If you suffer from irritable bowel syndrome (IBS), you are not alone. A whopping 30 million people in North America struggle with its symptoms, including belly pain, bloating, diarrhea and constipation. Relief may be on the horizon though, thanks to a dietary approach that is picking up speed: the low FODMAP diet.
What is the big deal?
Irritable bowel syndrome (IBS) can be relentless and difficult to treat. No definitive cause has been found yet and treatments are often limited to symptom management at best.
Symptoms of IBS
- Pain and discomfort in the lower belly
- Excess gas
- Alteration in bowel habits (constipation or diarrhea)
Sufferers report that symptoms can be continuous or follow a pattern of repeated relapse—all of which often interfere with their social and work lives. Many note that symptoms increase after eating, and people often try to manage their IBS symptoms by avoiding certain trigger foods.
This was the impetus for researchers in Australia, led by professor Peter Gibson at Monash University, who may have come up with a solution. They found a link between symptoms of IBS and certain carbohydrates found naturally in foods. They gave these carbohydrates the acronym, FODMAP.
What does FODMAP stand for?
- Oligosaccharides: carbohydrates found in onions, garlic, broccoli, and beans
- Disaccharides: carbohydrates found in milk products (lactose)
- Monosaccharides: carbohydrates found in fruits, honey, agave, and high fructose corn syrup
- Polyols: carbohydrates found in stone fruit, apples and pears as well as some artificially sweetened candies
FODMAPS are short-chained carbohydrates that can be poorly absorbed by the intestines, causing them to expand from an increase in water and gas buildup. The symptoms and degree of distress that results varies from person to person and often depends on the amount of food eaten. Patients with IBS are thought to be particularly sensitive to these effects.
You can learn more about this on the Monash University website. They have an informative video and even a smartphone app. The American Gastroenterological Association also offers a primer, Starting the Low-FODMAP Diet.
Before you dive in, though, there are a couple of things you should know about the low FODMAP diet.
1. The evidence is limited
The evidence in support of this diet is still in its initial stages, and it has its critics. A 2015 review of the evidence by the BMJ in their Drug and Therapeutics Bulletin cautioned that the evidence “is based on a few relatively small, short term unblinded or single blinded controlled trials of varying duration.” In other words, the lack of good research means we can’t say for sure whether this diet is effective yet.
Since the BMJ report came out however, at least a dozen more studies have been released showing a positive effect of the diet on symptoms associated with IBS. Here is a PubMed link if you want to take a look at some of the newer research.
2. The Diet is extreme
One look at the list of foods considered high in FODMAPs, and you will realize that a low FODMAP diet can be quite restrictive–and therefore, hard to stick to. It is also possible that it could result in nutritional deficiencies.
In an article published last month (April 2016), The Academy of Nutrition and Dietetics advocates medical supervision while on a low FODMAP diet. They warn that “cutting too many fruits, vegetables, plant-based proteins and dairy foods from the diet can lead to increased risk of deficiencies in nutrients such as fiber, minerals such as calcium, protein (for vegetarians or vegans) and vitamins A, C and D.”
It is important to know that a low FODMAP diet is not for everyone. While it may help relieve symptoms, it is not a cure, and it is not always effective. You should not attempt this diet without medical supervision. For many people who have been suffering from debilitating symptoms of IBS without effective treatment, however, the low FODMAP diet may provided some much needed relief from the storm. Talk to you doctor to see if it is right for you.
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