Symptoms of gut disorders, such as Irritable Bowel Syndrome (IBS), include gas, bloating, pain, constipation, and/or diarrhea.
They are often persistent, draining, and can take a serious toll on quality of life, triggering anxiety and depression.
People who have intolerances to FODMAPs foods may suffer these symptoms, as well as increased pathogenic bacteria, as a result of certain carbohydrates fermenting.
The low FODMAPs strategy is a dietary approach that is growing in popularity for IBS sufferers. Many of my patients have found relief when I’ve helped them through the FODMAP method. It’s clinically demonstrated to help 75% of patients improve their IBS symptoms.
The low FODMAP diet could be an important component for you in reducing your IBS symptoms. You can listen to my recent podcast with Dietitian Patsy Catsos on this topic here.
Could your health food be triggering your digestive symptoms? #IBS #FODMAPs http://ctt.ec/d35yw+ @FrancesLArnold
What are FODMAPs?
FODMAPs are short-chain carbohydrates with the following characteristics:
- Rapidly fermentable (causing gas and bloating)
- Incompletely absorbed in the small intestine
- Act as bacteria’s fast food in the large intestine
- Osmotically active (pulling water into the gut)
The term FODMAPs is an acronym that stands for the following:
Fermentable carbohydrates are fermented by bacteria, and this serves as a food source for our healthy bacteria. These can include prebiotic foods, such as onion, garlic, and banana.
O is for Oligosaccharides – Oligosaccharides are short-chain carbohydrates. This term represents both fructans (chains of fructose with a glucose molecule at the end) and galactans (chains of galactose with a fructose molecule).
- Fructans– The majority of people eat fructans as wheat, onion, garlic and many other vegetables.
- Galactans – Primarily, beans and lentils
D is for Disaccharides – This represents pairs of sugar molecules. Dairy is a good example.
M is for Monosaccharides – This is a single sugar molecule.
A is for AND
P is for Polyols – Polyols include sugar alcohols like xylitol, sorbitol, or mannitol. (Your clue is to look for ingredients with -ol to indicate a sugar alcohol.) The charming effects is usually diarrhea, constipation or gas. Large amounts of polyols rarely occur in nature, and we don’t naturally digest them very well. The do occur in several fruits and mushrooms. Where people get into a lot of trouble is when eating sugar-free or diabetic sweets.
Bananas and dairy contain FODMAPs
Where FODMAPs are found
Mushrooms contain Polyols
The purpose of a low FODMAPs diet
The purpose of the diet is to determine which food group is impacting your symptoms the most. The goal of elimination is to minimize symptoms while eating the most varied and healthy diet as possible.
The low FODMAP diet is a discovery process designed to help the person with IBS determine their personal trigger foods. I’ve had clients tell me they put themselves on a FODMAPs diet, but that it didn’t work for them. Upon deeper investigation, I discovered that they really just tried to restrict some of the FODMAPs food, but didn’t learn anything about which specific group impacted them the most.
The phases of a FODMAPs diet (super simplified)
Phase 1: Eliminate or reduce all FODMAPs. You’ll need to follow a specific meal plan in order to achieve this and maintain sanity.
Phase 2: Systematically re-challenge each FODMAP by GROUP, not by food item.
Phase 3: After you’ve learned about which group impacts you the most, you can develop a maintenance plan. You’ll need to ensure you’re able to eat the widest variety of food possible and support your nutrition needs.
Work with a qualified Registered Dietitian (RD) who understands FODMAPs. This RD can help you design a meal plan, interpret your symptoms, rule out other serious conditions, and ensure that you’re getting enough nutrition.
The low FODMAP diet is an evidenced based elimination diet shown to manage symptoms in 75% of those with IBS. The majority of the studies on the low FODMAP diet utilized a Registered Dietitian (RD) to help implement the diet. Work with an RD knowledgeable in the low FODMAP diet to be sure you are following it correctly. The diet has many nuances making it a challenging diet to implement on your own.
You may wish to get yourself a book to help you.
Resources I recommend:
- IBS: Free at Last! Change Your Carbs, Change Your Life with the FODMAP Elimination Diet, by Patsy Catsos
- Flavor without FODMAPs Cookbook: Love the Foods that Love You Back, by Patsy Catsos
- The Complete Low-FODMAP Diet: A Revolutionary Plan for Managing IBS and Other Digestive Disorders by Susan Shepard
Who might benefit from reducing FODMAPs?
Again, remember that the medical conditions listed can become very serious. Ensure you have a physician overseeing your case.
- Someone with IBS with gas, bloating, diarrhea, constipation.
- Someone who has already ruled out Celiac Disease (see why that’s important here)
- Someone whose IBS hasn’t responded to standard therapies;
- Someone with Small Intestinal Bacterial Overgrowth (SIBO)
- Someone already eating a lot of FODMAPs foods and is also having symptoms
- Is willing and able to adhere to dietary restrictions (may be difficult for someone not in control of food purchasing)
- Is not pregnant or dealing with an eating disorder
Have you tried the low FODMAP approach to IBS treatment? Share your story in the comments below!
- J Gastroenterol Hepatol. 2010 Feb;25(2):252-8. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Gibson PR1, Shepherd SJ
- National Institute of Diabetes and Digestive and Kidney Diseases
- Stanford Health Care
- Kate Scarlata, RD
- Patsy Catsos, MS, RD