How to Know if an Elimination Diet Will Fix Your Stomach Issues

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WHAT YOU EAT provides valuable nutrients that keep you healthy and fueled to take on the day. But sometimes certain foods don’t agree with you, cand cause gas, bloating, indigestion, and other stomach problems. If you’ve noticed you’re not feeling great after eating specific things, you could have a food intolerance or allergy.

The best way to pinpoint exactly which foods are giving you trouble is by doing an elimination diet.

“The purpose of an elimination diet is to isolate your food triggers and then reintroduce as many foods as possible,” explains Sarita Salzberg, M.D., a board-certified family medicine and addiction medicine physician at virtual health platform PlushCare. “Once you identify the foods that cause symptoms, you can avoid or limit them.”

Doing an elimination diet involves avoiding certain food categories that likely trigger your symptoms. The most common foods that cause food allergies and sensitivities include eggs, nuts, fish, milk, peanuts, shellfish, soy, wheat, and tree nuts, like almonds.

You track how you feel without those foods in your diet, and then add them back slowly and note any symptoms, according to the Cleveland Clinic. Elimination diets are meant to be followed for a short period of time to figure out your food triggers, according to the Academy of Nutrition and Dietetics.

People with functional gastrointestinal issues, like irritable bowel syndrome (IBS), can especially benefit from doing an elimination diet, Dr. Salzberg says. But it’s best to check with your healthcare provider before starting an elimination diet to rule out any medical conditions.

What Exactly Is an Elimination Diet?

You probably already have an idea which foods are causing you problems. Elimination diets can help you confirm it.

The diet involves cutting out these food suspects or other common food-allergy culprits. Then, you slowly reintroduce them one by one and examine any symptoms that you have.

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“Depending on the condition it’s used for, an elimination diet may exclude likely allergens, gastrointestinal irritants, or foods theorized as sources of inflammation,” says Julie Stefanski, R.D.N., registered dietitian nutritionist and spokesperson for the Academy of Nutrition and Dietetics.

Elimination diets aren’t foolproof, though, the Mayo Clinic says. Yes, they’ll help you understand what about your diet is causing stomach problems. But they alone can’t pinpoint whether the foods are an allergy or intolerance.

Food Allergy vs. Food Intolerance

Both food allergies and food intolerances can cause GI issues and other symptoms. But the reason behind the symptoms differs.

A food allergy is an immune system reaction that happens after you eat a specific food, even if it's just a tiny amount, according to the Mayo Clinic. Blood tests can measure your immune response to specific allergens.

Food allergies can cause digestive problems, hives, swelling, rashes, and even anaphylaxis. The allergies can be life-threatening. If you’ve ever had a severe reaction to a food, an elimination diet might not be safe.

Symptoms of food intolerance, or food sensitivity, might mimic a food allergy but are usually not life-threatening. Food intolerances involve the digestive system and occur when you struggle to digest certain foods, according to the American Academy of Allergy, Asthma, and Immunology.

About 10 percent of the global population has a food allergy—and, many more likely have food intolerances or sensitivities.

What an Elimination Diet Can’t Tell You

You’ll probably find out which foods are causing your stomach problems, but an elimination diet—especially if you try it without your doctor’s input—doesn’t necessarily tell you if you have a food allergy or sensitivity.

“Following an elimination diet without seeing a GI doctor isn’t going to reveal the underlying cause of the issue,” Stefanski says.

Another thing about the diets that make them short-term experiments, rather than long-term solutions is that they focus on specific foods than amounts of nutrients, she adds. People with liver disease and gastroparesis, or slow-stomach emptying, for example, might struggle with the amount of fat in foods, not a specific food.

How to Do an Elimination Diet

If you think an elimination diet can help your stomach issues, follow these steps:

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Talk to your doctor

Elimination diets are safest under the guidance of a medical professional. “It’s a good idea to get standard labs from a doctor to check for liver functions, gallbladder issues, and just baseline health,” Dr. Salzberg says. “Doctors can order a bloodwork check for common problems before starting an elimination diet.”

Removing specific nutrients from your diet could worsen some health conditions and lead to deficiencies. Your doctor can help you plan out your elimination diet.

Start removing trigger foods

“Typically, an elimination diet moves from most restrictive to less restrictive,” Stefanski says. “Multiple foods are eliminated at one time and then gradually reintroduced as single foods so that symptoms can be clearly identified.”

There's more than one type of elimination diet, depending on your individual symptoms. For instance, you might need a low-FODMAP diet, which calls for reducing dairy, wheat, beans, and certain fruits and vegetables that cause digestive issues for some people.

Working with your doctor will help you decide which foods to start eliminating, based on your symptoms and overall health. While you’re avoiding those triggers, you’re encouraged to monitor what you eat and any symptoms you experience, such as by keeping a food journal.

Stick to the diet

Your doctor will recommend a timeframe for following the elimination diet. Typically, the diet spans four to eight weeks.

“It can take time for the elimination phase of this type of diet to work and for your symptoms to subside,” Dr. Salzberg says. “Even if you feel great during the elimination phase, it’s not meant to be permanent.”

Reintroduce foods slowly

After the elimination phase, start reintroducing foods one at a time, based on your doctor’s advice. You should pay attention to any symptoms that you experience when you add something back to your diet.

“It’s important to find out which foods you may be able to reintroduce and tolerate,” Dr. Salzberg says. “A more moderate diet will be easier to maintain over time, and in nutrition, variety is always the best policy for getting all of your micronutrients.”

Once you figure out your food triggers, your doctor can help develop a long-term eating plan.

The most crucial aspect of an elimination diet is that you follow it based on your doctor’s recommendations, she emphasizes.

“You can’t cheat on an elimination diet—the whole experiment is invalid if you do,” Dr. Salzberg says. “Make an intentional commitment to yourself to complete the process before you start.”

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