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What is the Low FODMAP Diet? Does it work for IBS?

High FODMAP alert! Cauliflower pizza w/ asparagus

The low FODMAP diet may be the answer to your digestive issues

Recently, Instagram has been inundated users posting contrasting images of their bodies at various points throughout the day. Typically the first picture would show an athletic, toned abdominal section and the second picture depicts how that same region looks after experiencing irritable bowel syndrome (IBS) symptoms. It definitely is refreshing to see so many individuals honestly showing up on Instagram, sharing their issues with gut health. Gastrointestinal distress is common for many people so today we are discussing IBS and how the low FODMAP diet may provide relief from IBS symptoms.

IBS— What is it?

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGID) which affects the large intestine. FGIDs are disorders of gut-brain interactions, which affects how your body works. With IBS foods may move too slowly or too fast through your digestive tract which in turn will affect your bowel movements. IBS is a not a disease, therefore is does not have a clear cause; however, allergies, lactose intolerance, a low-fiber diet, eating large meals, high-fat foods or stress may play a role.  As per the Academy of Nutrition and Dietetics, studies estimate the 10 to 15 of adults suffering from IBS.

To be considered clinically as someone who suffers IBS, you will have to had symptoms consistent with Rome IV criteria (1). Typical symptoms occurring in individuals with IBS include abdominal discomfort, bloating, gas, and altered bowel habits without any pathological abnormality of the intestinal wall— meaning you shouldn’t have any visible signs of damage or disease in your digestive tract. IBS is a chronic condition which will have to be managed long term.

There are four types of IBS that are differentiated by changes in your bowel movements.  The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) has done a fantastic job at defining these types of IBS.  Follow this link to find descriptions of all four.

Vegan Shaved Brussels Sprouts Salad

High FODMAP alert! Shaved Brussels Sprouts Salad

Since FGIDs cause problems within your brain-gut interaction it would be beneficial to work toward alleviating the symptoms of IBS while maintaining a healthy gut micro biome.  Two quick solutions would be to take a probiotic, eat more fiber and hydrate properly. There are lifestyle changes you can make which include managing stress and anxiety through yoga or mediation, increasing physical activity and getting adequate sleep.  Additionally, you can follow a special eating plan called the low FODMAP diet.

What is the Low FODMAP Diet? Does it work for IBS?

FODMAPs stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols which are short-chain carbohydrates (sugars) that the small intestine absorbs poorly. Here are some foods that represent each FODMAP:

Fructans: garlic, onion, wheat
Fructose: fruit, honey, oranges, apples
Galactans: legumes such as beans and lentils
Lactose: dairy (milk, ice cream and yogurt)
Polyols: stone fruits such as peach plums and gasp! avocados & sugar alcohols such as sorbitol

So why is a low FODMAP diet a solution to your IBS symptoms? In those individuals suffering from IBS, these sugars are poorly absorbed in the small intestine, and fermented by gut bacteria in the colon causing flatulence and bloating through increased gas production and distention of the colon wall (2).

The low FODMAP diet alone won’t completely alleviate your IBS symptoms; however, it has been proven to be more effective than other standard dietary interventions in improving general symptoms and quality of life (2); however, researchers notes that more evidence is needed in this area. A low FODMAP diet could be potential first line approach combined with psychological and pharmacological treatment.

Homemade Popcorn – Perfect Low FODMAP food!

How do I start a low FODMAP diet?

Remember that the low FODMAP diet is not a “one size fits all” solution.  Work with your dietitian to eliminate foods which are causing you distress and find alternatives to ensure that the diet is nutritionally adequate.

Phase 1

Identify FODMAP foods and follow strict restriction for 4 to 6 weeks. Essentially, you want to find the the amount of FODMAP foods you can tolerate.  Work with your dietician to eliminate foods which are causing you distress and find alternatives to ensure that the diet is nutritionally adequate.

Phase 2

Reintroduction.  Foods restricted in phase 1 are slowly reintroduced and a long term way of eating is established. The overall goal is to identify the type and amount of FODMAPs that can be tolerated so that the end result is a diet lower in the problematic FODMAPs where maximum variety is achieved.

Note:  Please consult your primary care physician (PCP) and registered dietitian nutritionist (RDN) before beginning this diet.

Hopefully this article provided you with some knowledge with which you can use to consult your physician and dietitian.  Be on lookout for a specific Carter Hall Lifestyle PDF with all of the FODMAPs listed to help you in grocery shopping and daily meal prep.

#LiveNourished

References:

1 – Simren, Magnus, et al. “Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice.” Current Gastroenterology Reports, vol. 19, no. 4, 2017, doi:10.1007/s11894-017-0554-0.

2 – Varjú, Péter, et al. “Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-Analysis of clinical studies.” Plos One, vol. 12, no. 8, 2017, doi:10.1371/journal.pone.0182942.

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