Today, I am addressing a topic that can be very difficult for many to talk about…Irritable Bowel Syndrome or IBS. Individuals who suffer from IBS have symptoms of bloating, constipation, gas, abdominal pain and diarrhea on a chronic basis. Many of my patients that have IBS state that they have dealt with their symptoms for years even decades without any real symptom relief. What many don’t know is that the food you eat or even the supplements you take that are supposed to help with diarrhea/constipation may actually be making problems much worse.
In the past, diarrhea and constipation were treated with one dietary approach: fiber. Today, we are learning that some of these fiber sources can actually make symptoms more severe or prolong them. A more modern approach to treating IBS is following a low FODMAP diet. FODMAP is an acronym that stands for: Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polys. Basically this is a fancy way of saying “specific types of carbohydrates found in certain foods”. These types of carbs are often poorly absorbed, highly osmotic and rapidly fermented by bacteria in the gut that results in gas, bloating, abdominal pain and you got it-diarrhea and constipation. Eliminating these problematic foods has shown to have as high as an 86% success rate in decreasing symptoms in those with IBS.1
The list of foods that are high in FODMAPs is quite extensive and to be perfectly honest, it is also very overwhelming. FODMAPs can occur in almost all foods from fruits to vegetables, grains, dairy and beans. Even though this list encompasses practically all the food groups, there is still a wide variety of choices within these foods groups that are lower in FODMAPs and therefore, make suitable alternatives. For example, apples contain a high amount of fructose which can cause GI irritability in some individuals. However, blueberries and pineapple are two fruit choices that can be much easier on the digestive system.
For individuals with severe symptoms, following a full elimination trial of all the high FODMAP-containing foods can be very beneficial. Foods may be reintroduced one at a time back into the diet after about 6-8 weeks of the elimination phase to identify which specific foods are the ones that cause the onset of GI symptoms. Many find that there are only a few specific foods that cause their symptoms and thus, these foods should continue to be avoided. Individuals may also find that they can tolerate FODMAP-containing foods in small amounts but their symptoms can quickly develop if they consume quantities that surpass their threshold.
There are some more common FODMAP foods that typically affect most individuals with IBS. Engaging in a partial elimination of only the most common high FODMAP foods has also shown to provide relief for patients.These most common foods include:
- Wheat, rye (bread, pasta, crackers, cookies, cakes, pizza crust, etc)
- Garlic, onions, artichokes
- Apples, pears, watermelon, mango and high fructose corn syrup
- Sugar-free gum/mints, mushrooms
There is no universal safe food or specific meal plan for individuals with functional bowel disorders. Some trigger foods or chemicals are considered more common allergens than others; however, our individual immune systems and gut flora will have the final say-so to what one’s personal inflammatory triggers are. For more information on following a low FODMAP diet, please schedule an appointment with your Springfield Clinic dietitian.
1. Staudacher HM, Whelan K, Irving PM, Lomer MC. (2011).Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet.;24(5);487-495.