FODMAPs are a group of short-chain carbohydrates found in everyday foods such as pasta, bread, onions, garlic, beans, milk, apples, honey and mangoes. FODMAPs are commonly malabsorbed in the small intestine, causing uncomfortable symptoms such as abdominal pain, bloating, diarrhea and/or constipation in those suffering with irritable bowel syndrome (IBS).Download Here
The Low FODMAP diet was first defined in 2004 by researchers at Monash University, in Australia. It categorizes FODMAP foods that trigger gastrointestinal problems according to the type of carbohydrate they contain, i.e., Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.
The Low FODMAP diet is the go-to dietary intervention for those suffering with IBS. 45 million Americans (1 billion worldwide) suffer from IBS. There are 15 times more people who suffer from IBS than celiac disease which gave rise to the gluten-free diet. Studies show that following a Low FODMAP diet can provide complete symptom relief for up to 75% of people suffering from IBS, which is characterized by recurrent episodes of lower abdominal pain, bloating, diarrhea and/or constipation.
First, take a deep breath! Seriously…stress can trigger tummy trouble, so try not to get overwhelmed before you even start the low FODMAP diet.
Next, contact a knowledgeable dietitian to help guide you through the process. This may seem indulgent or unnecessary considering how much information is available online, but it will ensure that you are following the three phases of the diet correctly. If you feel confident that you can go it alone, try to wait until you have time to mentally and physically prepare yourself. You’ll be much more successful if you understand the low FODMAP concept, are aware of which IBS foods to avoid, have collected some good low FODMAP recipes, and have stocked your kitchen with low FODMAP foods.
Maybe, maybe not. Persistent symptoms are often due to dietary indiscretion, either intentional or not. If you are eating too many high FODMAP foods, IBS foods to avoid, or frequent, large portions of low FODMAP foods, then the diet is obviously not the culprit. Detailed food records should be able to reveal whether the problem is due to dietary “slippage,” or if something else it to blame. A dietitian with expertise in the Low FODMAP diet and foods for IBS can be very helpful with this, and may also be able to offer additional remedies or a different approach. If nothing seems to be helping, you may want to see your gastroenterologist again, or seek a second opinion, to verify the original diagnosis of IBS.
A Low FODMAP elimination diet is not one diet, even though it’s often portrayed that way. It's one of three distinct and equally important parts of a complete low FODMAP diet.
The FODMAP Elimination diet phase, which is what most people think of when they hear the term low FODMAP diet, was never meant to be followed indefinitely. After you have achieved symptom relief during this phase, it’s time to systematically test one FODMAP group at time in order to discover which FODMAPs are problematic for you; this is the Reintroduction/ Challenge phase.
The Integration phase is the diet you will follow “forever.” It will be uniquely yours; it may change over time, and it will most certainly contain some high FODMAP foods. The type and amount of these foods varies from person to person depending on a number of factors, including which foods provoked symptoms during the Challenge phase.
Elimination: During this phase, high FODMAP foods are avoided until symptoms are eliminated or significantly reduced. This can take anywhere from two to six weeks, depending on severity of symptoms and ability to adhere to the FODMAP elimination diet.
Challenge/Reintroduction: In the challenge/reintroduction phase, High FODMAP foods from each group are added back from the initial FODMAP elimination diet step in a controlled fashion. There are many ways to approach this, but it is important to challenge only one type of FODMAP at a time. For instance, when testing oligosaccharides, the rest of your diet should not contain other FODMAPs or it will be impossible to tell which one is responsible for your symptoms.
Integration: Once you have determined which FODMAP group(s) are a problem for you, it’s time to integrate what you’ve learned into your everyday life. It's important to remember that your ultimate goal is to include as many nutritious FODMAP foods in your diet as you can, because total avoidance is neither healthy nor practical.
In some ways, this is the hardest phase of all, because there’s no one roadmap that will be right for everyone. The good news is, there are more low FODMAP recipes, packaged foods, and other resources available to help you on your journey than ever before.
For more detailed information about the low FODMAP diet, we've broken down each phase in detail here.
This can be a concern (especially for people who tend toward constipation) because many fiber-rich foods are also high in FODMAPs. That said, as long as you know where to look, it is possible to get your recommended 25 to 30 grams of fiber per day while also keeping a lid on your FODMAP intake. Here are some good options: