Low FODMAP for IBS
What is Irritable bowel syndrome IBS?
Irritable bowel syndrome (IBS) is a condition that affects approximately 20% of the population.
It affects males and females of all ages.
If you have ever had irritable bowel syndrome, you know exactly how disruptive and chaotic it can be for your life. There are few words that are able to describe the stress, both physical and mental, that it typically causes in most sufferers’ lives. However, there are a few simple tweaks that you can make in your life that can actually have a huge effect on the severity of your IBS. Changing what you eat to match a well-researched IBS diet is one of the most effective and lowest cost treatments you can use in your battle against irritable bowel syndrome.
DO YOU HAVE IBS?
There is no diagnostic test for IBS. Diagnosis is made on symptoms.
There are many conditions that have symptoms similar to IBS. It is really important to try not to self-diagnose IBS, or any other condition, as they can all have different causes and different treatments.
It is therefore important to work with medical professionals to exclude other serious GI conditions (e.g. inflammatory bowel disease, coeliac disease and bowel cancer) and also some gynaecological conditions
To make sure you are on the correct path for your symptom management, a proper diagnosis via a medical doctor is recommended. If you suspect you have IBS or an adverse reaction to foods, you should seek the advice of a medical practitioner, such as your general practitioner, a gastroenterologist, an immunologist or a registered dietitian, and discuss your symptoms.
Symptoms commonly associated with IBS are listed below.
Please note, all of us can experience some of these symptoms from time to time; that is normal. However, when the symptoms are occurring frequently over a significant period of time (e.g., a few months), it is recommended you speak to your doctor about them, and request to start some investigations as to the cause.
The following IBS Symptoms can fluctuate in their severity from day to day and week to week.
- Changes in bowel habits (diarrhea or constipation or a combination of both)
- Abdominal pain or discomfort
- Excessive flatulence
- Abdominal bloating (feeling of fullness)
- Abdominal distension (abdomen increases in size, a look of being pregnant)
- Vomiting (less common)
- Fatigue, weakness, lethargy
Research from Monash University in Melbourne, Australia, shows that avoiding FODMAPs can greatly improve symptoms in up to 76 percent of IBS patients.
Low-FODMAP Diet vs. Standard Dietary on IBS
My primary motivation for launching IBS diet plan was to raise awareness of the low-FODMAP diet. The advice I was given after my diagnosis seemed psuedo-scientific and, frankly, baseless. Most importantly, it didn’t effectively treat my IBS symptoms.
The low-FODMAP diet did. And while the theory is still being tested for efficacy; today it held its own yet again.
A study conducted by H. M. Staudacher, K. Whelan, P. M. Irving, and M. C. E. Lomer aimed to determine whether a low-FODMAP diet is effective for IBS symptom control, and also how it stacked up against the standard dietary guidelines and conventional dietary treatment advice. Patients self-reported symptom severity, and the study concluded that 76% (three-quarters!) experienced great relief on a low-FODMAP diet as compared to 54% on a standard diet. General symptom response was also greatly improved – with the low-FODMAP group scoring 86% as compared to a standard of 49%.
More good news:
- 82% of IBS patients on the low-FODMAP diet experienced a reduction in bloating
- 85% of IBS patients on the low-FODMAP diet experienced a reduction in abdominal pain
- 87% of IBS patients on the low-FODMAP diet experienced a reduction in flatulence.
Keep in mind that patients were simply instructed how to follow the diet – their ability to follow it precisely and accurately was untested. It seems likely that nearly everyone who suffers from IBS could see a reduction in symptoms on a properly executed low-FODMAP diet.
Clearly, a low-FODMAP dietary treatment is much more effective than standard dietary advice for controlling irritable bowel syndrome symptoms.
CONSULTING A SPECIALIST FODMAP DIETITIAN
A dietitian may determine whether you have an intolerance by taking a dietary history. Before your appointment, it’s wise to keep a record of the food you eat in a typical week, and the symptoms you experience during those seven days
Once you have a diagnosis, a registered dietitian will provide expert advice on which foods to limit and what to replace them with.
Other IBS related Diseases
Because the diagnosis of IBS is based on the pattern of the symptoms, it is important to rule out other conditions that have the same symptoms, such as celiac disease and inflammatory bowel disease (IBD), both of which can mimic IBS.
Anyone with symptoms of IBS should be examined for these disorders before going on a low-FODMAP or gluten-free diet, so speak with your doctor about being tested if you haven’t already. However, bear in mind that is possible to have both IBS and another digestive disorder.
Low FodMAP also shows promise for treating persistent symptoms associated:
- Celiac disease
- Crohn’s disease
- Ulcerative colitis.
Low FODMAP IBS
The low-FODMAP diet is a simple treatment for irritable bowel syndrome (IBS), a condition that affects one in seven people worldwide
A diet low in FODMAPs is now recommended internationally as the most effective dietary therapy for IBS and other nasty disorders. A Low FODMAP Diet has also been proven, with solid scientific research, to reduce symptoms of fatigue, lethargy and poor concentration.
The principle of a Low FODMAP Diet for IBS is to restrict the foods high in FODMAPs causing chaos in the gut, before working out an individual’s own personal tolerance thresholds. This means it can be tailored to you specifically and as a result improve the gut symptoms associated with IBS.
What you have to remember is that it’s not about being the incredibly restrictive long term. The ultimate goal is to eat and live as freely as possible with the least restrictions you can get away with – the more FODMAPs you can return to your diet without triggering symptoms, the healthier your gut is likely to be.
Many people who experience IBS have already recognized a strong association between what they eat and the severity of their symptoms.
Many IBS sufferers find changing their diet much more appealing than taking medication. It means they are taking action themselves to relieve their symptoms, and that feeling of empowerment regarding their own health is important
EVERYBODY’S DIFFERENT with FODMAP
The short-chain carbs/FODMAPs are in everyday foods and are always poorly absorbed, but it comes down to you and your gut on whether, and how much, you can tolerate them.
People who have IBS have very sensitive intestines, and the stretching of the gut that comes from the poor absorption contributes to a lot of pain. Many can tolerate some FODMAPs, while others may find that all FODMAPs can be symptom triggers. Not everyone has a problem with all the different FODMAP groups, which is why it’s important to work with a nutritionist or dietician to figure out what exactly your specific trigger foods are.
By controlling and managing the consumption of foods that contain the FODMAPs triggering your symptoms you should then be able to significantly reduce or even say goodbye to your IBS type symptoms.
How do FODMAPs cause symptoms of IBS?
FODMAPs all have the same characteristics:
- They are poorly absorbed in the small bowel.
This means that many of these molecules arrive from the stomach into the small bowel but don’t get absorbed, instead of passing right through to the colon. This occurs either because they cannot be broken down or they are slow to be absorbed. We all differ in our ability to digest and absorb some FODMAPs: Fructose absorption is slow in all of us but very slow in some; some people do not make enough lactase (the enzyme needed to break down lactose); and the ability to absorb polyols (which are the wrong shape to pass readily through the lining of the small bowel) also varies from person to person. Since none of us can digest fructans and galacto-oligosaccharides (GOS), they are poorly absorbed in everyone.
- They are poorly absorbed in the small bowel.
- They are small molecules, consumed in a concentrated dose.
When small, concentrated molecules are poorly absorbed, the body tries to “dilute” them by forcing water into the gastrointestinal tract. Extra fluid in the gastrointestinal tract can cause diarrhea and affect the muscular movement of the gut.
- They are small molecules, consumed in a concentrated dose.
- They are “fast food” for the bacteria that live naturally in the large bowel.
The large bowel (and the lower part of the small bowel) naturally contains billions of bacteria. If molecules are not absorbed in the small bowel, they continue the journey to the large bowel. The bacteria that live there see these food molecules as fast food and quickly break them down, which produces hydrogen, carbon dioxide, and methane gases. How quickly the molecules are fermented depends on their chain length: Oligosaccharides and simple sugars are fermented very rapidly compared with fibre, which contains much longer chain molecules, known as polysaccharides.
Multiple types of FODMAPs are usually present in any one meal. Because they all cause distension in the same way once they reach the lower small bowel and colon, their effects are cumulative. This means that the degree of bowel distension can depend upon the total FODMAPs consumed, not just the amount of any individual FODMAP consumed. If someone who cannot digest lactose well and absorbs fructose poorly eats a meal that contains some lactose, some fructans, some polyols, some GOS, and some fructose, the effect on the bowel will be 1 + 1 + 1 + 1 + 1 = 5 times greater than if they ate the same amount of only one of that FODMAPs. That is why we have to consider all FODMAPs in food when modifying our diet.
Carbohydrates, which consist of sugars, starches, and fibre, are an important component of our diets since they provide our bodies with energy. Here’s how: Our digestive systems break down the carbs we eat until they can be absorbed through the intestinal wall into the bloodstream, where they’re converted into energy. And they’re in a lot of the foods we eat, including fruits, vegetables, bread, and pasta. But
certain carbs—the FODMAPs—can cause issues in people with IBS and other digestive disorders.
After ruling out other health conditions, you can also get a breath test, to identify and pinpoint the offending sugars in your diet. From here, you will have a base as to which sugars are the most malabsorbed, and can begin your low FODMAP journey to improve your symptoms.