Now I do not claim to be an expert. And as always, if you are experiencing symptoms that resemble IBS always talk to your doctor first before tackling the low-FODMAP lifestyle. But this post is a place to learn a little more about what FODMAP stands for, why you would choose the low-FODMAP diet, and a few things to consider before diving in. I have also summarized some of the important information on an infograph (download for free below!) and I have listed a few resources at the end of this post if you are looking for even more information!
FODMAP is an acronym that represents sugars that are poorly absorbed and/or digested in the gut. Each letter represents the group of short-chained sugars that are found in certain foods that can be especially irritable for people with IBS.
Fermentable: These are foods that are fermented by the bacteria that is already found in our gut. This fermentation process, simply put, is when a sugar molecule is converted into gas molecules as well as other byproducts such as lactic acid or alcohol. Therefore, this fermentation is what creates those uncomfortable symptoms we experience like excess gas.
Oligosaccharides: The most common oligosaccharides (short chains of sugars that are then linked together) are Fructan and GOS (Galactooligosaccharides) and are again poorly digested by those with IBS. Some of the foods on the high-FODMAP list that fit under this category are lentils, beans, garlic, and wheat.
Disaccharides: These are known as two sugar molecule chains. One of the main disaccharides is lactose, one we are all too familiar with. As you probably know, this is the sugar found in dairy products like milk, yogurt, cheese, and our beloved ice cream. In order to digest lactose properly, we need to have a specific enzyme called lactase. If we insufficiently digest lactose it can then ferment in our colon and create some of those nasty IBS symptoms.
Monosaccharides: These sugars are just one sugar/carb molecule. The main monosaccharide that can become a problem for us with IBS is called fructose. This sugar is found in most fruits and vegetables as well as natural sweeteners like honey and agave.
Polyols: These ones are what we call sugar alcohols. Polyols as a category are slowly, and therefore, only partially digested. Some of the common polyols are sorbitols and mannitol, which can be found in some fruits and veggies such as cauliflower, peaches, and commonly used mushrooms like button, portobello, and shiitake.
The misconception with high FODMAP foods is that they are only poorly absorbed in people with IBS. The fact is that these sugars are naturally slowly digested through the intestines of every individual.
Those little sugars travel through our intestines and cause a pull of water into the gut. This increase of water and the gas created by the fermentation process in the large intestine is what causes our intestines to expand. This is all a normal response to eating these short-chained sugars.
But what differs between those who have IBS and those who do not, is how sensitive our gut is to that distention. Those of us with IBS, have sensitive guts and this is what creates all those uncomfortable symptoms we deal with on a daily basis.
Examples of some potential IBS gut symptoms include:
The caution with staying on the low-FODMAP diet is there are specific types of foods that provide us with certain nutritional value that we cannot get if we eliminate low-FODMAP foods on an extended basis.
One example is prebiotics that render probiotics useless if you don't have them in your diet! This is why it is important to see the low-FODMAPs as a lifestyle and a process. It was created in mind that you would eliminate for a period of time, and then start to re-introduce those foods systematically to regain that nutritional value.
This is something I learned the hard way because I started getting stomach aches and regular IBS symptoms, even if I was not eating any of my trigger foods.So this is where I am in my journey now! I have chosen to use a dietician to help me with the re-introduction phase so that I have an expert helping me make the appropriate decisions along the way. Stay tuned to hear more about the re-introduction process and my experience throughout!
For those who have IBS, which the low-FODMAP diet is intended for, it can give you a lot of freedom. This may seem a little counterintuitive because you are starting with eliminating foods from your diet, but the freedom you can gain is from your symptoms. Here are a few of things that I personally gained by starting the low-FODMAP journey:
1. Significantly Less Bloating.
I know that when I started to eat a low-FODMAP diet I couldn’t believe how much better I felt! Specifically, feeling less bloated was the number 1 relief I gained.
2. Improved My Mental Health.
Constantly feeling bloated, uncomfortable, and not knowing if I needed to be close to a bathroom or not, became so unbelievably draining. And on top of that, not feeling any control over it created such a helpless feeling. The control that the low-FODMAP diet gave me over my life has allowed me to be more present in my day to day life again. Although my symptoms are not completely eliminated, feeling more in control of my own life gave me such an improved positive mindset!
3. Improved My Bowel Regularity.
Although this was not created entirely by going on the low-FODMAP diet it definitely is improved when I am eating mostly low-FODMAP foods.
The most trusted resource to get a list of high and low FODMAP foods is the Monash University Low FODMAP App . Monash University is the university to discover and create the FODMAP process and they are the ones to test all the different portions of food to determine whether they are considered high or low in FODMAPs.
There are 3 phases to the FODMAP process:
1. Elimination Phase
This is the phase where you eliminate all high-FODMAP foods from your diet and strictly follow the portion recommendations from the Monash University Low FODMAP App . Depending on which source you are referencing, the length of time that you must be in the elimination phase varies. According to Monash University, it is recommended to complete the elimination in a 2-6 weeks under the supervision of a registered dietician.
2. Re-introduction Phase
In the re-introduction phase we start bringing back some high-FODMAP foods in a systematic way. Again, how to specifically complete this phase seems to vary depending on who you ask, but I will stick the recommendations from Monash University.
They suggest introducing one food from one of the five categories of FODMAPs (fermentable, oligosaccharides, disaccharide, monosaccharides, and polyols) on the first day, but otherwise sticking to the strict low-FODMAP diet. For 2-3 days after re-introducing that one category, you go back to a strict low-FODMAP diet before re-introducing another food. This is to avoid any crossover so you are clear on which foods are your triggers.
It is also recommended to complete this phase with the help of a dietician who can help you know what foods to introduce, when to re-introduce them, and to help you interpret your body's response to each introduction. And the Monash App comes in handy again with offering suggested portion sizes and foods to use when introducing one of the categories back into your diet.
3. Maintenance/Personalization Phase
This phase is all about the long game. This is where you reintroduce foods that may be considered high-FODMAP, but were not found to be triggers for you in the re-introduction phase.
This is where you create a personalized FODMAP lifestyle that is unique to you. Triggers and non-triggers can change over time so it is important to keep testing them every few months. But this is the fun part! This is where you find your FODMAP style and learn what works best for you. And it is what allows you to gain those nutrients (fiber, prebiotics, etc.) back into your diet, that you may have lost during the elimination phase.
Seek a Physician's Advice
First things first, you need to determine whether the symptoms you are experiencing are indeed IBS. Request the appropriate tests to rule-out any sinister or more serious conditions such as IBD, Celiac Disease, colitis, or even Cancer. Although these are scary names, and unlikely, you still need to take the steps to make sure they are not the case.
Find a Registered Dietician
I would recommend taking some time to find a dietician that 1, specializes in IBS or gastrointestinal conditions, 2, is familiar with the Low-FODMAP diet so they can guide you through this process, and lastly, find one that you mesh well with.
Although credentials are important, it is also important that you both get along! You are way more likely to follow their advice if you trust them. And when you are more committed to your treatment plan and what your dietician suggests, the better the chance of improving your symptoms.
Live Your Damn Life!
Once you have taken the steps to get a diagnosis, find a specialist to help you through the Low-FODMAP process, and/or mold your habits to work towards improving your symptoms, remember that you are doing all this to improve your quality of life! Yes, it is important to follow the advice of your dietician and doctor, but it is also important to remember that we are human.
Remember that there are going to be weekends at the cottage, birthday parties and busy-A$$ days that may put you off track from time to time. Give yourself some grace, remember it is a process, and get back on track the next day.
For a reminder that this happens to everyone check out my post on feeling off track. I also share strategies that I use to help me get back to my regular routine.