What is a Low FODMAP Diet for IBS?
A low FODMAP diet is a novel dietary management approach employed in the treatment of irritable bowel syndrome or IBS. FODMAP is an acronym which stands for “Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.”
FODMAPs are certain types of carbohydrates (starches, sugars, and fiber) in foods that are hard for the bowel to digest. These carbs draw more water into the intestine and increase gas, resulting in pain, bloating, and diarrhea after consuming these foods. For the most part, these foods are not an issue unless you consume too much of them. But some individuals are intolerant or sensitive to them. Temporarily limiting or restricting your intake of high FODMAP foods for a couple of weeks to a few months may improve your symptoms of IBS. In fact, studies have indicated that a low FODMAP diet improves symptoms of IBS. One study even discovered that 76% of patients with IBS reported improvement in their symptoms following a low FODMAP diet.
The chief dietary sources of the 4 groups of FODMAPs include:
- Oligosaccharides: Legumes, rye, wheat, and several vegetables and fruits
- Disaccharides: Yogurt, soft cheese, and milk. Lactose is the chief carbohydrate
- Monosaccharides: Several fruits including mangoes, figs, and sweeteners such as agave nectar and honey. Fructose is the chief carbohydrate
- Polyols: Certain vegetables and fruits including lychee and blackberries, as well as some low-calorie sweeteners like those in sugar-free gum
What is Irritable Bowel Syndrome
Irritable bowel syndrome is an abdominal disorder characterized by a set of gastrointestinal symptoms such as abdominal pain, diarrhea, cramping, constipation, bloating, and changes in bowel movements due to the abnormal functioning of the gastrointestinal (GI) tract (usually the large intestine). IBS is a chronic disorder. While it can be mild and manageable for some, for others it can seriously affect their quality of life and interfere with activities of daily living. Medical intervention is crucial in the treatment of IBS, but dietary changes and consumption of certain diets may also be effective in treating IBS. In fact, about 70 percent of individuals with IBS note that specific foods worsen their symptoms. Hence, IBS treatment often involves diet and lifestyle modifications, probiotics, fiber supplements, and medications.
How Does a FODMAP Diet Work?
It is significant to bear in mind that low FODMAP diets are restrictive and must be temporary. A low FODMAP diet involves 3 stages:
- Elimination: In this stage, which can last from 2 to 6 weeks depending upon an individual’s response to the diet, an individual removes all high FODMAPs from their diet.
- Reintroduction: Once the elimination stage is over and an individual’s symptoms have significantly improved or returned to baseline, they can begin reintroducing FODMAP foods into their normal diet one at a time, about every 3 to 7 days. This can assist an individual to pick out foods which trigger their symptoms.
- Maintenance: The maintenance stage involves returning to a normal diet as much as possible, restricting only the FODMAP foods that trigger IBS symptoms. In the end, some individuals may be able to include most or all FODMAPs back into their diet without any symptoms.
Studies indicate that symptoms can continue to improve for a long duration after decreasing FODMAPs in the diet and even after reintroducing some of them. However, individuals should continue to keep away from the FODMAP foods that set off their symptoms.
Treatment for Irritable Bowel Syndrome with Low FODMAP Diet
High FODMAP diets are one of the causes of irritable bowel syndrome. Hence, it is important to avoid high FODMAP foods that aggravate the intestines, including:
- Vegetables: Onions, garlic, mushrooms, beans, asparagus, scallions, and shallots
- Fruits: Avocados, peaches, prunes, watermelon, blackberries, and dates
- Meats: Battered meats, breaded meats, sausages, and meats served with onion or garlic-based fillings and sauces
- Fish: Battered fish, breaded fish, and fish served with onion or garlic-based sauces
- Fats: Cashews, almonds, avocados, and pistachios
- Grains, cereals, and starches: Pasta, pastries, muffins, rye, gluten-based bread, wheat, lentils, and beans
Low FODMAP diets, which people can consume more generously than medium and high FODMAP foods for mitigating symptoms of IBS include:
- Vegetables: Baby spinach, green beans, zucchini, broccoli, eggplant, fennel, cucumber, chives, carrot, bok choy, and lettuces
- Fruits: Kiwifruit, blueberries, oranges, bananas, lime, grapes, pineapple, papaya, cantaloupe, and strawberries
- Proteins: Eggs, tofu, lamb, cold cuts, turkey, beef, pork, and chicken
- Seafood: Tuna, salmon, shrimp, lobsters, and crab
- Seeds: Sunflower, pumpkin, sesame, and linseeds
- Dairy: lactose-free milk, Parmesan cheese, and cheddar cheese
- Oils: Olive oil and coconut oil
- Fats: Walnuts, peanuts, butter, pumpkin seeds, oils, and macadamias
- Grains, cereals, and starches: Brown rice, oat bran, rice bran, popcorn, tortilla chips, buckwheat, maize, quinoa, millet, gluten-free bread, and potatoes
- Condiments: White rice vinegar, ginger, pepper, basil, chili, mustard, salt, and wasabi powder
- Beverages: White tea, green tea, black tea, peppermint tea, coffee, and water
It is important to discuss with your physician or dietitian prior to starting a low FODMAP diet. Physicians do not generally recommend this diet regimen for long-term purposes, as it removes some crucial, nutrient-rich foods from your diet. Nevertheless, several FODMAP foods are essentially prebiotics, which means they help stimulate the growth of beneficial gut bacteria and boost metabolism.
