FODMAPS & Digestion

Right now about 35 million American suffer with irritable bowel syndrome or IBS.  Those afflicted with it are familiar with the chronic abdominal pain, diarrhea and/or constipation, nausea, bloating and excess gas.  Sadly, there is not a test for IBS. So, what can we do?

Traditionally, people with IBS stick to regular meals, avoid large meals, and decrease fatty, spicy, and gas-producing foods, along with reducing caffeine, carbonated beverages, and alcohol.  Although that's a good way to start, some people need more help. That means keeping a food journal to see if you can identify triggers, along with amounts, or even combinations of foods and drinks.

Research is showing that there may be another reason these symptoms are appearing.  It could be due to FODMAPS.  FODMAPS are foods that can provoke a digestive response causing IBS symptoms.  FODMAPS is an acronym - Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, And Polyols.  Essentially, they are short-chained fermentable carbohydrates that are poorly absorbed.  Two common FODMAPS are lactose from milk, and fructose from fruits, vegetables, and sweeteners.

When a person is lacking or simply does not have enough of an enzyme it interferes with proper digestion, meaning it either cannot be fully broken down or it is absorbed too slowly.  This causes water absorption in the gut, which allows bacteria to ferment these carbohydrates quickly in the large intestine.  The result - bloating, gas, abdominal pain and diarrhea or other bowel movement changes.

Studies are showing that following a low-FODMAP diet can help alleviate symptoms.  One study showed that 51% of those following this diet for 4 weeks had "significant improvements" in abdominal pain, as well as bloating compared to the control group.

If you're interested in trying a low-FODMAP diet it is implemented in two stages.  The first stage eliminates high-FODMAP foods for about 6 to 8 weeks.  Next, each type of FODMAP is reintroduced in a particular way to see just what the individual is able to tolerate.  The good news is that you may find only certain types of FODMAPS are bothersome, and you may even be able to tolerate a small amount of one or two higher FODMAP foods.

Though the FODMAP diet may not be for everyone it could help those who have tried other methods without much success.  Before starting you will want to consult with your doctor to talk about your concerns, and when necessary be referred to a dietitian.

Here are some examples of low-FODMAP swaps:

Oligosaccharides (Fructans, GOS - common in legumes)

High FODMAP: onion bulbs, wheat, rye, barley, broccoli, kidney beans

Low FODMAP: green onion tops, cornmeal, rice, quinoa, oats, bok choy

Dissacharides (Lactose)

High FODMAP: cow's milk, soft cheese like ricotta or cottage cheese

Low FODMAP: hard cheese like cheddar, Swiss or provolone

Monosaccharides (Excess fructose)

High FODMAP: apple, mango, watermelon, agave syrup, fruit juice concentrate

Low FODMAP: maple syrup, cane sugar in small amounts, corn syrup

Polyols

High FODMAP: cherries, peach, apricot, plum, sorbitol, erythritol

Low FODMAP: blueberries, orange, kiwi (limit to one serving), pure stevia

Reference: Health & Nutrition Letter, Tufts University, March 2017, VOL. 35, NO. 1, Foods to Soothe Digestive Woes (pp.1 &3).