I get a lot of questions about why I follow this diet, what is this diet, and what the heck is a FODMAP? I've got all the answers right here! Just kidding, I still don't have all the answers to this, nor am I a certified professional (yet), but here are the facts I have learned through other professionals through this 3+ year journey. A lot of this information comes from the Monash University, an Australian team of health professionals working hard to better understand IBS.
Disclaimer: I am not a medical professional. This post is meant to be an educational guide and in no way intended for medical use.
1. What is IBS?
IBS stands for irritable bowel syndrome. It is a common disorder (statistics show between 10-25% of the U.S. suffers from it) affecting the large intestines. The precise cause of IBS is still relatively unknown. This is different than an IBD (irritable bowel disorder) - like Crohn's Disease or Ulcerative Colitis - which can be distinctly diagnosed.
There are 3 types of IBS: IBS-C (constipation), IBS-D (diarrhea), or IBS-C/D (alternating). According to the Mayo Clinic, factors that doctors believe play a cause in IBS include:
-Muscle contractions in the intestine: the walls of the intestines are lined with muscles that contract as they move food through your digestive tract. Stronger and longer contractions cause diarrhea, while weak and short intestinal contractions cause a slowdown, leading to hard and dry stool (constipation).
-Nervous system: poorly coordinated signals between brain and intestines can cause your body to overreact to changes that are normal to the digestive process, resulting in pain, discomfort, and diarrhea or constipation.
-Inflammation: some people with IBS have an increased number of immune-system cells in their intestines. This is associated with diarrhea.
-Severe infection: IBS can develop after a severe bout of diarrhea caused by a bacteria or a virus. It is also sometimes associated with a surplus of bacteria in the intestines, or a bacterial overgrowth.
-Changes in bacteria in the gut, or microflora: micoflora are the "good" bacteria that reside in the intestines and play a key role. Research shows that microflora in people with IBS can differ greatly from the microflora in healthy people.
Signs and Symptoms of IBS:
-Cramping or bloating
-Inability to pass gas
-Regular issues with diarrhea and/or constipation
-Mucus in stool
When to see a doctor:
-Diarrhea over night
-Persistent pain that isn't relieved by passing gas or a bowel movement
2. What is the low-FODMAP diet and what is a FODMAP?
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. These are fermentable carbohydrates in foods that are often difficult to digest, causing bloating and discomfort. More simply, the groups are named: fructans, fructose, polyols, and lactose. They have been found to be the leading cause of general IBS.
When prescribed this diet by a health professional, you will be given the list of "approved" foods and "things to avoid." For usually 6-8 weeks, you will eliminate these things from your diet entirely. You will often keep a food journal to document how you feel after meals and the patterns of your bowel movements.
After the suggested elimination time passes, you will slowly re-introduce foods. Keeping a food journal through this step is crucial! You will also want to do this slowly, and preferably with regular contact and consultation with your nutritionist or dietician. This process will help you figure out which types of foods cause IBS flare-ups.
Once the elimination and reintroduction periods are over, you will hopefully have a much better understanding of what your body can and cannot handle. This will vary for everyone! There are many studies happening now on whether or not this is something to maintain over a long period of time or not.
3. So what can and can't I eat on this diet?
See this page for a comprehensive list of low and high FODMAP foods:
There are so many blogs and instagrams (hello, Red Door Nutrition!) that are good for meal inspiration, recipes, and general support. You're not alone! There are so many people out there suffering with similar problems. A world without onions and garlic can seem so daunting, but I promise, it is possible.
4. Alright, I've consulted with my health professional and I've completed the reintroduction phase. I know what foods upset me, but I still have stomach aches! What now?
Being that stress and hormones are two other factors contributing to IBS, it is highly suggested that you do what you can to keep those things in check as well as taking care of your nutrition. Self-care is key! Practice self-care before you feel like you "absolutely need it" to help keep your stress levels down. Whether that is taking a long bath, taking a yoga class, or going for a walk or hike - whatever brings you happiness, do it!
Hopefully this post helped you better understand the science behind IBS and the ins and outs of the low-FODMAP diet. As I've stated, always start with a health professional - whether that is your gastroenterologist or a dietician or nutritionist. This post is not intended as medical advice but simply an educational guide to navigating this crazy stomach-ached world.