Manage irritable bowel syndrome with a FODMAP diet

Irritable bowel syndrome (IBS) is a common gastrointestinal condition affecting between 25 and 45 million people in the United States or about 1 in 7 people.  The majority of sufferers are women and all ages can be affected, including children. 

One way to manage the symptoms of IBS is through careful food choices.  A fairly new diet developed in Australia showing promise in managing IBS symptoms, is a way of eating called the low FODMAP diet. 

Symptoms of IBS

This gastrointestinal disorder is unpredictable, inconvenient and without a known cause of why it occurs. Symptoms of IBS can range from the following:

·      Abdominal pain

·      Altered bowel habits

·      Increased gas

·      Bloating

·      Cramping

·      Food intolerance

·      Diarrhea or constipation

Do not self-diagnosis

To be diagnosed with IBS, a person needs to have experienced signs and symptoms for at least 6 months.  IBS should only be diagnosed by a medical professional and not self-diagnosed.  A gastroenterologist is a doctor specifically trained in treating IBS and understands the issues associated with this condition.  Approximately 20% to 40% of all visits to gastroenterologists are due to IBS symptoms. 

Even though there is no known cure for IBS, there are treatments that can reduce or eliminate symptoms people experience.  Treatments include dietary modifications, lifestyle changes, and prescription medications.

A specific way of eating for IBS

Symptoms of IBS are highly intertwined with a person’s food intake and choices.  Anyone who has IBS will react differently to different foods making it important to identify foods triggering their symptoms.  There is where a specific diet that goes by the acronym – FODMAP – has proven to be highly effective for treating IBS and the annoying symptoms that accompany it.

What are FODMAPs?

FODMAP include a group of small carbohydrates (sugars and fiber) poorly absorbed in those with IBS in the small intestine.  The acronym FODMAP stands for the following:

F – fermentable

O – oligosaccharides (fructans and galacto-oligosaccharides)

D – disaccharides (lactose, milk sugar)

M – monosaccharide (excess fructose)

A – and

P – polyols (sugar alcohols such as mannitol and sorbitol)

FODMAPs are found in many commonly used foods such as wheat, barley, rye, apples, pears, mango, onion, garlic, honey, kidney beans, cashew nuts, agave syrup, sugar free gum, mints, and some medicines along with other sources.

Research has shown that up to 75% of those with IBS who follow a low FODMAP diet will have improvement of their gastrointestinal symptoms (gas, bloating, pain, change in bowel habits) related to IBS.

How does the low FODMAP diet work?

Anyone with IBS needs to determine what foods are triggering their symptoms.  In order to do that, the low FODMAP diet requires a 2-6 week elimination phase that involves removing foods high in FODMAPs to get a better idea of which FODMAP foods result in symptoms.

The diet is only temporary and is meant to help identify the foods causing symptoms of IBS.  Not all people with IBS will have the exact same foods causing their symptoms.  After following a FODMAP elimination phase and once it can be determined which foods are the culprits, then there is a re-introduction phase to pinpoint which FODMAP foods can be tolerated in smaller amounts and which ones to avoid completely greatly reducing or eliminating symptoms. 

The low FODMAP diet should only be implemented by a registered dietitian who can help navigate the many nuances of the diet and who can develop a personalized, well-balanced eating plan.

What is it about FODMAP foods that can trigger IBS symptoms?

FODMAP foods contain carbohydrates which can be present in different forms in food varying from long-chain carbohydrates to short-chain carbohydrates.  It’s the short-chain carbohydrates (FODMAPs) that are problematic for those with IBS.  These short-chain carbohydrates are poorly absorbed in the small intestine and then are rapidly fermented by bacteria in the gut. 

When microbes ferment FODMAPs, the gas they produce fills up and stretches the intestine (think of blowing up a balloon with air) causing bloating, abdominal pain, gas and cramping in those with a sensitive GI tract.  At the same time, FODMAPs can pull water into the small intestine (think of filling water into a water balloon) causing diarrhea in those with a fast moving intestine.  If a person is more prone to constipation, they may feel like they have that water balloon sitting right in the middle of their gut. 

Getting help following a FODMAP diet

Following a low FODMAP diet can be challenging which is why it requires the implementation and supervision of a dietitian knowledgeable in FODMAP foods. 

To find a registered dietitian in your area who has experience in helping those with IBS to follow a low FODMAP diet to relive symptoms, click on this link.