Dietary modifications play a key role in managing chronic abdominal pain, particularly when related to irritable bowel syndrome (IBS), in primary care. For people with IBS, dietary and lifestyle advice is a first-line management strategy, including having regular meals, avoiding long gaps between eating, and drinking at least 8 cups of fluid daily, mainly water or non-caffeinated drinks. Limiting tea and coffee to 3 cups per day, reducing alcohol and fizzy drinks intake, and moderating high-fibre foods and resistant starch can help reduce symptoms such as abdominal pain and bloating. Fresh fruit intake should be limited to about 3 portions per day NICE CG61.
Soluble fibre supplementation is generally safe, inexpensive, and can improve global IBS symptoms and abdominal pain, whereas insoluble fibre may worsen symptoms and should be avoided NICE CKS.
Food triggers such as alcohol, caffeine, spicy and fatty foods can exacerbate symptoms by affecting gastrointestinal motility and secretion, so identifying and avoiding these triggers is recommended NICE CKS.
If general dietary advice is insufficient, referral to a dietitian is advised for further dietary management, including supervised trials of exclusion diets like the low-FODMAP diet, to avoid nutritional deficiencies and ensure a balanced diet NICE CKS.
For chronic abdominal pain not related to IBS, such as chronic pancreatitis, dietary management includes assessment by a dietitian to address malabsorption and malnutrition risks, with specialist advice on food, supplements, and enzyme replacement therapy as needed NICE NG104.