Bananas and Stomach Pain

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)

Gut Dysfunction

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. 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. doi.org/10.3390/foods7020018

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

The University of Hawaii. Cooking banana.