Eating Apples With IBS: Dried, Green, Peeled, Cooked Apples, & more.

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Quick Insights: What you need to know.

Apples are high FODMAP fruits, containing both fructose and sorbitol.
In 3 out of 4 of IBS sufferers, Apples may trigger your IBS symptoms.
The only way to decide if apples are good or bad for your IBS is to have a 6-8 weeks of low FODMAP diet and then re-introduce apples to see its effects on your IBS.
A medium (160 grams) or even small (30 grams) serve of apples may trigger your IBS.
there is No significant differences between red (Pink Lady) and green (Granny Smith) apples regarding their FODMAP content.
Peeling, Cooking, Jucing, or drying of apples doesn’t seem to alter its effects on IBS.

Are apples good or bad for IBS?

Apples are high in both sorbitol and fructose. Fructose and sorbitol are both FODMAPs (rapidly-fermented short-chain carbohydrates) that can trigger your IBS symptoms (ref). So, apples are generally BAD for IBS.

However, some IBS patients can tolerate consuming small amounts of apples. So, the key is to experiment with different amounts and types of apples. experimenting and keeping a food diary of symptoms will help you to figure out whether it is good or bad for your IBS.

Today we will discuss the effect of apples on your IBS, which is dependent on many factors such as:

The cause and the type of your IBS.
The amount you eat from apples.
Processing of apples: peeling, drying, … etc.

Apples and IBS-C (constipation).

Sorbitol is known to have a laxative effect and it can trigger diarrhea. Apples are high in sorbitol. So, they can, theoretically, fight constipation-predominant IBS.

Apples (together with prunes and pear) are recommended for constipation in both children and adults, but the story is different with IBS-constipation.

Apples are high in both sorbitol and fructose (two FODMAPs). Those two sugars rapidly ferment and produce gas, resulting in worsening of your IBS symptoms such as abdominal pain, distension, and bloating. So, they can do more harm than improvement in your IBS-constipation (ref).

However, IBS-C patients are not equal. Therefore, two IBS-constipation patients may respond differently to different medications and food (including apples).

Also, a low FODMAP diet is not a lifetime diet, it should be trailed under the guidance of a dietitian for a period of 2-6 weeks. According to Monash University research, About 75% of IBS patients respond to a low FODMAP diet (including apples).

Another interesting fact about IBS low FODMAP diet is that different patients have different degrees of sensitivity to different types of FODMAP (Fodmaps are of 6 main types: fructose, lactose, Mannitol, sorbitol, GOS “Galacto-Oligo-Saccharides”, and fructans ).

So, Apples may not be pure evil to your IBS, Some people with IBS-C may tolerate apples based on:

Not all people respond to a low FODMAP diet.
People are not usually sensitive to all six types of FODMAPs.
Low FODMAP diet is not a lifetime practice.
Apples may have a beneficial effect on your IBS-constipation (they have a laxative effect).

In conclusion, apples can trigger IBS symptoms such as abdominal pain and bloat in a big portion of people with IBS constipation. However, Experimenting with apples is the key to figure out whether apples are good or bad for your IBS.

Keeping a food diary and recording symptoms related to apples with IBS will help you to decide the effect of apples on your IBS-constipation.

(Later in this article, we will explain exactly how to test apple effects on your IBS).

Apples and IBS-D (diarrhea).

It makes more sense to avoid apples with IBS-D (IBS-Predominant diarrhea). because sorbitol contained in apples is a laxative in nature and can worsen diarrhea.

People with IBS-D are more likely to benefit from restricting FODMAP. This is because FODMAPs (like sorbitol and fructose in apples) draw more water in to your digestive tract.

More water equals diarrhea, bloating and abdominal pain. Therefore, restricting apples may be a good option if you have a diarrhea-predominant IBS.

But always remember that not all people benefit from restricting FODMAPs. About 3 out of every 4 people will respond to the low FODMAP foods (including apples).

Shall you stop eating apples with IBS?

The answer to this questions can be confusing to some of you.

And there is no one answer that fits every IBS patient. And before we answer this, you have to remember some important facts:

A low FODMAP (including apples) diet is not a lifelong diet plan.
About 25% of people with IBS DON’T benefit from restricting their FODMAP.
To know the effect of apples on your IBS, You have to Follow the right FODMAP plan, better with a guidance from your dietitian or doctor.

To evaluate the effects of apples on your IBS, start a 3-phase Low FODMAP plan as follows (which will help you to decide if you will stop eating apples for IBS or not):

Phase 1: Restriction.

You have to start a low FODMAP diet plan in which you will restrict all types of FODMAPs for at least 6-8 weeks.

As an IBS patient, you will have a 75% chance to benefit from this 6 to 8 weeks restrictive diet. So, by the end of this 8-week phase, you will either:

Experience an IBS-sypmptom improvement (in 75% of cases): then you will complete the diet plan and move to the second phase (reintroduction).
Expernience No improvement in your IBS symptoms after 8 weeks (in 25% of cases): then you won’t probably need a low FODMAP diet (and you can eat apples now as restricting them didn’t provide a relief).

Phase 2: Reintorduction.

in this phase, (with the aid of your dietitian or doctor), you should start re-intorduction of FODMAP foods.

Basically, People with IBS are not sensitive to ALL the 6 types of FODMAPs. The strategy of re-introduction is to bring back one food type at a time (let’s say apples is the first food to reintroduce).

by keeping a food and symptom dairy, you will be able to decide whether apples are IBS triggers or Not.

Phase 3: Personalization.

In this phase you will continue to test different types and amounts of FODMAPs. This will help you to design a list or a plan for the exact food types and amounts that may hurt your IBS.

after a correct implementation of a low FODMAP diet challenge, you will be able to decide what types of foods to restrict and what to keep eating. this can be used to evaluate any food effects on your IBS symptoms.

Red apples (pink lady) and IBS.

As a general rule, apples are high in FODMAPs. but is there a difference between different types of apples?

A common type of apples is the red apple (pink lady), a one serve of a medium red apple (about 160 gm) is high in both sorbitol and Fructose (both are FODMAPs).
A small 30 gm serve (about 2 tablespoons) of a red apple contains a moderate amount of sorbitol. It can be eaten with caution, restrict if you are intolerant to sorbitol.
A low/green serve of red apples (about 25 gm) is low in FODMAPs. you will mostly tolerate such amount of a red apple.

Source: Monash FODMAP app. (a life saver app for IBS sufferers, highly recommended).

Green apples (granny smith) and IBS.

Green apples are usually have the same effects as red apples. They contain almost identical amounts of FODMAPs. a medium (160 gm) or even small serving (30 gm) of green apples can trigger your IBS. refer to red apples for details.

Source: Monash University FODMAP app available on Apple App store, and Google Play.

Dried apples and IBS.

Dried apples appears to contain the same amounts of FODMAP sugars (sorbitol and fructose) which can trigger your IBS. According to Monash Universtiy FODMAP app, even a small quantity of dried apples ( 8 rings or 30 gram) are high in fodmap. So, drying of apples doesn’t seem to make it more tolerable with IBS.

Source: Monash University FODMAP app available on Apple App store, and Google Play.

Peeled apples and IBS.

The FODMAP content of the apple is located in the its flesh, and not in the skin. So, peeling of apples doesn’t decrease its FODMAP content.

Peeled apples will provide a more FODMAP content per serving, so it will result in more worsening rather than improvement in your IBS symptoms.

Cooked apples and IBS.

We couldn’t find a specific research on the effect of cooked apple on IBS, However, It is unlikely for cooking to change the FODMAP content of High FODMAP foods from high to low (ref), (ref).

Cooking will only result in non-significant alternation of apple’s FODMAP content. so, cooked apples are unlikely to make it more tolerable to your IBS.

Apple juice and IBS.

Jucing of any High FODMAP fruit (including Apples) desn’t change its effect on your IBS. If your IBS is triggered By apples, jucing, mashing, peeling, or cooking doesn’t really result in significant changes regarding its effect on IBS.