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The Low FODMAP Diet: Keep stomach problems at bay!

stomach-painBeing a sufferer of severe IBS (irritable bowel syndrome) & food intolerance, you do come to realise how important watching your diet is. Surprisingly, a very large number of patients come in to my clinic complaining of the same thing – severe bloating after meals, gas & irregular bowel movements. Now, even if you haven’t been formally diagnosed with IBS, you will need to look at dietary triggers of such symptoms. However, it is always important to exclude medical conditions that are associated with these symptoms first. Hence, seeing your doctor or a gastroenterologist is a must  in order to rule out conditions such as coeliac disease or infection by bacteria in the stomach called Helicobacter pylori.

For those who are wondering what IBS is: Irritable bowel syndrome is a disturbance in the functioning of your digestive system and may cause the following symptoms:

  • Abdominal pain, often on the left side
  • Irregular bowel movements (constipation and/or diarrhoea)
  • Urgency to use your bowels
  • Gas and bloating

Symptoms of IBS have also been linked to stress and anxiety levels, however, the exact cause of IBS is not well understood.

Such symptoms can also be an indication of a food intolerance and if that is the case, you will need to work closely with a registered/accredited dietitian to determine the problem foods. Despite what many naturopathic clinics and medical centres may offer, there are no blood tests proven to diagnose a food intolerance!! Up to date, there is no scientific evidence to back such diagnostic methods although they have become very popular in the UAE. 

So whether you do have IBS or not, the low FODMAP diet may be able to offer some relief from symptoms of abdominal pain, bloating, gas and altered bowel movements. FODMAPs is a term given to a group of poorly absorbed, short-chain, rapidly fermentable carbohydrates. The term FODMAPs stands for Fermentable Oligo-, Di- and Mono-saccharides And Polyols. Examples of these carbohydrates include Fructose (e.g. sugar found in fruit), lactose (found in milk) and xylitol (artificial sweetener).If consumed in large amounts, FODMAPs are believed to increase the volume of liquid and gas in the small and large intestine, resulting in abdominal pain, gas and bloating. Keep in mind that FODMAPs are not the cause of IBS but controlling them in your diet will help reduce symptoms.

The low FODMAP diet involves eliminating high FODMAPs for a few weeks and must be followed under the supervision of a dietitian. As a summary, you can describe the low FODMAP diet as being a lactose free, gluten free diet with a range of fruits, vegetables and protein foods that are allowed.

The following list is a brief example of high FODMAP foods that are to be avoided for a certain amount of time as decided by your dietitian: (table extracted from Sports Dietitians Australia – The Low FODMAP Diet nutrition information sheet)

The foods listed below are described as LOW FODMAP foods which are to be included in your diet instead (Please note that this is not the complete list and a dietitian will be able to provide you with a full list of alternatives)

Fruits Grains Lactose Alternatives Vegetables
  • Blackcurrant
  • Blueberry
  • Cranberries
  • Grapefruit
  • Grapes
  • Gluten-free products
  • Rice cakes/Rice crackers/Corn Thins
  • Quinoa
  • Brown Rice
  • Rice based Noodles
  • Hard cheese, brie
  • Lactose-free products, such as lactose-free milk
  • Tomato (not concentrates)
  • Spinach/Baby Spinach
  • Cucumber
  • Zucchini
  • Alfalfa

As you follow the low FODMAP diet, you are required to keep a strict food and symptom diary where you record everything that you have eaten any symptoms you may have experienced. Initially, record 2 days of your typical diet including the symptoms you experience in order to have a baseline for comparison. Once the diet has been followed strictly for the number of weeks set by the dietitian, you will then proceed to food challenges. This involves a slow reintroduction of foods you’ve eliminated and monitor whether any symptoms occur. Once you do experience a symptom, then you will know that the following food is a definite trigger. Some people will have a certain threshold of tolerance, additionally, every individual will have different triggers where some may be common amongst others.

So if you are experiencing ongoing symptoms of abdominal discomfort, wind and altered bowel habits, see your doctor first then definitely consult a dietitian for an assessment of your diet. Writing down a 3 day diary of what you ate and what symptoms you have experienced prior to seeing someone will make it easier for us to know what may be the cause. Wishing you all happy healthy tummies!

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