It brings gassiness, bloating and abdominal pain…sudden attacks of “the runs”…and constipation that can linger day after uncomfortable day. For people with irritable bowel syndrome (IBS)—the majority of whom are women—such nasty symptoms are a sad fact of daily life and notoriously difficult to manage. Because a number of foods can trigger flare-ups, some IBS patients eliminate practically everything from their diets in a desperate attempt to avoid troublemakers, but then they wind up with multiple nutritional deficiencies (not to mention a darn boring diet) as a result.
So, it will no doubt come as a huge relief for patients to learn about a new dietary approach that significantly relieves IBS symptoms for three out of four sufferers while allowing patients to eat a wider variety of foods. The diet is called low-FODMAP—an acronym that stands for fermentable oligo-, di- and mono-saccharides and polyols. “These terms refer to carbohydrates that are poorly absorbed by our bodies during digestion. When the carbs reach the colon, they interact with bacteria there. Most people’s bodies handle this fermentation with no problem—we’re not even aware that it’s happening. But in some people, certain FODMAP foods bring on IBS symptoms. When these foods are avoided, flare-ups are far less likely,” said gastroenterologist William Chey, MD, a professor in the department of internal medicine at the University of Michigan Health System and a leading expert on the low-FODMAP approach.
Which foods are FODMAP? At first glance, you may be daunted by the size and scope of the FODMAP foods list, which includes many dairy products…several sweeteners…certain grains…and certain fruits and vegetables. However, if you are like many IBS patients, you have already severely restricted your diet. “I’ve had patients tell me that the only things they eat are chicken soup and crackers,” Dr. Chey said. (Ironically, wheat crackers and lots of noodles actually could cause problems, he added.) Because the low-FODMAP diet provides a targeted approach to identifying your personal troublemakers, you may end up being able to eat a more varied diet than you currently follow while experiencing fewer IBS symptoms. In fact, Dr. Chey noted, after the initial trial period, patients almost never wind up on a fully restricted low-FODMAP diet. For a list of FODMAP foods, see the Today’s Dietitian article at www.TodaysDietitian.com…or visit http://FreeDownload.is/pdf/fodmap-diet and click on “UVA Nutrition Services—Low FODMAP.”
How the diet works: For FODMAP-sensitive people, the colon acts like a bucket—it can handle the accumulation of only so much FODMAP material before it “overflows,” triggering symptoms. So, the goal is to figure out which and how much of the various types of FODMAP foods your body can handle. To accomplish that, you fully eliminate all FODMAP foods for six to eight weeks…then, over the following four months or so, you reintroduce them one at a time to determine the types and amounts of FODMAP foods your body can tolerate.
Important: This trial should be done under the guidance of a health-care professional. Because FODMAP science is so new, many doctors are unaware of it—so your best bet is to consult a dietitian experienced in monitoring patients as they adopt a low-FODMAP diet. For referrals, check the Irritable Bowel Syndrome Self Help and Support Group listing at www.IBSgroup.org…or visit the on-line resource www.IBSfree.net, which is edited by a registered dietitian, and click on “FODMAPs-Friendly Dietitian Directory.”