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    The FODMAP Diet- Could it help you?

    FODMAP Diet: What is it and how can it help you?

    First, a little information about Irritable Bowel Syndrome

    Irritable Bowel Syndrome is a functional bowel disorder of the gastrointestinal (GI) tract characterized by recurrent abdominal pain and discomfort accompanied by alterations in bowel function, diarrhea, constipation or a combination of both, typically over months or years.

    The cause of IBS is unknown.

    A diagnosis of Irritable Bowel Syndrome has been reported by approximately 15% of adults in the United States, and symptoms of IBS are responsible for over 3.5 million yearly visits to physicians. Research suggests that Irritable Bowel Syndrome is one of the most common functional GI disorders and is one of the most common reasons for consultation with a primary care physician or gastroenterologist.

    Despite IBS showing to have a significant negative impact on health-related quality of life, only 30% of people with IBS symptoms seek medical attention.

    Irritable Bowel Syndrome is found predominantly in women in a 2:1 ratio versus men.

    There are several subtypes of IBS.
    • IBS-D: Diarrhea predominant
    • IBS-C: Constipation predominant
    • IBS-A or IBS-M: Alternating, or mixed, between constipation and diarrhea
    • IBS-PI: Post Infectious IBS
    • PDV-IBS: Post Diverticulitis IBS

    What is the low FODMAP diet and how does it help with IBS?

    FODMAP is an acronym for Fermentable Oligo-, Di-, and Mono-saccharides And Polyols. The FODMAP diet is more properly called the Low FODMAPs diet, because the idea is to limit your consumption of these nutrients.

    FODMAPs are carbohydrates (sugars) that are found in foods. Not all carbohydrates
    are considered FODMAPs.

    The FODMAPs in the diet are:
    • Fructose (fruits, honey, high fructose corn syrup (HFCS), etc)
    • Lactose (dairy)
    • Fructans (wheat, onion, garlic, etc)(fructans are also known as inulin)
    • Galactans (beans, lentils, legumes such as soy, etc)
    • Polyols (sweeteners containing sorbitol, mannitol, xylitol, maltitol, stone fruits
      such as avocado, apricots, cherries, nectarines, peaches, plums, etc)

    FODMAPs are osmotic (means they pull water into the intestinal tract), may not be
    digested or absorbed well and could be fermented upon by bacteria in the intestinal
    tract when eaten in excess.

    Symptoms of gas, bloating, cramping and/or diarrhea may occur in those who could be
    sensitive to the effects of FODMAPs. A low FODMAP diet may help reduce symptoms,
    which will limit foods high in fructose, lactose, fructans, galactans and polyols.

    The low FODMAP diet is often used in those with irritable bowel syndrome (IBS). The
    diet also has potential use in those with similar symptoms arising from other digestive
    disorders such as inflammatory bowel disease.

    This diet will also limit fiber as some high fiber foods have also high amounts of
    FODMAPs. (Fiber is a component of complex carbohydrates that the body cannot
    digest, found in plant based foods such as beans, fruits, vegetables, whole grains, etc)

    Who should try the low FODMAP diet and long term considerations

    In my opinion, you should try the low FODMAP diet if you suffer from symptoms of IBS that canít be resolved by other means such as medication (or if you donít want to take medication)

    The low FODMAP diet can be a pretty considerable lifestyle change for most people considering the foods you will need to eliminate. When it comes to therapeutic elimination diets as this your goal should be to eat the widest variety of foods that you can tolerate. Some people will find that they can tolerate some foods and not others.

    Hereís the protocol that I recommend for my patients
    • Begin keeping a detailed food and symptom journal of your IBS symptoms.
    • Trial an elimination of FODMAPS for 6 weeks.
    • If the low FODMAP diet gives you relief after that time, start reintroducing foods one group at a time at a rate of 1 food type (such as lactose) every week.
    • Continue to make notes of symptoms as you reintroduce food. Once youíve gone through each food type, you can determine what you can tolerate and what you canít

    Additional strategies for reducing IBS symptoms

    In conjunction (or in replacement) with the low FODMAP diet I recommend considering the following supplements and methods:
    Peppermint oil
    Enteric coated peppermint capsules have been shown in research to significantly improve the symptoms of IBS by mechanism of GI motility regulation. 2-3 capsules per day of around 200-300mg is typically a tolerated dose.

    Lavender oil and Fish oil
    IBS can also be exacerbated by stress. Fish oil with a higher amount of EPA has been shown to help with depression (plus a whole lot of other benefits). Also, lavender oil is a viable and non habit forming treatment of generalized anxiety disorder (comparable to a low dose of ********** in supporting research)

    Prunes
    Prunes are a natural laxative and may help if you experience a constipation type of IBS.

    Calcium
    Calcium can sometimes make people constipated. So by that nature, it has helped some patients that have had issues with a diarrhea type IBS.

    Probiotics
    I recommend a supplement that has multiple strains of bacterial flora.

    Fiber
    Psyllium husk is a stool bulking agent that is low in gas formation in the gut. Most people with IBS seem to tolerate it just fine.

    Over the counter and prescription medications
    Thinks like GI motility regulators, laxatives, and anti diarrhea meds are available and should be discussed with your physician.

    Resources

    This list is in no particular order and is by no means extensive.

    General IBS info http://www.ibsgroup.org/
    FODMAP protocol http://stanfordhospital.org/digestiv...et-Handout.pdf
    Peppermint oil for IBS http://www.ncbi.nlm.nih.gov/pubmed/24100754
    Lavender oil for anxiety http://www.ncbi.nlm.nih.gov/pubmed/24456909
    Fish oil for depression http://www.ncbi.nlm.nih.gov/pubmed/15664306
    FODMAP research
    http://www.ncbi.nlm.nih.gov/pubmed/20136989
    http://www.ncbi.nlm.nih.gov/pubmed/20659225
    http://www.ncbi.nlm.nih.gov/pubmed/20659218
    Probiotics and IBS http://www.ncbi.nlm.nih.gov/pubmed/16633134
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  2. #2
    THE OG PBateman2's Avatar
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    Decent read. Don't have IBS but definitely good to know.
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