03 Jun 2015 What if FODMAP doesn’t help IBS?
One of the first places IBS sufferers go to find relief from symptoms including symptoms including bloating, heartburn, digestive pain, wind, constipation and diarrhoea. is the FODMAP diet.
What is a FODMAP diet?
The FODMAP diet which was created in 1999 by Dr Sue Shepherd when she discovered through her PhD research that limiting FODMAP foods alleviated IBS symptoms in patients.
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. In plain speaking, FODMAPs are short chain carbohydrates that are poorly absorbed by the small intestine. When these molecules arrive at the large intestine undigested they become a food source for the bacteria that live there normally and create symptoms of IBS.
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What if a FODMAP diet doesn’t improve symptoms?
From our experience of working with clients with IBS, if you have no change in symptoms after being on a low FODMAP diet, you may want to take the diet further by making these additional changes.
- Avoid all sugar – If you suffer with bloating, cut out all fruits and sugars as the unfavourable bacteria in the gut may be feeding off the fructose. If reducing fruit improves symptoms, consider taking a pre/probiotic to increase friendly bacteria in the gut
- Avoid the deadly nightshade family – including tomatoes, white potatoes, chillis, peppers and aubergines. The nightshade family contains Saponins and Lectins, which are chemicals that affect intestinal permeability and can cause leaky gut
- Avoid coffee – especially if your IBS is stress related. The caffeine in coffee has a stimulant effect and can create additional stress in the body. Caffeine dependence increases dehydration which can affect the bowel (the majority of our water is absorbed by the large intestine) which increases headaches and migraines.
- Cut out processed food including
- rice milk (this can often contain inulin, a fibre that is known to increase bloating)
- wheat free breads and pastas (grains contain lectins that affect intestinal permeability)
- cheese and dairy products, many people do not have enough of the enzyme lactase to digest the sugar in dairy called lactose
- Drink water – Increase your intake of water to 2 litres a day and drink it AWAY from food
- Up Your Fibre – Increase your vegetable intake to ensure healthy quantities of soluble and insoluble fibre
Elimination diets take a while to take effect. Gluten can take 3-4 months to completely leave your system so bear with it.
If after 4 months of a FODMAP and elimination diet, or if you don’t want to wait months to get clarity on what is going on, book in with a practitioner for Food Intolerance Testing which will identify the foods that are causing issues.
It is also worth considering your symptoms may be caused by other factors including a malfunctioning ileo-cecal valve or low stomach acid and if an elimination diet does not improve symptoms it would be worth investigating these areas further.
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