Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects 1 out of 10 people in the United States each year. Symptoms like cramping, diarrhea, gas and bloating can have a significant effect on a person’s quality of life. Diet is one way people manage the symptoms of IBS. A common treatment approach is to avoid the foods that trigger symptoms. A new diet for IBS, developed in Australia, is showing promise in managing IBS symptoms. It’s called the low FODMAP diet.
What are FODMAPs?
FODMAPs are short chain carbohydrates and sugar alcohols that are poorly digested by the body. They ferment in the large intestine (bowel) during digestion, drawing in water and producing carbon dioxide, hydrogen, and methane gas that causes the intestine to expand. This causes GI symptoms such as bloating and pain that are common in disorders like IBS.
FODMAPs are in some foods naturally, or as additives. They include fructose (in fruits and vegetables), fructans (like fructose, found in some vegetables and grains), lactose (dairy), galactans (legumes), and polyols (artificial sweeteners). These foods are not necessarily unhealthy products. Some of them contain fructans, inulin, and galactooligosaccharides (GOS), which are healthy prebiotics that help stimulate the growth of beneficial gut bacteria. Many of them are otherwise good for you, but in certain people, eating or drinking them causes gastrointestinal symptoms.
Symptoms and signs that you may be eating too many high FODMAP foods
FODMAP’s are not absorbed well in the small intestine. They increase the amount of fluid in the large intestine (bowel) and they produce more gas. Symptoms and signs that suggest you may be eating products high in these short chain carbohydrates are:
- Abdominal distention
- Abdominal pain
- Diarrhea (similar to IBS symptoms)
- A feeling of fullness after eating or drinking only a small amount of food or liquid
Eat less of these foods:
- Lactose: Cow’s milk, yogurt, pudding, custard, ice cream, cottage cheese, ricotta cheese, and mascarpone cheese
- Fructose: Fruits, such as apples, pears, peaches, cherries, mangoes and watermelon; Sweeteners such as honey and agave nectar. Products with high fructose corn syrup.
- Fructans: Vegetables (such as artichokes, asparagus, brussels sprouts, broccoli, beetroot, garlic and onions). Grains (such as wheat and rye). Added fiber (inulin, for example).
- GOS: Chickpeas, lentils, kidney beans, broccoli, and soy products.
- Polyols: Fruits such as apples, apricots, blackberries, cherries, nectarines, pears, peaches, plums, and watermelon. Vegetables such as cauliflower, mushrooms, and snow peas.
- Sweeteners: Sorbitol, mannitol, xylitol, malitol, and isomalt (found in sugar-free gum and mints, and cough medicines and cough drops).
Eat more of these foods:
- Dairy: Lactose-free milk, rice milk, almond milk, coconut milk, lactose-free yogurt. Hard cheeses such as feta and brie.
- Fruit: Bananas, blueberries, cantaloupe, grapefruit, honeydew, kiwi, lemon, lime, oranges, and strawberries.
- Vegetables: Bamboo shoots, bean sprouts, bok choy, carrots, chives, cucumbers, eggplant, ginger, lettuce, olives, parsnips, potatoes, spring onions, and turnips.
- Protein: Beef, pork, chicken, fish, eggs, and tofu.
- Nuts/seeds: Almonds, macadamia, peanuts, pine nuts, and walnuts (limit to 10-15 each).
- Grains: Oat, oat bran, rice bran, gluten-free pasta, rice, corn, quinoa, white rice, and corn flour.
How the diet works
This diet consists of severely restricting or eliminating those particular foods and drinks for a short period of time because it may not meet all the nutritional dietary requirements you need. It can be very restrictive, and it is not recommended as a permanent diet.
For 3-8 weeks, foods and drinks that contain FODMAPs are limited or avoided. After that, individual foods can be introduced back into the diet, one at a time, to see whether that particular food or drink causes symptoms. If it does, you know you need to avoid that type of product. If no symptoms occur after consuming a particular food or drink for a week, it may be considered safe to continue to eat.
All the physicians at Hunterdon Gastroenterology can assist you with the FODMAP diet.
Call us today for more information! 908-483-4000.
Cunha, John. P. D.O., MedicineNet. Low FODMAP diet for IBS. 2/2017.
Harvard Health Publishing. FODMAP diet to Manage Irritable Bowel Syndrome. 7/2015.