBS studies, so research cannot establish which drinks will affect you or how strongly.

1. Alcoholic drinks

Alcohol can irritate the digestive tract and affect bowel movement, potentially worsening diarrhea or abdominal discomfort in some people with IBS. Mixed drinks may contain additional possible triggers, such as carbonation, fruit juice or sweeteners.

If alcohol seems to bring on symptoms, avoid it or discuss your intake with a clinician. Pay attention to the mixer as well as the alcohol: changing both at once will not show which ingredient was responsible. Research has not established a reliable symptom threshold for drinks in IBS.

2. Caffeinated coffee

Caffeine can stimulate bowel contractions, which may be uncomfortable for someone whose IBS includes urgency or diarrhea. Coffee drinks can also contain milk, sweeteners or other additions that may contribute to symptoms.

If coffee appears to be a trigger, try reducing it or avoiding it and note whether your symptoms change. Decaffeinated coffee is not necessarily symptom-free for everyone, especially when it contains other additions. We found no coffee-specific IBS trials, so the effect cannot be predicted for an individual.

3. Apple and pear juice

Apple and pear juice can contain fructose and sorbitol, carbohydrates that some people absorb poorly. Unabsorbed carbohydrates can draw water into the bowel and be fermented by gut bacteria, contributing to gas, bloating or diarrhea.

If either juice seems to worsen your IBS, check mixed-fruit drinks for it as an ingredient as well. The amount consumed and your own tolerance matter; a reaction to one juice does not prove that every fruit juice will cause symptoms. No juice-specific IBS evidence was provided to quantify this effect.

4. Regular milk and milk-based drinks

Regular milk contains lactose, a sugar that can cause gas, bloating or diarrhea when it is not fully digested. Lactose intolerance and IBS are not the same diagnosis, although their symptoms can overlap.

If a milk-based drink causes symptoms, consider whether lactose is the issue and discuss persistent symptoms with a clinician. Lactose-free milk may be better tolerated by someone sensitive to lactose, but it still contains milk proteins and is not suitable for a person with a milk allergy. We found no milk-drink-specific IBS studies to show who will benefit from avoiding it.

5. Drinks sweetened with sugar alcohols

Some sugar-free drinks contain sugar alcohols, also called polyols. Sorbitol, mannitol and xylitol can be incompletely absorbed, potentially drawing water into the bowel and contributing to gas or diarrhea.

Check the ingredient list rather than assuming that every drink labeled sugar-free contains these sweeteners. If a drink seems to cause symptoms, note the sweetener and amount you consumed before deciding whether to avoid it. The mechanism is plausible, but we found no drink-specific IBS studies to establish how often these beverages cause symptoms.

6. Carbonated drinks

Carbonation adds gas to a drink and can increase belching or a feeling of fullness and bloating. Some carbonated drinks also contain caffeine, alcohol, fructose or sugar alcohols, making it difficult to identify the trigger from the drink name alone.

If fizzy drinks bother you, compare your response to a noncarbonated version without changing other ingredients where possible. You may tolerate some carbonated drinks better than others. We found no carbonation-specific IBS study, so the size of any effect on IBS symptoms is uncertain.

7. Energy drinks

Energy drinks can contain caffeine, which may stimulate the bowel and worsen urgency or diarrhea in susceptible people. Depending on the product, they may also be carbonated or contain sweeteners that are possible triggers.

Read the ingredient list and consider whether symptoms follow the drink itself, a particular ingredient or a combination. If energy drinks consistently make your IBS worse, avoiding them is reasonable; do not assume a sugar-free version will necessarily be better tolerated. Research has not established the effects of energy drinks on IBS.

8. Drinks with added inulin or chicory-root fiber

Some drinks marketed as prebiotic contain added inulin, chicory-root fiber or other fermentable fibers. Gut bacteria ferment these fibers, which can produce gas and contribute to bloating or discomfort in some people with IBS.

Check the ingredient list if a fiber-added drink causes symptoms, and avoid that product if you find it repeatedly bothers you. This does not mean all dietary fiber is harmful or that you should remove it from your diet. We found no trials of these drinks in IBS, so individual tolerance remains uncertain.

9. Drinks sweetened with added fructose

Fructose can be absorbed less completely when it is present in excess of glucose. For some people, the unabsorbed fructose can contribute to gas, bloating or diarrhea; the amount and the drink's overall composition matter.

If a sweetened drink bothers you, check whether fructose is listed as an ingredient and record the amount you drank. High-fructose corn syrup on a label does not, by itself, establish that a drink will trigger IBS or that its fructose content exceeds what you can tolerate. We found no drink-specific IBS studies to predict a response.

How can you identify drinks to limit with IBS?

Start with drinks that seem to coincide with your own symptoms, rather than cutting out every item on the list. Record what you drank, approximately how much, other ingredients and any symptoms. Food, stress and other factors can also affect symptoms, so a single reaction does not establish the cause.

If you notice a repeated pattern, try avoiding that particular drink and observe whether symptoms change. When appropriate, reintroducing it can help you assess whether the pattern returns. Avoid changing many foods and drinks at once: that makes the result harder to interpret and can lead to unnecessary restrictions.

A restrictive low-FODMAP diet should be planned with a clinician or registered dietitian, who can help with reintroduction and nutritional adequacy. It is not necessary for everyone with IBS. Maintain adequate fluids, particularly if you have diarrhea; ask your clinician for individual advice if you have been told to restrict fluids.

Who should be careful, and when should you see a doctor?

Seek urgent medical care for blood in your stool, black or tarry stool, severe or worsening abdominal pain, fainting, or signs of severe dehydration such as confusion or very little urine. Do not assume these signs are caused by IBS.

Arrange a medical assessment for new or persistent symptoms, unexplained weight loss, anemia, symptoms that wake you from sleep, or persistent vomiting. A clinician can consider causes other than IBS and advise on appropriate care.

If you are pregnant, are planning dietary changes for a child, have a food allergy or another medical condition, or take medicines, speak with a clinician before making substantial restrictions. Do not stop prescribed medication because you suspect a drink or ingredient is triggering symptoms.