Irritable Bowel Syndrome? Try The Low FODMAP Diet

Dealing with IBS can be tricky as symptoms of IBS vary widely among individuals. Cramping, abdominal pain, constipation, and diarrhea can occur simultaneously and sometimes the flare-ups happen suddenly, affecting day-to-day activities. It can be triggered or worsened by irritable bowel syndrome- risk factors such as stress, certain foods, hormonal changes or infections.

As there is no cure, lifestyle and dietary changes are the only options to manage the symptoms. Tracking all the meals, finding out the foods that cause flare-ups and then being conscious to avoid them is a hectic task.

The FODMAP diet is a savior for IBS! Read on to understand the concept of FODMAPs, their impact on the digestive system, and how to incorporate a low-FODMAP diet to alleviate your IBS symptoms.

Understanding Irritable Bowel Syndrome

Irritable Bowel Syndrome is a common gastrointestinal disorder that affects the large intestine (colon).

IBS has symptoms like abdominal pain, bloating, gas and changes in bowel habits such as diarrhea, constipation or both. 
Its exact cause is unclear, but etiological factors include increased epithelial hyperpermeability, gut dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered brain-gut interactions.

There are four types of the condition:

1. IBS with constipation (IBS-C)

2. IBS with diarrhea (IBS-D)

3. Mixed IBS (IBS-M) -symptoms that alternate between constipation and diarrhea

4. Unsubtyped IBS (IBS-U) -for people with other symptoms than mentioned.

• Other irritable bowel syndrome symptoms include- excessive gas, pellets or flat ribbon stools, mucus in poop, incomplete bowel emptying, food intolerance, fatigue, anxiety, depression, heartburn and indigestion, headaches, frequent urination etc. In IBS, you experience these symptoms weekly for three months or less often for at least six months.
• To alleviate the symptoms, avoid trigger foods like caffeine, alcohol, and fatty foods, increase fiber intake, manage stress and regular exercise.
• IBS diagnosis is done by checking its symptoms. A colonoscopy for irritable bowel syndrome looks for signs of blockage or inflammation in your intestines.
• IBS isn’t life-threatening, nor makes your body vulnerable to getting other colon conditions or cancers. But it seriously hampers the lifestyle with the associated symptoms. It calls for its effective management with a low fodmap vegetarian diet.

What are FODMAPs?

• FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are a group of short-chain carbohydrates and sugar alcohols commonly found in various foods.
• These substances draw water into your digestive tract, which could make you bloated, stay in the intestine for too long and get fermented by bacteria in the colon, leading to IBS symptoms.
• Consuming high amounts of FODMAPs can trigger or worsen symptoms such as bloating, gas, abdominal pain, diarrhea and constipation.

High-FODMAP foods to avoid

1. Fermentable Oligosaccharides:

• This group includes fructans and galactooligosaccharides (GOS).
• Fructans are in foods such as wheat, rye, barley, onions, garlic, wheat, rye, onion, garlic, artichoke, dairy products and certain fruits and vegetables.
• GOS is present in legumes (beans, lentils), certain grains, soybeans, and nuts.
• Due to the lack of enzymes that break down oligosaccharides, IBS patients can’t digest or absorb them. Fermentation by gut bacteria produces gas and results in bloating and cramps.

2. Disaccharides:

• The main disaccharide is lactose, found in dairy products such as milk, yogurt, and soft cheeses.
• The lack of enzyme lactase in the body with increasing age inhibits the breakdown of lactose. Gut bacteria then ferment lactose, leading to symptoms of bloating and flatulence.

3. Monosaccharides:

• It refers to excess fructose found in certain fruits like apples, pears, mango, fig and honey and in some sweeteners like high-fructose corn syrup, agave, jam etc.
• Excess fructose consumption can cause fructose malabsorption, cause an increase in water in the small intestine and increases IBS symptoms.

4. Polyols:

• These are sugar alcohols, including sorbitol, mannitol, xylitol and maltitol.
• Polyols are in some fruits containing pits or seeds, such as apples, avocados, cherries, figs, peaches, or plums, cauliflower, mushroom, sugar-free gum and candies.

Low FODMAP diet: What you can eat

• You need a low FODMAP diet meal plan to tone down the IBS symptoms.
• In a study published in the journal Gastroenterology, about 3 out of 4 people with IBS had their symptoms ease right away after starting a low-FODMAP diet and felt the most relief after 7 days or more on the plan.
• It also helps manage the symptoms without medications and tremendously improves the quality of life.
• The low FODMAP diet lets you include your favorite foods with low FODMAP snacks and whole foods and a gluten-free low FODMAP diet.
• Low FODMAP diet constipation can be observed in a few. It can be caused by eliminating some gluten-containing grains like whole wheat and significantly reducing your intake of high-fibre legumes, which can decrease your fibre intake and lead to constipation. Increasing dietary fibre intake and fiber supplementation can help you overcome the issue.
• A diabetic low FODMAP diet should be carefully personalized with the help of a dietician. The diabetic diet and FODMAP diet can be combined, keeping a few things in mind, such as choosing carbs that have a lower GI, increasing fibre levels with fruits and veggies or supplementation, choosing cooking oils with the highest monounsaturated fats, choosing oily fish such as salmon and sardines that can help improve your gut microbiome and is FODMAP friendly!
• Low FODMAP vegetarian diet should include plant-based proteins such as tofu, tempeh, lactose-free yogurt, lactose-free milk, eggs, and small servings of cooked legumes like canned chickpeas or lentils, gluten-free whole grains, low FODMAP fruits and vegetables, healthy fats etc.
• A vegan low FODMAP diet can have a vegetarian diet except for dairy alternatives like lactose-free or low-lactose vegan alternatives like almond milk, coconut milk, or lactose-free plant-based yogurts.

Implementing a Low-FODMAP diet

A low-FODMAP diet involves three steps: restriction, reintroduction and personalization. These can be implemented with the help of a registered dietician or a gastroenterologist. They will help you to limit FODMAPs but keep a balanced whole food-low FODMAP diet that meets all your nutritional needs.

1. Restriction phase:

Under the guidance of a registered dietitian who specializes in gastrointestinal disorders, you will be asked to stop eating certain foods for 6-8 weeks to see if your symptoms improve.

All the high FODMAP foods will be forbidden like the-

• Dairy-based milk, yoghurt and ice cream
• Wheat-based products such as cereals, bread and crackers
• Beans and lentils
• Vegetables such as artichokes, asparagus, mushrooms, onions and garlic
• Fruits, such as apples, cherries, watermelon pears and peaches
• Cashews, pistachios, dried fruits, honey, high-fructose corn syrup

2. Reintroduction:

• Once the symptoms are better, individual FODMAP groups are gradually reintroduced to determine which specific types of FODMAPs may be problematic for the person.
• You can bring back foods one at a time at a rate of one item per week as per the advice from your doctor or dietitian.
• It will identify your sensitivity to specific FODMAP carbs, and that’s good news!
• Maintaining a food diary or a symptom chart lets you track your reactions to various foods.

3. Personalization:

• Reactions to FODMAP carbs can be different in people, so generalization is not possible here.
• Personalization of diet under guidance is a must as it gives a clear understanding of the foods that trigger your digestive problems, the type and amount of a particular food you could tolerate in the reintroduction phase and then create a diet that accommodates your needs, preferences and nutritional requirements.

Potential benefits of a Low-FODMAP diet

• You can observe a considerable change in bloating before and after a low fodmap diet as the FODMAP diet reduce bloating by restricting short-chain carbohydrates from the diet that are fermented by gut bacteria, causing the release of gas.
• Nausea is linked to indigestion, constipation or bloating associated with IBS. You can also observe subsequent improvement in irritable bowel syndrome nausea with the low FODMAP diet.
• There is bowel regularity and enhanced quality of life.

Conclusion

The irritable bowel syndrome disability is due to the chronic symptoms of IBS like, abdominal pain, bloating and changes in bowel habits that can be persistent and affect daily activities, work, and social interactions. Dealing with the symptoms, unpredictability of flare-ups, and limitations imposed by the condition takes a toll on mental health and emotional well-being. Also, dietary regulation makes it difficult to have a varied diet.

The low FODMAP diet is instrumental in managing IBS. Developing a personalised low FODMAP diet plan with the help of your gastroenterologist and dietician will ensure that your symptoms and quality of life have improved.

Don’t forget the power of positive thoughts, meditation, stress reduction exercises and lifestyle changes. It can heal you inside out! Remember, if you care about your body, your body will reward you with good health in return.