When I first heard the acronym FODMAP I had NO idea what it meant. Was it a food map? Does F stand for fructose? It honestly was a mystery to me.
Today’s blog post will focus on explaining the terms FODMAP, IBS and how to manage symptoms through a low FODMAP diet.
What is IBS?
IBS stands for Irritable Bowel Syndrome and represents a wide range of symptoms of digestive discomfort including bloating, abdominal pain, nausea, heartburn, diarrhoea, constipation, a noisy abdomen and excessive wind1,2. Some sufferers also experience muscle aches and pains and urinary frequency and urgency (irritable bladder)2. The variety and severity of symptoms differ between individuals1.
It is important to understand that if you do suffer from a number of these symptoms, it does not automatically mean you have IBS and/or food intolerances*. You must consult with your doctor so they can monitor these symptoms and perform tests to ensure you are not suffering from another condition2.
*Note- Some people may suffer from IBS and have no food intolerances or malabsorption and some people with food intolerances may not have IBS.
What are FODMAPs?
The term FODMAP stands for:
Fermentable- promptly digested by bacteria present in the bowel
Oligosaccharides- fructans and galacto-oligosaccharides
Polyols- sorbitol, mannitol, xylitol and maltitol2.
Many of you may now be even more confused. What are these long words which end in ‘saccharide’ and ‘ol’?
- Saccharide= sugar
-Monosaccharide: contains one sugar
-Disaccharide: contains two sugars
-Oligosaccharide: contains less than ten sugars
-Polysaccharide: contains more than ten sugars2.
- Polyols= sugar alcohols2.
All you need to take from this acronym is that it represents a group of carbohydrates which are poorly absorbed in the small intestine which can lead to digestive discomfort2.
How are the FODMAPs and IBS related?
The small intestine poorly absorbs FODMAPs, which results in the release of fluid into the small intestine1. The presence of this fluid can result in abdominal discomfort and diarrhoea1. The undigested FODMAPs can also act as food for bacteria present in the small intestine2. When bacteria feed on these undigested carbohydrates, they produce gas which can cause bloating and abdominal pain1.
We all produce gas when consuming FODMAPs so why do some of us suffer from IBS and others do not? This comes down to differences between individuals including:
- The amount of gas individuals produce
- How our bowel responds to bloating
- How effectively our abdominal wall moves the gas formed by the bacteria
- How sensitive our bowels are
- How our brain responds to signals sent from our gut2.
Image sourced from: http://www.med.monash.edu/cecs/gastro/fodmap/mal-absorption.html
Limiting the amount of high FODMAP foods consumed by IBS suffers has been shown in several studies to effectively manage and reduce such symptoms of digestive discomfort1!
What is a low FODMAP diet?
A low FODMAP diet, as the name reveals, does not contain high FODMAP foods which can cause excess gas production and fluid release, reducing digestive discomfort in many sufferers2. The diet still does contain FODMAPs, but in lower amounts, to assist in the management of symptoms2. Below I have listed examples high FODMAP foods to avoid and low FODMAP foods to include in your diet in an effort to reduce IBS symptoms.
It is important to note that everyone is different. One food may be fine for one IBS sufferer, but cause symptoms in another. For example, some IBS sufferers can tolerate lactose while others cannot2. It is important that you work with an accredited practicing dietitian when adopting a low FODMAP diet. A dietitian will ensure you are getting all the nutrients your body needs while developing a meal plan which works for you.
*The foods listed above were sourced from ‘Food Intolerance Management Plan’ written by Dr. Sue Shepherd and Dr. Peter Gibson2.
Steps to identifying what may be causing your digestive discomfort
- Identify changes in digestive function. This may include feelings of nausea, bloating, abdominal pain, excessive wind and altered bowel movements.
- Monitor changes and potential causes. If they persist, consult your GP.
– It’s a great idea to keep a food diary prior to consulting with your GP or dietitian as this may assist in the diagnosis process.
- Your GP is likely to run several tests to identify possible causes, including tests for coeliac disease, abnormal gut bacteria, inflammatory bowel disease, bowel cancer (if risk factors indicate possibility) and other causes.
- If other conditions are ruled out and symptoms continue, your doctor may diagnose you with IBS.
- You may undergo hydrogen breath tests to identify if the cause of your digestive discomfort is a result of a food intolerance or malabsorption. Your doctor can refer you to undertake such tests.
- Consult with an accredited practicing dietitian to devise an appropriate meal plan to alleviate symptoms.
- Your dietitian can assist you with re-introducing FODMAPs into your diet one at a time.
Tips to assist in managing food intolerances, malabsorptions and/or IBS
- Source a variety of resources, such as Dr. Sue Shepherd’s ‘Food Intolerance Management Plan’, to help gain a further understanding of the low FODMAP diet
- Always check menus before going out for meals to ensure it is safe for you to eat there; call if necessary
- Checkout Sue Shepherd’s range of low FODMAP pasta sauces, curry bases and soups available in most major supermarkets
- Print out a complete list of low FODMAP foods you can eat and high FODMAP foods you can’t eat and stick them on the fridge; this will help both you and your family/partners/room-mates when it comes to grocery shopping and preparing meals
- Source and trial a number of low FODMAP recipes, this will assist you in learning how to adapt your old favourites to become FODMAP friendly
- Use a number of herbs and spices, as well as garlic infused oil to flavour your food! Your meals don’t have to be plain and boring!
- Follow @lettuce_talk_nutrition for insight into what a low FODMAP diet looks like on a daily basis 🙂
For more information check out:
1 Nanayakkara, W. S., Skidmore, P. M. L., O’Brien, L., Wilkinson, T. J. & Gearry, R. B. Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date. Clinical and Experimental Gastroenterology, Vol 2016, Iss Issue 1, Pp 131-142 (2016), 131 (2016).
2 Shepherd, S., Gibson, P. & O’Meara, M. Food Intolerance Management Plan. (Penguin, 2012).