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High FODMAP Foods

How to use the Low FODMAP diet to heal your gut

The Low FODMAP diet is now commonly recommended to ease a range of digestive symptoms associated with small intestine bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS). It originated out of research by Monash University and has since been widely researched and proven helpful.

FODMAP is an acronym for:

  • Fermentable
  • Oligosaccharides
  • Disaccharides
  • Monosaccharides
  • Polyols

Eek! So what is that in plain English? These are types of sugar that are poorly absorbed by the small intestine and are fermented by bacteria to produce gas. They can cause IBS type symptoms such as gas, bloating, constipation and diarrhea in some people.


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. 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.

A Low FODMAP diet can help you to isolate the types of foods that are causing your symptoms. Once your GP has examined you for other conditions, such as coeliac disease, this diet can help you get back to basics – I commonly recommend this diet as a first step when working with gut issues. It 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 is recommended that you consult with a health care consultant, dietician or Nutritional Therapist, such as myself, before embarking on a low-FODMAP diet.

FODMAPs can feed bacteria in the small intestine, which should only contain a small number of bacteria compared to the colon. This can lead to Small Intestine Bacterial Overgrowth (SIBO). Whereas in someone with a healthy gut, these sugars will pass through the small intestine until they get to the colon where they will act as a food source for beneficial bacteria that live there.

What is the low FODMAP diet?

The low-FODMAP diet helps you identify the foods that are causing your symptoms – this varies from person to person. You start by removing foods that are high in FODMAPs for 2-4 weeks or until symptoms ease.

There are many foods that are restricted but you have to remember why you are doing this – The long-term benefits far outweigh the difficulty of eliminating these foods for this period. Remember, everyone reacts to these foods differently so the Low-FODMAP diet allows you to find out which foods are problematic for you.

As a qualified Nutritional Therapist, I can guide you through this process, help you with tasty and tolerable alternatives to high FODMAP foods, and guide you through the re-introduction phase and help you to identify other causes of your gut issues

The main sources of FODMPs include (there are other high FODMAP foods not on this list):

Oligosaccharides: Wheat products, vegetables such as onions and garlic, all beans and pulses including chickpeas, lentils and soybean, and inulins added to foods such as certain yoghurts, protein bars, and milks.

Disaccharides: The main one is Lactose and many people are Lactose intolerant. 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.

Monosaccharides: These are simple sugars with excess fructose being the main one. Examples of foods containing an excess of fructose include fruit juices, apples, cherries, watermelon, peaches, plums, nectarines, mango

Polyols: Mushrooms, fruits such as apricots, chewing gum, and added sugar alcohols 

How does the low-FODMAP diet work?

Phase 1 – FODMAP Restriction

Phase 1 is a strict restriction of all high FODMAP foods for two to four weeks, or until symptoms settle. Monash University have an app which can be used to know the FODMAP content of various foods.

You can keep a Food symptom diary, or use our smartphone coaching app, to keep track of how certain foods are affecting you.

Phase 2 – FODMAP Reintroduction

During this phase, you methodically re-introduce foods that were restricted in Phase 1. Foods are re-introduced one-by-one and in a specific order. The idea is that at the end of this process you will have a better understanding of which foods trigger your symptoms, and you can continue to eat the ones, you do not react to. 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?

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. For this reason, eliminating all high FODMAP foods is not a long term solution, and you should always work to re-introduce as many of them as possible. But for many people, this diet can be a lifesaver and is well researched.

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!), what they are reacting to, 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.

IBS Diagnosis

Is IBS an incurable disease?

Imagine having a condition that severely limits what you can eat, what you can do, and that can strike at any time. Your GP may not be able to help either and doesn’t know what is causing your condition. After a few months or years with Irritable Bowel Syndrome (IBS),  you may come to believe that there is little that can be done to help you. That it’s not possible to find out what is causing your symptoms. If you have had IBS for a while, you know what I’m talking about, and I really do feel for you!

This belief may have started when your GP told you that little can be done. And this makes sense from a GP’s point of view: Doctors call IBS a ‘functional gastrointestinal disorder’ which means the gastrointestinal tract doesn’t show any physical abnormalities but functions abnormally.

A doctor usually gives an IBS diagnosis using a process of exclusion. This means that once all their tests come back normal but symptoms persist, the diagnosis is given. As the underlying cause isn’t known, a GP can then only treat the symptoms using drugs or surgery or you may be told there is nothing that can be done or told simply to eat more fiber or Metamucil.

But this is NOT the final answer. Most of these treatments don’t work well, because they don’t address the underlying causes of your digestive disorder.

If you take one thing away from this post, I want it to be the hope and understanding that is possible to improve your IBS. You can increase the diversity of foods you eat. It is possible to lessen the constant worry about your digestion and improve your wellbeing and quality of life.

 

What is causing my IBS?

As a Functional Medicine practitioner, I aim to get to the root cause of health issues. This is important! Only by finding the root cause, can we weed out the health issue for good. Imagine you are pulling a tough weed out of your garden. The weed breaks and leaves the roots behind. By addressing only the symptoms, it’s as if you are pulling this weed out of your garden. When the roots remain, the weed will grow back.

Some of the possible causes of IBS include bacterial and fungal overgrowth, possible parasites, slow digestion, food intolerances, gluten disorders, small intestinal bacterial overgrowth  (SIBO), emotional wellbeing and stress, and carbohydrate maldigestion. For example, in some people, toxins released during an infection may damage nerves, which in turn can cause abnormal muscular contraction of the bowel, especially when stressed. This is a disruption of the gut-brain axis which I’ll talk more about later in this article.

 

Small intestinal bacterial overgrowth (SIBO)

We normally have about 1.5kg (3 lbs) of bacteria, about 500 species, in our gut. Usually, most of these bacteria live in our large intestine and our small intestine is relatively sterile. But bacteria can also take over our small intestine and then SIBO develops. These bacteria then ferment food in the small intestine causing bloating, gas and belching, diarrhea, and constipation.

Significantly, up to 80% of people with IBS, have SIBO.  That’s far more than in the general population. Therefore, in people with symptoms, it makes sense to test for SIBO. The most common test is a breath test which measures gas production by the bacteria in the small intestine.

If SIBO is found, anti-biotics or diet, anti-microbials, and probiotics maybe used to resolve it. This is great news for people with IBS! A natural approach may also focus on increasing motility (i.e. the speed at which food passes through the small intestine) to clear out the bacteria in the small intestine. Proper digestion is also important. Digestion requires enough digestive enzymes and stomach acid. Eating mindfully in a low-stress environment (not at your desk) also helps. 

 

Food sensitivities

But unfortunately, the causes of IBS in everyone aren’t the same. Candida, or a parasitic protozoa such as Blastocystis Hominis and Dientamoeba Fragilis can cause IBS type symptoms.

Another major cause of IBS is food sensitivities. These are not true allergies but low-grade reactions to foods that may not be seen until several hours or days after eating. British medical journal Gut found that eliminating foods identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms.

When working with an individual, I may start with diet, removing the possible trigger foods for IBS. This may take the form of a low FODMAP diet. FODMAPs are sugars that are fermented by our gut bacteria and this may cause bloating and IBS type symptoms in some people. Monash University, one of the pioneers of the low FODMAP diet, say the diet should be used for 2-6 weeks and not for life. After the elimination phase that removes high FODMAP foods from the diet, the re-introduction phase monitors the individual response to the re-introduction of a high FODMAP food.

But even when trigger foods are identified, I’m still looking to find out why that person has an issue with that food. FODMAP foods tend to be healthy, fibre rich foods, that feed our good gut bacteria, and so we work towards being able to re-introduce these foods.

So overgrowth of bacteria in the small intestine and food intolerances are two major causes of IBS but there are others. These include poor digestion, parasites, stress or previous trauma.

 

What if I’ve looked at these causes, and I still have IBS?

In many cases of IBS, our guts have become overly sensitive. Certain foods or a build-up of gas (bloating) affect us more than in other people, even when eating a healthy diet and doing all the right things. 

If you have improved your diet,  ruled out food sensitivities, and parasites, then your IBS likely involves disturbed neural functioning of the gut-brain axis. In which case, you may need to work with the brain as well as the gut (see what do I do next?).  

 

What do I do next?

In most cases, it is possible to identify your personal causes of IBS – It doesn’t have to be just a label attached to untreatable symptoms. Solutions can be found if you look at the underlying causes and address them.

  1. Try taking digestive enzymes with meals to help break down food while your gut heals. Also, try eating in a mindful way to reduce stress and aid digestion. Once healed, eating bitters before eating will stimulate the release of these enzymes without a supplement
  2. Try an elimination diet for 30 days such as a Low FODMAP diet, or a diet which removes the common triggers of gut issues: dairy, gluten, added sugar, alcohol, yeast, eggs, corn, soy, and peanut. Dairy, gluten, added sugar and excessive alcohol are the most important triggers to remove. After 30 days, re-introduce foods systematically one by one to isolate which foods are causing your symptoms.
  3. Test for SIBO, food sensitivities, parasites or other gut issues through a practitioner to help identify your root causes. A practitioner can help you identify which tests, if any, may help you. They will also be able to help identify your root causes by taking a detailed health history and symptoms analysis.
  4. Work with the brain If no cause for the IBS can be found in the previous step, then pay attention to the brain. This can involve a variety of approaches and modalities, ranging from activation of the rest and digest arm of the nervous system (parasympathetic),  stress reduction, exercise, blood sugar balance, acupuncture, counseling, or hypnotherapy.
  5. Repair the gut once the cause of IBS has been removed through repopulation with good bacteria and repairing increased intestinal permeability (leaky gut)

By taking steps such as these, and seeking out the underlying causes of IBS, you can really improve your health and finally overcome your digestive disorder.

 


Stephen Ward (MSc) is trained in assessing the root cause of your health issues and together, we can work this out.  We will also look at improving other areas of your health as we assess your health status using the Functional Medicine model.

Call 0491611043 or BOOK ONLINE to arrange a time for Free 20 Minute Intro consultation.

Alternatively, send me a message and I’ll get back to you ..