FODMAPs: Potential Ally for IBS
Have you been told that you have IBS (Irritable Bowel Syndrome), but can’t figure out which foods are causing you trouble? Do you suffer from uncomfortable digestive complaints like gas, bloating, abdominal pain, constipation, diarrhea, or all of the above? If so, you are not alone. About ten to fifteen percent of the world’s population suffers from IBS. Two in three IBS sufferers are female. While IBS is not harmful per se, it can significantly affect quality of life. It can have a devastating effect on a person’s physical, emotional, social, and work life. One potential cause is food. It can be difficult, however, to figure out which foods are causing trouble. The low FODMAPs diet has received much attention lately in the IBS world: Some studies have shown that 75 percent of IBS sufferers find at least some relief when following the low FODMAPs diet. This is a big deal.
FODMAPs is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. That is a mouthful. Thankfully, there is no need to remember all of that. What you should know is that FODMAPs are certain types of carbohydrates of short and medium-length, and polyols are sugar alcohols. Many people find them difficult to digest and have uncomfortable digestive symptoms as a result.
FODMAP-rich foods fall into five major categories: lactose, excess fructose, fructans, polyols, and Galactans/GOS. Lactose is probably the most familiar and includes most milk products such as fluid milk, ice cream, milk powder, and soft cheeses like ricotta and cottage cheese. Foods with excess fructose range from asparagus, artichokes, sugar snap peas to apples, pears, and watermelon, to certain sweeteners like agave syrup, honey, and high fructose corn syrup. Fructans include wheat, barley, rye, garlic, onions, and snack bars made with chicory root or inulin. Polyols include sugar alcohols such as maltitol, sorbitol, isomalt, xylitol, polydextrose, and mannitol. They are commonly found in “sugar-free” candies, mints, and cough drops. Polyols are also found in real foods such as prunes, dried figs, blackberries, mushrooms, and cauliflower. Lastly, foods rich in Galactans/GOS include peas, lentils, dried or canned beans, and soymilk. These foods are just examples and by no means a complete list. As you can see, all food groups are represented here, and it can quickly become confusing.
While most people experience some digestive discomfort when they eat certain FODMAP-rich foods (think beans), there is another group of people that is particularly less able to digest these types of carbohydrates. These sensitive individuals react strongly and negatively after eating FODMAPs. When they do consume FODMAPs, they get symptoms like gas, bloating and distention, as well as constipation or diarrhea.
FODMAPs are not easily absorbed in the small intestine for anyone. But sensitive individuals have an even harder time of it. These individuals will have many of the FODMAPs land in the large intestine still intact. Here, the colonic bacteria, or microbiota, feed on the carbohydrates. Depending on how much is consumed, overfeeding and overgrowth of the bacteria in the large intestine can occur, which causes excess production of gas. This in turn can lead to bloating, distention, constipation and/or cramping. And because FODMAPs are carbohydrates that are relatively smaller in size, they can also pull water into the intestines through a process called osmosis. This can lead to watery stool or diarrhea.
What to do
If you suspect that you might have a FODMAP intolerance, speak with your doctor first to rule out potential other, more serious, causes of your symptoms. Once this is done, you may want to embark on an elimination diet. (There are also breath tests that exist for certain, but not all, FODMAPs, but they are not always accurate.) An elimination diet consists of two phases. The first phase is the elimination phase, in which you eliminate all FODMAPs for a period of two to three weeks. If you find marked relief from your symptoms, you may want to continue on to the second phase, or the reintroduction phase, which can take roughly six weeks. During this phase you will test each food group individually and systematically to find out which ones are in fact causing your symptoms. It is key to track your symptoms every day, and to be vigilant about avoiding all FODMAPs during the elimination phase. The approach is detailed and can be quite tricky to implement correctly. Speak with a knowledgeable health care practitioner to make sure you are following the elimination diet properly.
While testing your FODMAP tolerance for two months may seem daunting, it will be well worth the effort. Those who suffer daily from digestive symptoms know how debilitating they can be and how negatively they can affect quality of life. You will know if you are FODMAP-sensitive within two, sometimes three weeks. Most sensitive people will find at least some relief within about a week on the elimination phase. This ease in symptoms will hopefully then motivate you to continue through the reintroduction phase, one group at a time, until you know exactly which foods you react negatively to and which foods you are fine with. The end result will be you in control of your symptoms. Wouldn’t that be worth it?
The information provided in this article is intended for general use only and is not to be used in place of medical advice from a licensed health professional.