Irritable bowel syndrome is a silent disorder. Silent because sufferers don’t want to humiliate themselves by talking about their bowel troubles. Yet, the lives of 12-15% of the population globally are conditioned by this terrible affliction. Probably more like 20% in the western world. That’s one in five people.
If you have IBS, you will know the pain of trapped wind, the discomfort of bloating and the embarrassment of your dependence on knowing the location of the nearest toilet. IBS sufferers are split between those with diarrhoea (the majority), constipation and those who swing between the two (the minority). But all have lives that are dominated by IBS.
The mechanism of what causes IBS is unknown, and there is no cure, but they do know that the brain to gut connection is faulty, and distorted signals are sent from the brain to the gut which behaves in a hyper-sensitive way.
Until now, there has been no solution for the misery of this large group of people. Doctors have thrown a plethora of different medicines at them, which gave temporary, minor relief but left behind even more problems from their side effects.
But, now we have the low Fodmap diet – a magical, life-changing diet which can completely eliminate IBS symptoms. In fact, it has been scientifically proven by the research centre at the Monash University in a double blind, quadruple-arm, randomized, cross-over, placebo-controlled rechallenge trial to significantly reduce the symptoms in 75% of those with IBS. That’s massive.
So what is this diet?
These are all poorly absorbed short-chain carbohydrates, which basically are indigestible sugars.
In IBS sufferers, some or all of these sugars are poorly absorbed in the small intestine and excess travels on down into the large bowel where the anaerobic bacteria feast on them causing fermentation, resulting in bloating, trapped wind etc.
It is impossible to eliminate all Fodmaps from our diet because we would die of malnutrition, but we can limit our intake of them by consuming only those with a low Fodmap content. By doing this in a careful and calculated way, symptoms become negligible.
The Elimination Diet
During this phase of the diet, you eliminate all high Fodmap foods and eat only those low in Fodmaps. Once your symptoms are gone (this could take anywhere from 2-6 weeks), you move onto stage two (see later).
But make no mistake, this is a complicated diet. It is not a matter of excluding one thing from the diet like gluten or lactose. It is about controlling the amounts of Fodmaps consumed. A list of good foods and bad foods is only one of the puzzle pieces and, by using that alone, the diet is sure to fail. It is a diet of amounts, combinations and accumulation of Fodmaps throughout the day. On top of that, we are all individual, and our absorption levels are different to anyone else’s. Finding the perfect balance is tricky. We are given (by the Monash University) the average amount we can eat of the low Fodmap foods but these are exactly that – an average. For example, we can have one banana but you might find you can tolerate only ½ a banana before symptoms begin.
The Reintroduction Stage
During this phase, foods from the individual groups are tested carefully and systematically to find the perfect final diet for the individual.
It is rare for someone to have problems absorbing all the Fodmap groups. For example, only 45% of people with IBS malabsorb fructose and 25% malabsorb lactose. You may only have major issues with one group, say fructose, and be able to absorb certain amounts of another Fodmap group, say polyols, and have no trouble at all with another group, say lactose. You will discover this during this stage.
Something you have to be aware of when you try this diet is that it has to be done 100% or not at all. Even one high Fodmap food will cause symptoms and muddy the waters. This is not something you can dabble with or introduce slowly, or you will think it is not working. Many people give up on this diet before they get it right and so leave behind a diet which could have saved them.
Are Fodmaps the complete picture?
There are a few other gut irritants that you have to be aware of when you do this diet even though they don’t involve Fodmaps.
- a) Fat – every cell in our body requires fat to survive, but it can irritate your gut at too high an amount and cause symptoms. We are all different, and you have to find the level that you can cope with.
- b) Alcohol – this is also a gut irritant and completely unnecessary in our diet. So, it is best to limit it or eliminate it completely.
- c) Excess gas intake – the gas in carbonated drinks irritates the gut and should be avoided. Smoothies are also questionable because of the large quantity of air that is pumped into them during their making. Also, it is best to eat with your mouth closed and to avoid talking while chewing so that no air is ingested.
- d) Caffeine – this also irritates the gut and should be avoided as much as possible.
3) Fibre – fibre is essential for a healthy diet but too much will irritate the gut and cause symptoms. This is one of those individual things where you have to push against that fine line between having enough fibre to keep things moving along well in your digestive system and not causing symptoms like bloating.
So, this will not be an easy journey but it is a journey, if followed meticulously, which will give you enormous relief from your IBS symptoms. It is truly a miraculous diet.
Permitted Food On The Low Fodmaps Diet
(this is not all inclusive)
Broccoli (½ cup), common cabbage (1 cup), bell peppers (½ cup), carrot (1), celery (¼ stalk), cucumber (½ cup), eggplant (½ cup), green beans (10), kale (1 cup),
leeks (green part only -½ cup), lettuce (1 cup), peas (¼ cup), potato (1), pumpkin (½ cup), radishes (2), spinach (1 cup), spring onion (green part only – 2), sweet potato (½ cup), tomatoes (1), zucchini (½ cup).
Bananas (1), blueberries (20), cantaloupe (1/2 cup), grapes (20), honeydew (1/2 cup), kiwifruit (1), lemon juice (1 tsp), oranges (1), passionfruit (1), paw paw, (1/2 cup), pineapple (1/2 cup), raspberries (10), rhubarb (1/2 stalk), rock melon (1/2 cup), strawberries (8).
Gluten-free bread and cereals, amaranth, arrowroot, brown rice (1cup), buckwheat, millet, oats (1/4 cup), oat bran (2 tbsp), gluten-free pasta (1 cup), polenta (1 cup), potato starch/flour, quinoa, quinoa flakes (1 cup), white rice (1 cup), rice noodles (1 cup), sorghum, sourdough oat bread (1 slice), puffed wheat (1/2 cup), sourdough spelt bread (2 slices).
Chickpeas – canned (1/4 cup), Lentils – canned (1/2 cup), lentils green/red, boiled (1/4 cup).
Note: you can have more canned lentils than uncanned as long as you drain and rinse them because most of the Fodmaps have leeched out into the liquid.
Cheddar (40gms/1.4oz), cottage cheese (4 tbsp), feta (1/2 cup), halloumi (50gms/1.8oz), ricotta (2 tbsp), lactose-free milk (1 cup), hard cheeses including brie and camembert (40gms/1.4oz), lactose-free yoghurt (1 small pot), butter.
Note: dairy products like hard cheeses and butter are very low in lactose because they are mainly fat.
Suzanne Perazzini is the author of two low Fodmap cookbooks, Low Fodmap Menus and Low Fodmap Snacks. She is also the creator of the Inspired Life Low Fodmap Coaching Program. She lives in New Zealand in a house overlooking the Pacific Ocean with her husband and son. Since discovering the low FODMAP diet, her irritable bowel syndrome issues, which she has suffered from all her life, have all but disappeared. Her blog, www.strandsofmylife.com , focuses on the low FODMAP diet and features videos, recipes and articles on irritable bowel syndrome. Her mission in life is to help those who suffer from irritable bowel syndrome to implement the low Fodmap diet.
If you want to have a complimentary, obligation-free phone call from Suzanne to discuss your issues and her coaching program, fill in the application form on this page and she will call you.
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