Is Paleo Good for IBS? A Closer Look at the Diet's Effects

October 31, 2025 •

4 min read

A 2019 study published in the European Journal of Nutrition found that long-term adherence to a Paleo diet was associated with unfavorable changes in gut microbiota composition. This critical finding raises serious questions for those asking: is paleo good for IBS? While proponents suggest it can ease symptoms, science indicates it's not a suitable long-term solution for gut health.

Quick Summary

The Paleo diet removes processed foods, dairy, and grains, potentially offering short-term relief from some IBS symptoms. However, long-term adherence can negatively impact gut microbiome diversity and cause nutrient deficiencies, making it an unsuitable long-term strategy.

Key Points

Limited Scientific Evidence: There is limited scientific evidence to support the long-term effectiveness of the Paleo diet for managing IBS symptoms.
Gut Microbiome Risk: Long-term adherence to Paleo can decrease gut microbiota diversity, potentially harming gut health.
Nutrient Deficiency Concerns: The exclusion of grains, legumes, and dairy in Paleo raises risks for nutrient deficiencies, particularly fiber, calcium, and vitamin D.
High-FODMAP 'Paleo' Foods: The Paleo diet does not eliminate all high-FODMAP foods, meaning some 'Paleo-friendly' items can still trigger IBS symptoms.
Superiority of Low FODMAP: Targeted approaches like the Low FODMAP diet are better-studied and more effective for identifying and managing IBS triggers.
Personalized Approach is Best: The most effective diet for IBS is a personalized one, developed in consultation with a healthcare professional or dietitian.

Understanding the Paleo Diet

The Paleo diet is based on the eating habits of early humans, focusing on lean meats, fish, fruits, vegetables, nuts, and seeds while excluding grains, legumes, and dairy. Proponents believe this approach can reduce inflammation and improve overall health by avoiding processed foods and common allergens.

How a Paleo Diet Could Potentially Help IBS

Some individuals with IBS may experience initial symptom relief on a Paleo diet due to the elimination of common triggers. This includes avoiding processed foods, grains and legumes containing fermentable carbohydrates (FODMAPs), and dairy, which can be problematic for those with lactose intolerance. The focus on whole foods may also improve nutrient intake and digestive regularity for some.

Significant Downsides of the Paleo Diet for IBS

Despite potential short-term benefits, the Paleo diet is not widely recommended as a long-term solution for IBS management due to its restrictive nature and potential risks to gut health.

Negative Impact on Gut Microbiome

Studies suggest that long-term adherence to the Paleo diet can negatively alter the gut microbiome. Research has indicated lower levels of beneficial gut bacteria, such as Bifidobacteria, and reduced overall gut microbial diversity in those following the diet long-term. This is often linked to the exclusion of prebiotic fibers found in whole grains and legumes.

Nutrient Deficiencies

Eliminating entire food groups like grains, legumes, and dairy can lead to nutritional deficiencies. This includes a potential lack of fermentable fiber crucial for gut bacteria, which can worsen constipation. Avoiding dairy can also lead to deficiencies in calcium and vitamin D if not properly supplemented.

Hidden IBS Triggers in Paleo-Friendly Foods

The Paleo diet does not eliminate all high-FODMAP foods. This means some approved items like garlic, onions, avocado, asparagus, honey, and certain fruits can still trigger IBS symptoms in susceptible individuals.

Risk from High Fat Intake

Certain versions of the Paleo diet can be high in fat from sources like red meat and oils. High-fat meals are known to trigger IBS symptoms, particularly in those with IBS-D, and can exacerbate bloating and abdominal pain.

Paleo vs. Low FODMAP: A Comparative Look

For managing IBS, the Low FODMAP diet is often considered a more targeted and evidence-based approach compared to Paleo.


Feature	Paleo Diet	Low FODMAP Diet
Primary Focus	Mimicking ancestral diet; general health promotion.	Identifying specific IBS triggers by targeting fermentable carbohydrates.
Eliminated Foods	Grains, legumes, dairy, processed foods, refined sugars.	Only foods high in FODMAPs during elimination phase.
Duration	Considered a long-term, lifestyle change.	Short-term (2-6 weeks) elimination phase, followed by systematic reintroduction.
Scientific Evidence	Limited, and some studies show negative long-term gut health effects.	Multiple randomized, controlled trials support its effectiveness for IBS symptoms.
Nutrient Concerns	High risk of long-term nutrient deficiencies (fiber, calcium, etc.).	Lower risk due to short-term nature and professional guidance during reintroduction.
Best for IBS	May provide temporary relief but not a recommended long-term strategy.	A better diagnostic tool and management strategy for identifying triggers and reducing symptoms.

How to Approach a Diet for IBS Symptoms

A personalized and strategic approach is recommended for managing IBS rather than adopting a highly restrictive diet like Paleo.

Consult a Healthcare Professional or Dietitian: Seek guidance from a doctor or registered dietitian specializing in IBS before making significant dietary changes.
Try a Targeted Elimination Diet: The Low FODMAP diet is a proven short-term method for identifying specific triggers, best undertaken with professional supervision.
Prioritize Gut-Nourishing Foods: After identifying triggers, focus on a balanced diet with whole foods, prebiotic fibers, and probiotics from tolerated sources to support a healthy gut.
Manage Other Lifestyle Factors: Stress reduction, exercise, and sufficient sleep are also vital for effective IBS management.

For more information on dietary approaches to IBS, consult resources such as those provided by the National Institutes of Health.

The Verdict on Paleo and IBS

While the Paleo diet's emphasis on whole foods has general health benefits, its restrictive nature makes it less suitable for long-term IBS management. Evidence suggests long-term Paleo can negatively impact beneficial gut bacteria, potentially worsening digestive health. A personalized, systematic approach like the Low FODMAP diet is generally considered a safer and more effective way to identify and manage IBS triggers.

Conclusion

For those with IBS, considering the Paleo diet warrants caution. While it may offer temporary relief by removing processed foods, the risk of nutrient deficiencies and negative gut microbiome changes over time are significant concerns. Health professionals often recommend more evidence-based and less restrictive strategies, such as a medically supervised Low FODMAP diet, to find a sustainable and personalized approach to managing IBS and promoting long-term gut wellness.

Frequently Asked Questions

The Low FODMAP diet is considered a more evidence-based and targeted approach for managing IBS symptoms because it focuses specifically on fermentable carbohydrates that cause digestive issues, rather than broadly eliminating entire food groups like the Paleo diet does.

Yes, it can. The Paleo diet is high in fat, which can trigger symptoms like diarrhea in some IBS sufferers. The sudden increase in fiber from fruits and vegetables can also cause issues if your digestive system isn't used to it.

Long-term adherence to the Paleo diet, which excludes entire food groups like grains, legumes, and dairy, can lead to deficiencies in important nutrients such as fiber, calcium, and vitamin D.

No. Many foods that are part of the Paleo diet are high in FODMAPs, which are common triggers for IBS symptoms. Examples include garlic, onions, avocado, and some fruits.

Some studies show that long-term Paleo can decrease the diversity of beneficial gut bacteria, like Bifidobacteria, which can compromise overall gut health. This is often linked to the exclusion of prebiotic fibers found in whole grains and legumes.

Yes. Some people find success by combining the whole-foods focus of Paleo with the specific FODMAP-trigger identification of a Low FODMAP elimination diet, guided by a dietitian. This creates a more personalized and less restrictive approach.

While eliminating processed foods may reduce inflammation for some, the potential negative impact on gut microbiota and the high fat content in some versions of the diet can actually be pro-inflammatory for a sensitive IBS gut.