Introduction
The abbreviation of FODMAP is Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. They are short-chain carbohydrates and sugar alcohols, which are not absorbed properly by the body. The failure to absorb these substances results in gas, abdominal pain, and bloating. FODMAP can be present in food naturally or can be added. Eating food containing a lot of these substances can result in gas, stomachache, abdominal distention, and diarrhea.
The main sources of FODMAPs include:
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Oligosaccharides - Onions, garlic, wheat, legumes.
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Disaccharides - Dairy products like yogurt, soft cheese, which contain lactose.
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Monosaccharides - Fruits like figs and mangoes, honey, and other sweeteners.
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Polyols - Fruits like blackberries and lychee, and sugar-free drinks and gums.
What Is a Low FODMAP Diet?
Foods that are high in FODMAP like some vegetables and fruits, lentils, wheat, milk products containing lactose, corn syrup, and sugary beverages should be avoided in a low-FODMAP diet. You can include lactose-free dairy, soy, oats, brown rice, hard cheese, meat, fish, seeds, chicken, eggs, quinoa, and nuts in this diet.
This diet is started by completely eliminating or restricting food high in FODMAP for 3 to 8 weeks. After this, a low-FODMAP diet is reintroduced to see if it causes gastric problems. As it is a very restrictive diet, it is not a permanent solution. This diet may help with gastrointestinal (GI) problems like irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO).
What Are the Foods to Be Avoided?
Some of the food items that need to be avoided are:
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Wheat.
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Garlic.
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Onion.
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Fruits like apples, cherries, apricots, pears, mangoes, pears, watermelon, and nectarines.
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Vegetables like asparagus, cauliflower, leeks, mushrooms, Brussels sprouts, and snow peas.
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Legumes and pulses like broad beans, chickpeas, kidney beans, and butter beans.
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Sweeteners like corn syrup, honey.
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Rye.
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Soft cheese like cottage cheese and ricotta.
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Milk.
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Chamomile and Chai tea.
What Are the Foods That Can Be Included?
Foods that are low in FODMAP are:
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Brown rice.
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Maize.
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Oats.
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Quinoa.
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Tapioca.
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Chives.
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Ginger.
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Lemongrass.
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Turmeric.
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Asafoetida.
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Fruits like unripe banana, kiwi, oranges, pineapple, and strawberries.
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Vegetables like capsicum, carrot, eggplant, kale, and spinach.
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Protein like tofu, eggs, chicken, fish, and seeds.
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Sweeteners like maple syrup, sucrose, and glucose.
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Hard cheese like cheddar and parmesan.
Does a Low-FODMAP Diet Help IBS?
IBS (irritable bowel syndrome) is a common gastrointestinal disorder that affects the large intestine. This condition is more common in women than in men. IBS causes symptoms like abdominal pain or discomfort, bloating, gas, feeling of incomplete bowel movement, inability to empty bowels, mucus in stools, constipation or diarrhea, nausea, and indigestion.
Doctors and scientists are still unable to find the exact cause of this disease. IBS patients experience significant relief from symptoms with diet changes. A low-FODMAP diet has also shown promising results in the treatment of IBS.
A clinical trial that compared the effect of this diet in IBS patients found that IBS symptoms improved by up to 50 % in patients within a week of implementing this diet. It helped with symptoms like abdominal pain, gas, and stool consistency. Another study found that 86 % of IBS patients noticed improvements in their symptoms while on this diet. Many other studies showed similar results.
Who Can Benefit from a Low-FODMAP Diet?
A low-FODMAP diet is only advisable for individuals who have been diagnosed with IBS. If you do not have IBS, then this diet is not for you, as it might result in harmful side effects. This is true because foods rich in FODMAPS promote the growth of good gut bacteria, which is essential for a healthy digestive system. If you have been diagnosed with IBS, you can try this diet after consulting your treating doctor. It is found to be helpful for IBS patients, who have:
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Active abdominal symptoms.
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Had no relief even after stress management therapies.
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Symptoms even after avoiding food like alcohol, coffee, etc., which trigger symptoms.
There is not enough evidence to support that this diet is helpful for children with IBS.
How to Start a Low-FODMAP Diet?
A low-FODMAP diet involves the following three stages:
Stage 1 - Restriction:
In this stage, all food items that are high in FODMAPs are avoided for about 3 to 8 weeks. People who follow this diet often think they should avoid all FODMAPs long-term, but this stage should only last about 3 to 8 weeks. Most patients notice changes in symptoms in a week, but some might take longer. If you feel your symptoms are much better, you can start with stage 2.
Stage 2 - Reintroduction:
Here, high-FODMAP foods are reintroduced in the diet. This is to identify the types and amount of FODMAPs the patient can tolerate. Here, the patient tries specific foods one by one for three days each. Some patients can tolerate certain high-FODMAP food, but it is important not to overdo it. It is best to consult a dietician, who will be able to guide you properly through this stage.
Stage 3 - Personalization:
Otherwise called modified low-FODMAP diet, in this stage, the food that you tolerated in stage 2 are taken. The quantity might be limited, but it is important to introduce high-FODMAP foods in your diet.
Conclusion
Many studies have shown the following results in IBS patients:
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It reduces symptoms like stomach pain, bloating, gas, etc.
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As IBS symptoms are debilitating, most patients lead a symptom-free life with the help of this diet.
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It improves the overall quality of life.
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It has also been shown to increase energy levels in people with IBS.
Go for this diet only if all other treatment modalities have failed to give satisfactory results. Always consult a doctor before starting this diet. And do not attempt to do a low-FODMAP diet without consulting a dietician. For more information on this diet, consult a dietician online.
