IBS & the Low FODMAP Diet
IBS can be unpredictable and debilitating, symptoms include gas, bloating, cramping, constipation or diarrhoea or altering between the two. While no one knows what causes IBS and there is currently no known cure, the good news is it can be well managed with a low FODMAP diet. Joanna and Marnie are here to help you get off the IBS rollercoaster and rediscover the joy of eating.
There are many conditions which cause similar symptoms to IBS, including Coeliac Disease, Inflammatory Bowel Disease (Crohn’s and Colitis) and even some cancers. It is essential to rule these out and investigate any “red flags” with your doctor before exploring dietary modifications.
There are many conditions which cause similar symptoms to IBS, including Coeliac Disease, Inflammatory Bowel Disease (Crohn’s and Colitis) and even some cancers. It is essential to rule these out and investigate any “red flags” with your doctor before exploring dietary modifications.
What are FODMAPs?
FODMAP is an acronym for four groups of short chain carbohydrate, or sugar molecules found naturally a variety of fruits, vegetables, grains, legumes and milk products.
When we eat, food passes from the mouth down the oesophagus to the stomach. In the stomach food is mixed and broken down before being slowly released into the small intestine. Enzymes in the small intestine continue to break food down to single molecules so that it can be absorbed across the wall of the small intestine into the blood stream. Any part of food that isn't broken down or absorbed in the small intestine will continue down the gastro-intestinal tract and pass into the large intestine for elimination.
When we eat, food passes from the mouth down the oesophagus to the stomach. In the stomach food is mixed and broken down before being slowly released into the small intestine. Enzymes in the small intestine continue to break food down to single molecules so that it can be absorbed across the wall of the small intestine into the blood stream. Any part of food that isn't broken down or absorbed in the small intestine will continue down the gastro-intestinal tract and pass into the large intestine for elimination.
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There are two processes that can occur during this progression that may trigger symptoms in certain people including; bloating, cramping, wind, constipation or diarrhoea or a combination of the two:
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Fermentable:
Oligosaccharides: Di-saccharides: Monosaccharides: And Polyols |
Molecules resist digestion, pass through the digestive tract to the colon where they are fermented, creating IBS symptoms.
“oligo” means “few” and “saccharide” means sugar. These molecules made up of individual sugars joined together in a chain. Include Fructans & Galactans found in onion, garlic, wheat, barley, rye, inulin, some dried fruit and Legumes (kidney beans, lentils, chickpeas, soy beans). “di” means two. This is a double sugar molecule. Lactose is the di-saccharide found in milk, yoghurt, some soft cheese’s, ice cream, custard and cream. “mono” means single. This is a single-sugar molecule. Fructose in excess of glucose found in asparagus, apples, mango, honey, cherries, some dried fruit, pears, juice and high fructose corn syrup. Sugar alcohols including Sorbitol & Mannitol found in cauliflower, mushrooms, snow peas, stone fruit and certain artificially sweetened products e.g. mints and gums. |
A low FODMAP diet is recommended to be implemented under the guidance of an Accredited Practising Dietitian. The low FODMAP diet is not a forever diet. It is intended as a diagnostic tool, which is designed to identify a persons’ individual dietary triggers so that they can modify their long term diet to allow as much variation and flexibility as possible while still managing IBS type symptoms.
You can read more about the three phases of the low FODMAP diet here.
You can read more about the three phases of the low FODMAP diet here.
Do I need food intolerance testing?
If you think that gluten or wheat may be contributing to your abdominal symptoms, it is important to be tested for Coeliac Disease. Your GP can request a blood test or refer you to a specialist for assessment. It is important to note, that for a blood test or biopsy to accurately diagnose coeliac disease, you must be eating gluten regularly for at least 6 weeks prior to testing. If you are already following a gluten free diet you can request a gene test. While the gene test does not diagnose coeliac disease, it can exclude coeliac disease.
Onset of a food allergy in adults is rare, allergies such as nuts and shellfish are most often diagnosed in childhood. If you are reacting to certain foods, you may have food intolerance.
Food intolerances and IBS do not involve the immune system, nor do they provoke the release of antibodies. This means that there are no tests that can accurately diagnose a food intolerance. The current gold standard for diagnosis is an elimination diet followed by a rechallenge phase under the guidance of a qualified dietitian. For more information on food intolerance testing please refer to this document from the Australian Society or Clinical Immunology and Allergy.
If you have had a positive breath test to fructose or lactose malabsorption, its important to know this isn’t a diagnosis. You will still need to undergo the elimination and challenge phase of the low FODMAP diet to identify if these are the trigger for your symptoms.
Similarly, if you have had a negative test result, it is still important to seek help from an Accredited Practising Dietitian to determine if other FODMAPs (oligosaccharides or polyols) or other molecules in food are causing your symptoms.
If you think that gluten or wheat may be contributing to your abdominal symptoms, it is important to be tested for Coeliac Disease. Your GP can request a blood test or refer you to a specialist for assessment. It is important to note, that for a blood test or biopsy to accurately diagnose coeliac disease, you must be eating gluten regularly for at least 6 weeks prior to testing. If you are already following a gluten free diet you can request a gene test. While the gene test does not diagnose coeliac disease, it can exclude coeliac disease.
Onset of a food allergy in adults is rare, allergies such as nuts and shellfish are most often diagnosed in childhood. If you are reacting to certain foods, you may have food intolerance.
Food intolerances and IBS do not involve the immune system, nor do they provoke the release of antibodies. This means that there are no tests that can accurately diagnose a food intolerance. The current gold standard for diagnosis is an elimination diet followed by a rechallenge phase under the guidance of a qualified dietitian. For more information on food intolerance testing please refer to this document from the Australian Society or Clinical Immunology and Allergy.
If you have had a positive breath test to fructose or lactose malabsorption, its important to know this isn’t a diagnosis. You will still need to undergo the elimination and challenge phase of the low FODMAP diet to identify if these are the trigger for your symptoms.
Similarly, if you have had a negative test result, it is still important to seek help from an Accredited Practising Dietitian to determine if other FODMAPs (oligosaccharides or polyols) or other molecules in food are causing your symptoms.
