Treatment

Low FODMAPs diet

Dr John Freeman

Low FODMAPs diet

Medically reviewed by:
Dr John Freeman

When it comes to health, food can significantly impact your body. Since SIBO is one of the most common digestive disorder in first-world countries, it’s essential to know what it is and how it affects you. Food is a common trigger for symptoms like stomach pain and bloating in many people with this condition.

The symptoms of SIBO can be reduced significantly by adhering to a low FODMAPs diet, which restricts the consumption of fermentable carbohydrates. According to research, wheat and beans containing FODMAPs have been linked to various digestive issues, including gas, bloating, abdominal pain, diarrhea, and constipation.

Restricting certain foods can substantially impact SIBO symptoms, and low FODMAPs diets can help with this.

What is a low FODMAP diet, and how does it work

The osmotically active short-chain carbs are nondigestible but force water into the digestive tract. These short-chain carbohydrates have a high degree of resistance to digestion. However, instead of being absorbed into your bloodstream, they make their way to the distal end of your intestine, where most of your gut bacteria may be found.

Your gut bacteria then utilize these carbohydrates as fuel, resulting in the production of hydrogen gas and the development of stomach problems in those who are susceptible to it. FODMAPs also have the additional effect of drawing fluids into your colon, resulting in diarrhea.

Consequently, FODMAPs cause gas, bloating, stomach pain, and altered bowel habits that range from constipation to diarrhea. Many people with SIBO have reported that these carbs can either cause or exacerbate their symptoms.

A wide variety of foods contain varying amounts of FODMAPs. Depending on the type of food, there may be only one or several types. Foods high in the different types of FODMAPs include:

      • Fructose: a simple sugar that can be found in many fruits and vegetables. It also makes up the structure of table sugar and most added sugars, and it is found in many fruits and vegetables.
      • Lactose: a carbohydrate that can be found in dairy products like milk
      • Fructans: are found in many foods, including grains like wheat, spelt, rye and barley.
      • Galatians: found in high levels in legumes
      • Polyols: sugar alcohols like xylitol, sorbitol, maltitol, and mannitol which are found in some fruits and vegetables and are often used as sweeteners.

Result of consuming FODMAPs

The majority of FODMAPs flow through your intestine without being broken down. Therefore, they’re entirely resistant to digestion and are classified as dietary fiber. However, some carbohydrates behave similarly to FODMAPs only in some individuals. Lactose and fructose are examples of such sugars. The general sensitivity to these carbs varies from person to person as well. Scientists believe that they contribute to digestive disorders such as SIBO.

After reaching your colon, FODMAPs are fermented and consumed as fuel by the microorganisms in your intestines. A similar thing occurs when dietary fibers nourish your beneficial gut bacteria, resulting in various health benefits. In contrast, bacteria that feed on FODMAPs tend to produce hydrogen, a different form of gas from that produced by friendly bacteria. Gas, bloating, stomach cramps, discomfort, and constipation are possible side effects. (3rd Party Verified).

Many of these symptoms are caused by intestinal distention, which can also cause your stomach to appear larger than usual. The FODMAPs have also been shown to be osmotically active, which means that they have the potential to suck water into your colon and cause diarrhea.

Food with low FODMAPs

People who are sensitive to FODMAPs eat a lot of fermentable carbs, which can cause symptoms in those who aren’t. This ingredient can be found in many different foods.

The low FODMAP diet allows you to eat a variety of foods. From a regular or high FODMAP diet, the typical daily intake of FODMAP carbs ranges from 0.5 to 1 ounce (15 to 30 grams). However, if you adhere to the low FODMAP diet’s recommendation of eating small, frequent meals, you can consume only 0.08–0.1 ounces (2.5–3 grams) of food per day.

Because many foods are naturally low in FODMAPs, it’s a good thing that there are so many of them. If you’re on a low-FODMAP diet, here are some of the foods you can enjoy:

meats, fish, and eggs (good to eat unless they add wheat or high fructose corn syrup which are high FODMAPs)

all fats and oils

most herbs and spices

nuts and seeds (including seasma seeds, peanuts, macadamia nuts, almonds, and pine nuts but not cashew or pistachios, which are high in FODMAPs)

fruits, such as:

  • unripe bananas
  • blueberries
  • cantaloupe
  • grapefruit
  • grapes
  • kiwi
  • lemons
  • lime
  • mandarins
  • melons (except watermelon)
  • oranges
  • passionfruit
  • raspberries
  • strawberries

sweeteners (stevia, maple syrup, and molasses)

dairy products if they are lactose-free as well as hard cheeses and aged softer varieties (like Camembert and Brie)

vegetables, such as:

  • alfalfa
  • bell peppers
  • bok choy
  • carrots
  • celery
  • chives
  • cucumbers
  • eggplant
  • ginger
  • green beans
  • kale
  • lettuce
  • olives
  • parsnips
  • potatoes
  • radishes
  • spinach
  • spring onion (only green)
  • squash
  • sweet potatoes
  • tomatoes
  • turnips
  • water chestnuts
  • yams
  • zucchini

grains, such as:

  • corn
  • oats
  • quinoa
  • rice
  • sorghum
  • tapioca
  • beverages (water, coffee, tea, etc.)

A low FODMAP diet discourages the consumption of caffeinated beverages such as coffee, black and green teas, even though they are all low FODMAP foods.

If you’re on a FODMAP diet, you should also check the ingredient lists on packaged foods. In addition to prebiotics, fat substitutes, and low-calorie sugar substitutes, food manufacturers may use FODMAPs in their products.

Advantages of Low FODMAPs diet

High-FODMAP foods are restricted on a low-FODMAP diet. According to scientific evidence, people with SIBO may benefit from following this diet.

    1. Digestive problems may be alleviated.
    2. A FODMAP-free diet has been found to reduce both stomach pain and bloating.
    3. An 81 percent and 75 percent greater chance of alleviating stomach pain and bloating were found in four high-quality studies, respectively.
    4. Flatulence, diarrhea, and constipation can be alleviated by following this diet.
    5. A low FODMAP diet is now the first line of therapy for SIBO in many countries.
    6. You may experience a better quality of life. SIBO is associated with sufferers’ lower quality of life. Social interactions and even work performance may be negatively affected by these symptoms.
    7. Studies show that a low-FODMAP diet improves overall health by reducing the severity of symptoms.
    8. Dietary fiber may help alleviate various mental and physical health issues by promoting a sense of well-being by improving digestion.

Who should follow a Low FODMAPs diet

A low-FODMAPS diet is recommended for anyone with a sensitivity to fructose and diosgenin. Not everyone can follow a low FODMAP diet. This diet may cause more harm than good if you haven’t been diagnosed with SIBO.

This is because most FODMAPs are prebiotics, which aid in the growth of good bacteria in the gut—because of this, removing them could have a negative impact on your overall health.

Vitamin and mineral deficiency may result in a significant reduction in the amount of fiber in your diet, which can exacerbate constipation. For this reason, you should only follow this diet under the supervision of a dietitian who has expertise in digestive disorders to ensure adequate nutrition.

If you suffer from SIBO, you might want to take a look at the following diet:

  • have recurring digestive issues
  • failed to benefit from basic dietary recommendations, such as reducing the size and frequency of meals and abstaining from everyday stress triggers like alcohol, caffeinated beverages, spicy foods, and others

Research into other conditions, such as diverticulitis and exercise-induced digestive issues, is needed before a conclusion about the diet. It’s best not to try this diet for the first time while on the road or during a hectic or stressful period. SIBO sufferers may benefit from a low-FODMAP diet, but this should only be done under the guidance of a medical professional and only after exhausting all other options.

Low FODMAP diet: how to follow it

The three stages of a low FODMAP diet are complicated and require careful planning.

Stage 1: The restriction is the first step.

All high FODMAP foods must be strictly avoided during this phase. FODMAP-free eating is a popular fad among those who follow this diet, but this phase should last no longer than four to eight weeks. This is because FODMAPs are critical to gut health.

Within the first week of treatment, some people notice an improvement in their symptoms, while others need the entire eight weeks. Within six weeks, up to 75% of those who follow this diet report an improvement in their symptoms.

If your digestive symptoms are sufficiently alleviated, you can move to stage two.

Stage 2: Reintroduction is the second stage.

You’ll be gradually reintroducing high-FODMAP foods back into your diet during this phase. Depending on the individual, it can last from six to ten weeks, but this is the typical range.

Few people are sensitive to all types of FODMAPs, so it is essential to figure out which ones you can tolerate. It is also crucial to determine how much food contains FODMAPs you can handle — also known as your “threshold level.”

In this step, you’ll go through a 3-day trial period of sampling small amounts of various foods one at a time. While testing each food, it is recommended to maintain a strict low FODMAP diet and wait 2–3 days before reintroducing a new one to avoid additive or crossover effects.

After establishing your minimal tolerance, you can test your patience with higher doses, more frequent intake, and high-FODMAP foods. Just remember to take 2–3 day breaks between each test. It’s best to go through this process with the assistance of a licensed dietitian.

People with SIBO can tolerate small amounts of FODMAPs, unlike people with most food allergies, who must avoid them altogether.

Stage 3: Personalization

By reintroducing well-tolerated FODMAPs while restricting others, the “modified low FODMAP diet” comes to be known as such (9Trusted Source).

When it comes to FODMAPs, the amount and type of FODMAPs are based on the tolerance level you established in stage 2. One size does not fit all, nor is the low FODMAP diet a permanent way of eating. The ultimate goal is to reintroduce high FODMAP foods at a safe level for you to eat.

It is essential to reach this final stage for optimal diet variety and flexibility. Long-term compliance, quality of life, and gut health benefit from these characteristics. Finally, there are three steps to following a low-FODMAP diet. Achieving long-term symptom relief and good health necessitates completing all of the steps.

How would you feel if your symptoms didn’t improve?

For some people with IBS, the low FODMAPs diet isn’t effective. More than a third (35%) of those who try a new diet fail miserably. The good news is that other non-diet therapies can help. If you’d like to look into other options, talk to your doctor.

Take the following steps before you give up on the low FODMAPs diet.

    1. Double-check your ingredient list. FODMAPs are commonly found in packaged foods. Garlic, sorbitol, and xylitol are common culprits that can cause symptoms even at low doses.
    2. Make sure your FODMAP information is accurate. Foods low in FODMAPs can be found all over the internet.
    3. Take into account additional sources of tension or stress in your life. A SIBO patient’s diet isn’t the only factor that can exacerbate the condition. Another major factor is stress. Even if you follow a healthy diet, your symptoms may persist if you are under pressure.

Summary

Some people aren’t able to benefit from a low FODMAPs diet. However, a few common errors should be checked out before attempting any other therapies.

In the end, Low FODMAPs diet may significantly impact IBS patients’ digestive symptoms. To see results, you must go through a three-stage process that can take up to eight weeks, and not everyone with IBS will benefit from it.

Because FODMAPs are prebiotics that supports gut health, this diet may do more harm than good if you don’t need it. FODMAP-rich foods are important dietary sources of vitamins and minerals, as is clear from the list above. However, if you suffer from SIBO, this diet could profoundly affect your quality of life.