The low-FODMAPS diet for managing IBS

Find out about the diet that could help alleviate the painful symptoms of irritable bowel syndrome (IBS).

06 October 2015
by Meg de Jong

Irritable Bowel Syndrome (IBS) is a chronic condition affecting the intestines and colon, which can cause cramping, abdominal pain, bloating, gas, constipation or diarrhoea, amongst other symptoms.

While IBS is not caused by food and can’t be cured by diet, certain foods can exacerbate its symptoms. Which food differs from person to person, and from time to time.

New evidence is showing that eliminating a range of foods known as FODMAPS can be very effective in managing the condition. This new dietary approach, which sees patients reducing rapidly fermentable, short-chain carbohydrates, is getting dramatic results – reducing gut disorder symptoms by up to 75%, according to a 2010 paper by Monash University in Australia.

What are FODMAPS?

The acronym FODMAP stands for: Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. This includes a family of carbohydrates and sugar alcohols that can be easily fermented in the gut and trigger symptoms of digestive distress including gas, pain and bloating, explains Kathie Swift, in her book The FODMAPS Diet.

How does the low-FODMAPs diet work?

The FODMAPs code divides foods into three groups:

  1. Avoid
  2. Limit
  3. Enjoy

The list of foods to avoid contains many fairly obvious things, like alcohol and dairy, but also has healthy foods such as certain fruits, vegetables, beans and legumes. You can find a more comprehensive list of FODMAP foods here

The idea is to reduce the total number of FODMAPs you consume for a two-week period, while monitoring the effect on your symptoms. If it seems too overwhelming to avoid them all, begin by eliminating the ‘top offenders’, such as wheat, onions and milk. Some patients’ symptoms respond much more quickly than others.

However, Dr John Wright, a Cape Town-based gastroenterologist, explains that IBS patients’ sensitivity to foods may vary from time to time, so what is a trigger for you now, may no longer be in a year’s time.

Reintroducing FODMAPs into your diet

After about two weeks, once your symptoms have settled and your gastrointestinal tract has had a chance to heal and regenerate, you can consider gradually reintroducing small amounts of FODMAPs. Swift recommends going slowly and taking note of specific foods or combinations of foods that aren’t well tolerated.

Tips for following the FODMAPS diet

Some of the following tips can be found in Swift’s book:

  • Read labels on any packaged consumables to ensure you aren’t ingesting any ingredients high in FODMAPs.
  • Keeping a food/symptom diary can be helpful in tracking what does and doesn’t work for you.
  • Be sure to have your last meal several hours before going to bed.
  • Be sure to get enough FODMAPs-friendly vegetables in your diet for your overall health.
  • Chew your food thoroughly before swallowing in order to aid digestion.

But the diet doesn’t work for me…

While for many, eliminating certain foods can be extremely helpful in managing the symptoms of IBS, in other cases, sufferers may find that managing their diet is not the answer for them. In fact, the International Foundation for Functional Gastrointestinal Disorders (IFFGD) explains that the simple act of eating (smelling, tasting or chewing food) can activate the intestines before food is even swallowed, and which food is being eaten is of no consequence.

Dr Wright also stresses that IBS is a physiological disorder complicated by psychological factors, rather than a diet-based one. He explains: “We all know that when we are stressed our tummies feel tight. With extreme stress we may even evacuate. Clearly our psyche has an effect on our bowel. IBS is simply an exacerbation of this normal reflex,” he says. As IBS is not an allergic disease, he cautions that an elimination diet may not be the most effective approach to managing your symptoms.

Dr David Epstein, a specialist physician and gastroenterologist at Vincent Pallotti Hospital in Cape Town, adds that an accurate diagnosis is of utmost importance when it comes to IBS. “IBS can easily be confused with coeliac disease, mild inflammatory bowel disease, infections or other conditions,” he explains.

If in any doubt, or if your symptoms continue to worsen, consult with a medical professional without delay.

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