What is a low FODMAP diet?

And how does it help IBS?

Irritable bowel syndrome is a common gut disorder that affects one in seven adults. Everyone’s experience with IBS can however be very different. The most common symptoms include:

  • Stomach pains
  • Bloating
  • Constipation
  • Diarrhea
FODMAP plan for IBS diet

These symptoms can be easy to ignore if they only happen once in a while but when you experience these at least once a week, they can start to have a knock-on effect on your quality of life.  You might start staying at home instead of going out with friends or you just can’t concentrate at work like you used to. This is the time to address your IBS once and for all.

When done correctly, the low FODMAP diet has been found to reduce the symptoms of bloating and pain in around 86% of people

Heidi Staudacher. Journal of Human Nutrition and Dietetics. 2011

There is lots of information on the internet about a low FODMAP diet encouraging you to do it yourself but research shows that you get much better results when this is done under the supervision of an experienced dietitian. The Gastroenterological Society of Australia recommends the reintroduction of FODMAPs should be guided and assessed by an Accredited Practising Dietitian (GESA 2013). The re-introduction phase can take several weeks so don’t waste this time and effort by not doing it properly.

We only use dietitians who have post graduate training or many years of experience using the low FODMAP diet and managing gastrointestinal disorders.  Every person’s symptoms and gut are different so applying the same strategy to everyone doesn’t work. It will work for a few but then the rest are left more confused than when they started.

Our gastrointestinal dietitians have post graduate training or many years of experience using the low FODMAP diet and managing gastrointestinal disorders. 

Before you start…

Before you jump into a low FODMAP diet there are some steps to follow to ensure that we are not masking another medical cause for your symptoms:

Step 1: Eliminate other possible medical causes with the help of your GP such as coeliac disease, inflammatory bowel disease,  bowel or ovarian cancer. Some IBS symptoms are also found in these conditions and should be ruled out first. Your GP may refer you to a gastroenterologist for further tests.

Step 2: Once an IBS diagnosis has been confirmed by your GP then see an experienced dietitian to see if there are some simple diet and lifestyle solutions that may help reduce your pain. We don’t want to put you through a low FODMAP diet if there is a simpler solution.

Step 3: Still experiencing pain and bloating then this is the stage that we would start a low FODMAP elimination diet to identify the foods that need to be removed from your diet initially to give you your quality of life back.

One of the most common mistakes people make is staying on the low FODMAP diet longer than they need. A low FODMAP diet is bad for gut health and should be followed only long enough to identify the foods you are reacting to. An experienced dietitian is the ideal health professional to guide this process.

Not sure if you have IBS?

We have been around long enough to remember when IBS wasn’t considered a medical condition at all!  But now there is so much good evidence about it’s diagnosis and treatment that there are internationally accepted criteria for diagnosing IBS (after other possible causes have been ruled out) which your GP will also use.

These criteria are called Rome IV. You should be able to tick them all off to support a diagnosis of IBS

Click the link below to put your symptoms to the test and see if you meet all criteria. This can then be used to show your GP and explain your symptoms.

Do you have IBS? Take the test

What are FODMAPS?

FODMAPs is a term that is used to describe the range of carbohydrates and sugars which can cause bloating because they are poorly absorbed by the body. Undigested food sits in the intestine and is fermented by bacteria which leads to fluid secretin and gas production. For the vast majority of people, this doesn’t cause a problem but around 20% of the population who have IBS, this leads to pain, diarrhoea and/or constipation.  FODMAPS are found in everyday foods and are important for good gut and overall health.

FODMAPS are dietary sugars from the following groups:
Oligosaccharides: Fructans and galacto-oligosaccharides (GOS)
Disaccharides: Lactose
Monosaccharides: Fructose in excess of glucose
Polyols: Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt

The Low FODMAP Diet process

There are three important phases to a low FODMAP diet for IBS.

Phase 1: Low FODMAP Diet

The exclusion phase is where you remove the foods that are most likely to problematic for you. Our dietitians will provide a specific list that will depend on your symptoms. Our dietitians will also give you plenty of practical information to make it easier such as recipes and shopping lists.

Phase 2: Test your tolerance to FODMAPS

The re-introduction and tolerance testing phase. Our dietitians will give you an individualised plan and guide you through the practical steps to test your tolerance to each of the FODMAP foods. Doing this phase correctly is vital for an accurate diagnosis and so you can move back to a more normal diet and focus on improving your gut health.

Phase 3: Return to a normal diet with a focus on improving gut health

Returning to a normal diet.  Although at this stage you are likely to be feeling a lot better, it is important to complete this phase of the diet to ensure that you are meeting your nutrient requirements. Cutting out foods or groups of foods put you at risk of nutritional deficiencies or new unwanted symptoms such as lethargy, low mood and weight gain.

This is because FODMAPs contain important nutrients for good gut health and therefore it is important you replace these lost nutrients. Good gut health has been linked to the function of the brain and may affect the body’s production of hormones which affect appetite, energy and weight as well as neurotransmitters that can affect mood. Our dietitians are very experienced health professionals and the best placed to develop your personalised long-term eating plan.

Are there any other tests for IBS?

There is no other diagnostic test for IBS. Hydrogen-methane breath-testing only measure some but not all possible trigger foods.

Completing all three phases of the low FODMAP for IBS diet can diagnose your food triggers.

Making life easier on a low FODMAP IBS diet

A low FODMAP diet can be difficult to incorporate into your everyday life. Have a dietitian on hand to give practical tips and meal plans for eating out and at home. This will make it easier to incorporate the changes into your life.

Eating out – People find it quite difficult to eat out whilst completing the trial. The best way to avoid FODMAPs is by sticking to more basic meals and restaurants. e.g. Pub meals are often more FODMAP friendly than Indian, Asian, Italian, Mexican cuisines.

Probiotics – Probiotics can also be beneficial. Check with your dietitian for the most appropriate one for your symptoms.

Laxatives and fibre supplementsOften these supplements contain sugars and sweeteners that are not recommended on the Low FODMAP diet.

Chewing gum and artificially sweetened productsMany contain sorbitol, mannitol, xylitol which are not suitable for a Low FODMAP diet.

What if the low FODMAP diet doesn’t work for me?

Most people do respond which makes it very important to follow the protocol correctly.  For people who don’t respond to the Low FODMAP diet then a more restrictive elimination diet may be considered by our dietitian.

If you feel there is little or no improvement after completing this process we may refer you back to your GP for further testing. Also some people who find that their IBS is worsened by periods of stress may benefit from psychological support to help manage the stress and anxiety.

These are our dietitians with specialist experience in IBS treatment and FODMAP diets.

Amanda Turbill, APD

Aloysa Hourigan, Gastointestinal Dietitian

Molly Warner, Accredited Practising Dietitian

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If you or someone you know could benefit from an expert’s advice get in touch with My Nutrition Clinic today.

annaFODMAP diet plan for IBS