Irritable Bowel Syndrome – The Low FODMAP Diet
Wind, bloating, diarrhoea and or constipation? Always looking for the nearest loo? Help is here!
When I tell people that there is a diet to treat IBS and it has a success rate of up to 86%, they are often very interested, probably because IBS affects around 20% of the population in the UK.
When I tell them it’s called The Low FODMAP Diet, they say:
‘The Low WHAT Diet!?’
FODMAPs are fermentable sugars that are common components of many foods and some drinks. FODMAP is an acronym of the names of these sugars which are: (fermentable), oligosaccharides, disaccharides, monosaccharides and polyols.
So you see, the The Low FODMAP Diet is actually a sensible name and far less complicated than the alternative!
The problem with FODMAPs is that they are present in lots of different foods including, apples; pears; onion; garlic; milk; wheat and on and on. This means that IBS suffers, almost invariably, struggle to pinpoint which foods are causing their symptoms because they are everywhere!
FODMAPs cause problems for IBS suffers because some of them are not absorbed in the small bowel and instead, travel through to the large bowel where they are fermented by bacteria. This fermentation allows gasses to build up and causes bloating. The presence of the sugar also draws more water to the bowel, which can cause diarrhoea.
Some people have constipation predominant IBS or IBC-C and for them, it seems that the FODMAPs slow the large bowel right down and stop the poo from being moved along and out effectively.
We are not certain why some people get IBS and others don’t but it is linked to how effectively our small bowel absorbs FODMAPs, which is likely to be genetically determined.
Most people know of some foods that cause them wind or bloating and chances are it will be a high FODMAP food. This is harmless until it starts impacting on your quality of life.
The Low FODMAP Diet requires someone to eliminate FODMAPs from their diet for 6-8 weeks and then reintroduce them in a step-by-step process. Reintroducing in this way allows us to find out if it is just one or two of the fermentable sugars that are causing the problem or whether it a case of keeping all the FODMAPs down to a certain level.
The overall goal is getting to a point where a person’s symptoms are under control and they are able to consume a balanced diet that meets all their nutritional requirements. It is also really important that after the reintroduction phase, a person feels confident to enjoy meals out and new foods without being afraid of developing uncontrollable symptoms.
Sometimes people see their doctor and are diagnosed with IBS, then are sent away with the advice to ‘look up The Low FODMAP Diet’. Unfortunately this is rarely a successful strategy for 3 reasons:
1) The diet is complicated and needs a dietitian’s eye to help people see where they are including FODMAPs in their diet to and help them find alternatives.
2) The internet is awash with conflicting advice on which foods are and are not FODMAP friendly.
3) People forget about ensuring a healthy balanced diet is achieved at the end.
Oddly, these doctors also seem to forget that people often have other dietary needs like vegetarianism, religious customs or health problems such as high cholesterol or osteoporosis which make following this diet more complicated.
If you have IBS and don’t know where to turn, help is at hand. A dietitian who is trained in this approach should be near by!
I can provide face to face or Skye/FaceTime consultations http://sophiedietitian.com
so please get in touch.
Helping people resolve IBS is such a privilege as it can be a really debilitating condition that really affects someone’s quality of life. Seeing the difference in someone after they have followed this diet is a real highlight of my work.