The Low FODMAP Diet for IBS & Endometriosis
FOD-what?
Have you been told by your doctor or a friend to try the low FODMAP diet? Wondering what the hell a FODMAP is?
FODMAPs are a collection of carbohydrates found in plant foods that are not properly digested or absorbed in the gut and contribute to the awful symptoms experienced by people with irritable bowel syndrome. FODMAP is an acronym that stands for:
Fermentable
Oligosaccharides: Fructans & Galactans – in wheat, onions, garlic, and legumes 🧅
Disaccharides: Lactose – in dairy products like milk, soft cheeses, and yogurts 🧀
Monosaccharides: Fructose – in honey, apples, peaches, and cherries 🍯
And
Polyols: Sorbitol and Mannitol (sugar alcohols) – in some fruit and vegetables and used as artificial sweeteners 🌽
Thank goodness the smart folks at Monash University came up with the abbreviation.
A 2017 Monash University study looked at the effectiveness of a low FODMAP diet on symptom management among women with IBS alone or in conjunction with endometriosis. The findings showed 72% of women with endometriosis had greater than a 50% improvement in bowel symptoms on the low fodmap diet, with more women experiencing improved symptom management if they had both IBS and endometriosis compared to IBS alone.
How do FODMAP foods affect the gut?
When FODMAPs are eaten, they pass through the stomach and arrive in the small intestine, undigested, causing water to be drawn inside, increasing the liquid volume inside the gut. Then upon reaching the large intestine, the gut bacteria eat and ferment the FODMAPs causing a huge production of gases like methane and hydrogen. This double whammy of water movement and gas production in the bowel can cause digestion to either slow down or speed up and therefore cause the bathroom result of constipation, diarrhoea, flatulence, bloating, and pain.
Whilst FODMAPs affect all of us, they only seem to cause a noticeable problem for those with IBS and also Endometriosis. These groups of people have something called “visceral hypersensitivity”, meaning their gut and brain overreact to the changes of expansion and movement in the bowel and feel it more sensitively than others. Hypersensitivity causes pain and pain causes a “fight or flight” stress reaction which exacerbates the symptoms of IBS even further. If you’ve ever done a “nervous poo”, you will probably be familiar with this feeling.
How do you follow the low FODMAP diet?
The low FODMAP diet comes in 3 main phases: Eliminating high FODMAP foods from the diet; Reintroducing FODMAP groups systematically to identify triggers; then Personalising the FODMAP diet to suit each individual. It is EXTREMELY important you complete all three steps of the FODMAP diet as staying with the elimination phase longer than 6 weeks can start to damage your gut, immune system, and overall health. The FODMAP diet also requires supervision from a certified FODMAP dietitian (like me) as there is a real science to the process which can quickly get overwhelming and cause nutritional deficiencies on your own.
What can you do to get started?
Don’t stress, you CAN regain a sense of control and joy again in living a normal life with IBS. Managing your diet is a major part of tackling the issue, of which FODMAP plays a significant role. However, it is not the only factor to consider.
Try these tips:
Explore mindful exercise to desensitize your gut and help you wind down from the day. Start a regular Pilates, yoga, swimming or meditation class or any other hobby you enjoy.
Drink lots of fluid, mainly water. Keeping well hydrated is pivotal for healthy, regular digestion.
Eat slower and more frequently, rather than having large meals less often.
Reduce spicy foods, caffeine, and alcohol and check if your symptoms have improved. As these foods tend to be the popular culprits, there’s no harm in addressing them first.
Watch out for high-fat foods and meals as these can trigger pain and digestive discomfort very quickly. Limit things like fast food, hot chips, battered fish, deep-fried foods, coconut cream curries, and smashed avo.
If you’re struggling and feel like you’ve tried everything to get your symptoms under control (even past attempts at the low FODMAP diet), apply for a complimentary strategy call with me to discuss a game plan specific to you.