I lived with excruciating digestive symptoms, for what felt like an eternity.
The pain I experienced from bloating was my constant companion and no medical interventions gave me any real respite until I discovered the low FODMAP diet.
I was given the vague and unsatisfying diagnosis of IBS in my early 20’s but over the years my condition worsened into an inflammatory bowel disease called Ulcerative Colitis.
It was obvious to me that some foods caused immediate discomfort. But despite being able to clearly identify some specific dietary triggers, there were still too many variables for me to fully understand. At times, I felt I couldn’t safely eat anything without feeling dreadful afterwards.
Things can only get so bad before you have to stop and rethink everything. I started to do my own research into diet and gut issues.
If you have read my healing journey you will know I ditched gluten first. This is a common ingredient to go first and for very good reason. (Gluten containing grains are FODMAPs by the way) Saying goodbye to bread, pasta and the million foods containing gluten made such a noticeable difference to my symptoms that I became fascinated about why this should be.
In my search for answers, I discovered the low FODMAPs diet.
So, What are FODMAPs?
FODMAPs are found in the foods we eat.
FODMAPs is an acronym (abbreviation) referring to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. They are a collection of poorly absorbed simple and complex sugars that are found in a variety of fruits and vegetables and also in dairy milk and wheat.
- Oligosaccharides (eg. Fructans and Galacto-oligosaccharides (GOS))
- Disaccharides (eg. Lactose)
- Monosaccharides (eg. excess Fructose)
- Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)
Common FODMAPs in your food include:
Fructose: A sugar found in most fruits and vegetables.
Lactose: A sugar found in dairy foods like milk.
Fructans: Very similar to fructose, found in many vegetables and grains
Galactans: Found primarily in legumes.
Polyols: Sugar alcohols like xylitol, sorbitol, maltitol and mannitol. You find them mainly in artificial sweeteners and chewing gum.
Why FODMAPs cause digestive grief
FODMAPS are short-chain carbohydrates (types of sugars) that don’t get properly absorbed during digestion. Instead, these foods sit down in our gut too long and start to ferment.
The IBS network says, “Poorly absorbed sugars pass through the small intestine and enter the colon, where they are fermented by bacteria, releasing gas, which stretches the sensitive bowel causing bloating, wind and pain. Fructose, lactose and polyols tend to retain water in the bowel and may result in loose motions and diarrhoea.”
When I looked at the high FODMAP food list for the first time I knew I was onto something life changing. I was already suspicious of many of the key offenders and was keen to eliminate others that I had never even suspected.
So what causes FODMAP intolerance?
Clinical studies recognise SIBO (small intestinal bacterial overgrowth) as being the primary cause of IBS symptoms and FODMAP intolerance. Check out this post in the Good Gut Guide for the low-down on SIBO.
FODMAPS are only part of the problem
It’s important to understand that FODMAPS in themselves don’t actually cause IBS, they simply exacerbate symptoms. In saying this, continual assaults of high FODMAP foods on a sensitive digestion system can increase the severity of IBS. I certainly noticed this. My food intolerances and IBS symptoms were only worsening with time. It is difficult to know which came first, the IBS or FODMAP malabsorption?
There are a lot of things at play, not every FODMAP food will cause symptoms in everyone. Everyone is unique and has their own level of FODMAP malabsorption. For example, I’m most sensitive to fructans and galactans, a small amount can cause immediate pain. For someone else, fructose may be the biggest IBS trigger.
Dose makes the poison
Also, portion size matters. A handful of almonds are considered low FODMAP, but if you eat an entire bowl then you will end up eating a high amount of FODMAPs.
FODMAPs and gut healing – the bottom line
Healing your gut lining is imperative. If you remove all FODMAPs from your diet for a short time, you give your gut bacteria a chance to rest and rebalance. You create the conditions to allow healing to begin.
However, a low FODMAP diet is not in itself a total solution to IBS. It is simply one piece of the healing puzzle. The most important thing is the state and condition of your gut flora!
The low FODMAPS diet plan
I won’t outline the low FODMAP diet here. My preferred reference is Shepard Works. That’s a great place to start.
Also, a basic printable PDF food list can be found here
Low FODMAP diet is not a forever, lifestyle diet
Despite the discomfort they may cause, high FODMAP foods include many very nourishing foods that shouldn’t be left out of your diet permanently. Shepard Works says “a LOW FODMAP Diet, is not a NO FODMAP Diet. Eliminating all FODMAP foods from the diet over the long term is not desirable or recommended.”
Keep a food diary
Gut healing is a very individual process. It’s important to pay attention to your own symptoms and listen to what your body is telling you. Keeping a diary can be valuable for you and for your health practitioner. I didn’t do this but I really wish I had.
Also, understanding FODMAP trigger foods and knowing what family of sugars they belong to becomes helpful when navigating food labels and meal planning.
Don’t go it alone
There are many resources and diet recommendations to follow on-line, however I do recommend you find a supportive, health professional to work with you on this journey. Go gentle and go slow.
For further reading, I highly recommend the following articles.
Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach – Journal of Gastroenterology
FODMAPS: could common foods be harming your digestive health? – Chris Kressor
The low Fodmap diet – Shepard Works