The Low Down on Low FODMAP

What are FODMAPs?

‘FODMAP’ is an acronym which stands for ‘Fermentable Oligosaccharides, Disaccharides, Monosaccharides & Polyols’; the names of different groups of poorly-absorbed short-chain sugars, including not only fructose and lactose, but also molecules called fructans, galacto-oligosaccharides (GOS) and sugar alcohols, like sorbitol and mannitol.

What foods are FODMAPs found in? 

FODMAPs are found in a wide range of foods and food products, including vegetables & fruit, cereals & grains, legumes, pulses, nuts, dairy and manufactured goods.

Why should I be concerned about FODMAPs?

When consumed in either food or drink, FODMAPs can be poorly absorbed in the small intestine, continuing their path along the gastrointestinal tract until they reach the large intestine, where these 2 things can happen:

• FODMAPs are readily fermented by bacteria in the large bowel, contributing to gas production there.

• FODMAPs are highly osmotic, which means they attract water into the large bowel, which can result in increased bowel actions, and/or alterations in normal bowel habits.

These 2 processes can trigger undesirable symptoms like flatulence, bloating, diarrhea, constipation or a combination of both.

What does a FODMAP diet involve, and is it for me?

There are 3 phases of the FODMAP diet, which include the following:

• The first phase is where high FODMAP foods are strictly eliminated for 2-6 weeks, while gut symptoms are monitored. It is strongly advised this phase is undertaken under the supervision of a FODMAP expert dietitian. If you are looking for a qualified Dietitian to help you through this phase, start here.

• The second phase is where high FODMAP foods are slowly reintroduced to determine tolerance to different FODMAPs. This phase involves trialing all FODMAPs, and should also be undertaken under the expert supervision of a FODMAP trained Dietitian.

• In the third phase, you will work with a Dietitian to achieve a more flexible diet, working with him/her to suit your unique level of tolerance to all the FODMAPs.

The low FODMAP diet has proven the most effective way to relieve symptoms of irritable bowel syndrome (IBS), with up to 85% of patients following the diet experiencing symptom relief. A low FODMAP diet is recommended as a preferred treatment for IBS.

How do I know if I have IBS?

If you struggle with ongoing gut disturbance that is affecting your quality of life, you must make it a priority to visit your doctor.

An IBS diagnosis is made using the Rome IV criteria:

"Recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following criteria:

• Related to defecation
• Associated with a change in frequency of stool

• Associated with a change in form (appearance) of stool." (1)

An IBS diagnosis is made by a doctor. It is advised that diagnosis is followed up by an initial consultation with a Dietitian trained in FODMAP and IBS, to ensure the most evidence-based nutrition care is provided.

Please take a few minutes to watch the below video to learn more about the role of the low FODMAP diet in IBS symptom management:

How do I know if a low FODMAP diet is for me?

Make it a priority to see a Dietitian to get a clinical assessment for the requirement for commencing a low FODMAP diet. Do not make any changes to your diet without first seeking expert advice and supervision.

Looking for a IBS & FODMAP expert practitioner? Click here to find someone near you.

How can I learn more about by gut symptoms?

Click here to learn about the common types of gut conditions. If you are concerned about any of your symptoms, please visit your doctor.

References

Jenifer K Lehrer et al. (2019) What is the Rome IV criteria for diagnosis of irritable bowel syndrome (IBS)? Department of Gastroenterology, Jefferson Health System Torresdale Campus, Philadelphia.

How do FODMAPs Trigger IBS Symptoms? https://www.monashfodmap.com/blog/the-fodmap-grand-tour-down-under-ibs/, The Monash FODMAP Team, Dec 18, 2015.