Should individuals with existing gastrointestinal problems eat bananas?

Bananas

• Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
• Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
• Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
• If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
• Bananas can make the stomach hurt due to:
• Irritable bowel syndrome (IBS)
• Cramping
• Gas
• Bloating
• Other gastrointestinal (GI) problems.
• Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.

Stomach Pain

• Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
• Some individuals can experience bloating and gas after eating them.
• One reason is because of their soluble fiber content.
• Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
• This can lead to gas and bloating. (Jackson Siegelbaum Gastroenterology. 2018)
• Bananas also contain sorbitol – a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)

Irritable Bowel Syndrome – IBS

• Bananas can be a common trigger food for individuals with IBS.
• This is because as bananas break down in the stomach, they can generate excess gas. (Bernadette Capili, et al., 2016)
• Bananas are also high in fructose/simple sugar especially when they have overripened.
• Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
• Ripe bananas are considered to be high in FODMAPS – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
• Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
• Unripe bananas are considered to be low-FODMAP food. (Monash University. 2019)

Allergy

• Banana allergies are rare and affect less than 1.2% of the global population.
• Many individuals with a banana allergy are also allergic to pollen or latex because of similar protein structures. (Day?o?lu A, et al., 2020)
• An individual with a banana allergy may experience wheezing, narrowing of the throat, or hives within minutes of eating.
• They can also experience nausea, abdominal pain, vomiting, and diarrhea. (Family Medicine Austin. 2021)

Fructose Intolerance

• An individual with fructose intolerance has difficulty digesting fructose.
• Individuals with this intolerance should restrict or limit fructose. (UW School of Medicine and Public Health. 2019)
• Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
• Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
• This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual’s diet. (UW School of Medicine and Public Health. 2019)
• Most can tolerate small amounts of fructose found in fruits like bananas.
• There is often more difficulty tolerating large fructose amounts found in honey and high fructose corn syrup. (UW School of Medicine and Public Health. 2019)

Prevent GI Symptoms

• If experiencing gas, bloating, or abdominal discomfort after eating bananas, consider limiting the portion size.
• For example, instead of eating one or more bananas a day, try eating half of a banana to see if symptoms resolve.
• Alternatively, if there is a belief that there is fructose malabsorption, try temporarily removing all high-fructose foods.
• If the body begins to feel better, slowly add foods that contain fructose.
• This can help you pinpoint the foods that are causing the problem. (UW School of Medicine and Public Health. 2019)
• If you’re eating bananas that are too green or unripe, you may also experience stomach discomfort.
• Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
• Resistant starch ferments slowly, so it usually does not cause as much gas as other fiber types. (The Johns Hopkins Guide to Diabetes. 2020)
• Ripe or cooked bananas have less starch and more simple sugars, making them easier to digest. (University of Hawaii. 2006)
• Drinking more water and gradually increasing fiber intake can also reduce GI side effects. (The Johns Hopkins Guide to Diabetes. 2020)

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Gut Dysfunction

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References

MedlinePlus. Bananas and nausea.

Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.

U.S. Food and Drug Administration. Sorbitol.

Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. https://doi.org/10.1016/j.nurpra.2015.12.007

Johns Hopkins Medicine. 5 foods to avoid if you have IBS.

Monash University. Bananas re-tested.

Day?o?lu A, Akgiray S, Nacaro?lu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013

Family Medicine Austin. Banana allergy.

UW School of Medicine and Public Health. Fructose-restricted diet.

Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. https://doi.org/10.3390/foods7020018

The Johns Hopkins Guide to Diabetes. What is resistant starch?

The University of Hawaii. Cooking banana.