One challenging aspect of eating for IBS and/or SIBO is finding a suitable milk or plant milk to drink. The main reasons for this are that manufacturers tend to add ingredients such as emulsifiers and thickeners in addition to sugar.
Here are some suggestions, along with things to be mindful of when choosing one or more milks.
Options for purchasing SIBO and IBS-friendly milk
The general advice I give to clients is to avoid any added gums, thickeners and emulsifiers. Also, minimal added sugar is important.
Spend some time researching what’s available to you where you live. Some brands may use wording such as “FODMAP friendly” but this isn’t regulated so please be careful with any claims. If an additive is listed and you don't know what it is, look it up. The less ingredients in the milk, the better!
- lactose-free cow's milk (not suitable if dairy allergy or a sensitivity to casein or whey is present*)
- coconut milk or cream from a can with minimal ingredients (usually just coconut and water eg. Ayam brand) - you can dilute and blend it if need be because it's not homogenous
- rice milk without gums and minimal/zero added sugar
- almond milk, hazelnut milk or macadamia milk without gums and minimal/zero added sugar
- soy milk made with mostly protein rather than the whole bean (so, not Bonsoy for example) - in Australia, the So Good brand is suitable
*I also recommend avoiding if autoimmunity is present or conditions such as eczema, acne or endometriosis
Other tips, including making your own milk
- If you have a decent blender, it’s not too difficult to make your own nut milk - you will find plenty of recipes online and will need a nut milk bag to strain the milk. As for ingredients, the only additions aside from the nuts should be salt and a little sweetener.
- I’ve found that a small amount of smooth cashew butter - or even tahini - can sometimes take the place of plant milk in a recipe. Usually 1 -2 tsp is enough when diluted in a cup of water - you will need a blender to ensure it’s mixed in well. This means that if you don’t drink a lot of milk, you don’t need to worry about waste.
- Use the Monash FODMAP app to check FODMAP-safe serving sizes as they are different for every type of milk
- Lower serving sizes apply to oat milk and higher serving sizes apply to lactose-free cow's milk, almond milk, rice milk, macadamia milk or soy milk made with soy protein
- Sometimes the flavour of the various plant milks isn't too appealing so mixing more than one can sometimes help offset strong flavours
- A little maple syrup can be added to help with flavour too.
- If you are concerned about waste, you can also freeze some in small jars or ice cube tray to avoid waste
Store-bought options in Australia
I'm listing the Australian options I'm aware of - I'm sure there are probably more. I'm not familiar with brands in other countries, so if in doubt you can follow the suggestions above to choose a suitable IBS and SIBO-friendly milk.
- Lactose free milks are available from many brands including Paul's Zymil, Woolworths, A2 (this last one may be a good option compared to regular lactose free milk for those with immune-mediated conditions)
- Ayam coconut milk or coconut cream - you can dilute these with hot water as they are high in fat - may not be suitable for those with hydrogen sulfide SIBO except in small amounts
- Pure Harvest almond milk or Coco Quench - does contain a small amount of brown rice which can ferment, so you may want to test small amounts
- Nutty Bruce - unsweetened almond milk, coconut and almond milk (both contain some brown rice which can ferment so stick to small amounts)
- Sanitarium So Good Soy Regular long life - this one does have a few more additives than other brands but ferments less than Bonsoy for example
STRUGGLING WITH THE DIET?
If you’re still struggling, a non-diet approach is the Nerva hypnotherapy app from Monash which has been shown to be just as effective as the low FODMAP diet. It is a 6 week program for less than the cost of 1 hypnotherapy session. For people who want to go down this route, I do suggest still avoiding your big dietary triggers - for many it’s onion and garlic - but avoiding a strict diet if you can (as this is the whole point of the hypnotherapy app). I have started recommending this more and more for people who find the diet side of things challenging, if there has been a history of disordered eating or if someone has a very short list of foods they can tolerate.
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