Using the Low FODMAP diet to heal your gut

The Low FODMAP diet is a specific food plan designed to manage IBS and digestive complaints. It does this by reducing high ‘FODMAP’ foods in the diet – I will explain what this means in this article.

The Low FODMAP diet is now commonly recommended to manage a range of digestive symptoms associated with small intestine bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS).

What are FODMAPs?

FODMAP is an acronym for:

• Fermentable
• Oligosaccharides
• Disaccharides
• Monosaccharides and
• Polyols

Eek! So what is that in plain English?

These are types of sugars, found in many natural foods, that trigger fermentation, bloating, gas and pain in the gut.

Why am I reacting to high FODMAP foods?

Bloating is a common reaction to high FODMAP foods. This is because the bacteria in your gut feed on these sugars and produces Hydrogen and Methane gases which bloat you.

An excess of bacteria or bacteria in the wrong place, such as the small intestine, can cause this sensitivity. This is called Small Intestine Bacterial Overgrowth (SIBO) and is identifiable through a breath test.

Other causes of a reactivity to high FODMAP foods include

• A fungi (Candida) overgrowth in the gut
• Psychological or emotional stress
• Poor digestion of your food. Focussing on slowing down and chewing your food well will aid digestion.

Can a low FODMAP diet help you?

Recent research found up to 86 percent of people with IBS saw improvements in their symptoms while on a low FODMAP diet.

But the Low FODMAP Diet has not only been shown to help many people with IBS, but may also be helpful for other gut conditions such as coeliac disease, Crohn’s and Colitis.

It has also been found to decrease inflammation, as measured by histamine in the gut, which may reduce neurological symptoms such as brain fog, which may be associated with IBS.

Once your GP has examined you for other conditions, such as coeliac disease, this diet can help you reset your gut, ease your symptoms whilst you work on the underlying causes of your gut issues, ideally with a health professional. It can help you to isolate the types of foods that are causing your symptoms.

How does the low-FODMAP diet work?

The low-FODMAP diet involves 2 phases: eliminating high FODMAP foods and then re-introducing them individually to ascertain their effect on your symptoms.

Once you have been through this process methodically, you will have a better idea which of these foods your body does or does not tolerate.

Phase 1 – FODMAP Restriction

Phase 1 is a strict restriction of all high FODMAP foods for 4 to 6 weeks, or until symptoms settle.

Avoid all high FODMAP foods and limit medium FODMAP foods to once per meal (only if tolerated) during this phase.

Many of the medium and high FODMAP foods are low FODMAP in small quantities. I recommend referring to the excellent app from Monash University to get precise portion size information.

Keeping track of how particular foods affect you is also recommended. That way, you can more clearly see patterns between what you eat and how you feel.

** Be careful with inulins added to foods such as certain yoghurts, protein bars, and milks

*** It is lactose in milk that is high FODMAP but lactose is not the same as dairy: Cream, hard cheeses and butter contain a limited amount of lactose. Most people with malabsorption can handle 4g of Lactose before they encounter issues, and so a thin spread of butter or a dash of milk may be OK, but a Latte may not. If you reacting to lactose free milk, it’s something else in milk, besides lactose, that is causing you issues.

Phase 2 – FODMAP Reintroduction

Food re-introduction should then be done systematically, re-introducing one food group at a time so that you can identify which of the eliminated foods you may still react to. Keeping a journal will be helpful.

Test with one FODMAP group at a time, introducing a new group each week, starting with polyols

Follow these guidelines when  re-introducing high FODMAP foods:

1. On test day for a food, eat two regular sized portions
2. Where possible choose a food that contains mainly one type of FODMAP (the examples in the table above are good)
3. Wait for 24 hours for any reaction
4. If there is a reaction, avoid that food for now. Wait until your symptoms have subsided before trying another food
5. If there is no reaction, you can include that food in your diet (many excluded foods are nutritious and support beneficial gut bacteria), and move on to trying another food in that food group

The idea is that at the end of this process you will have a better understanding of which foods trigger your symptoms, and which ones you can include in your diet again. This process will take several weeks or months, and I suggest you work through this process with a Nutritionist, such as myself, or a dietitian.

Is this the perfect diet?

The Low-FODMAP diet can be a life saver for many people and can transform some people’s quality of life and well being within days…

But like anything, there is a downside. When you do a restrictive diet like this, you run the risk of cutting out many nutrient-rich foods and good sources of fibre –  fibre is fuel for the beneficial bacteria in our colon, and is an important part of a healthy diet. Many high FODMAP foods are also healthy and are nutrient dense.

For this reason, and contrary to the belief of many people, the low FODMAP diet is not a long-term solution. It should be used whilst the underlying causes of your gut issues are being worked on, either on your own or with a practitioner (this process is detailed here).

What next?

You can, of course, do the low-FODMAP diet and re-introduction on your own, but many people prefer to work with a Nutritionist such as myself to help them identify what they can eat (that’s tasty too!), and to guide them through the re-introduction phase. We even have a coaching app for your phone so that I can support you through this process.

Also, as the diet doesn’t necessarily help you find the root cause of your IBS, a practitioner can help you with testing for a bacterial or fungal overgrowth that may be causing your issues and work with you on other causes of your health issues.

If you’d like to talk me to about the low-FODMAP diet, or your options for working with IBS or other health conditions, please contact me with any questions or give me a call.