Reverse your IBS symptoms by making changes in what you eat!

If you have been diagnosed with IBS and want to reverse your symptoms without medications, then stay with us. We have got you covered. This article is your one-stop place for everything you need to know about IBS and a low FODMAP diet!

FODMAP is a specialized diet formulated by researchers in the Monash university Researchers came up with a diet low in FODMAP foods to avoid IBS symptoms.

The word FODMAP might be new for you, but at the end of this article, you would be able to make changes in your daily food intake without any other guidance.

Starting with IBS, Irritable bowel syndrome or IBS 1 is a chronic GIT disorder marked by the following symptoms:

• Bloating
• Flatulence
• diarrhea
• abdominal pain

Food is the main trigger for these symptoms. IBS affects your life quality and makes your everyday living miserable, but goodness is that It does not lead to cancer or other lethal diseases.

How does food trigger IBS?

Certain foods have small chain carbohydrates that are not readily absorbed by the small intestine. When this food reaches the large intestine, these carbohydrates are fermented by colon bacteria. Fermentation produces gas that causes distension 2 of the already sensitive colon. Colon gets triggered, and this results in the manifestation of symptoms.

If you have been noticing any symptoms of IBS, we advise you to visit a doctor and not self-diagnose yourself. Self-diagnosis may cause more harm than good.

What is FODMAP?

FODMAP3 is an acronym for Fermentable Oligosaccharide, Disaccharide, Monosaccharide And, Polyols. These are small-chain carbohydrates that are poorly absorbed in the intestine, leading to abdominal discomfort and other symptoms of IBS mentioned above.

Fermentable: Fermentation is the enzymatic decomposition of carbohydrates by gut microbes in the large bowel. Fermentation produces gas.
Oligosaccharides: These are carbohydrates containing three or more than three subunits of monosaccharides. Fructans and Galacto-oligosaccharides GOS are fermentable oligosaccharides. They are present in wheat, rye, onions, garlic and, legumes.

Monosaccharides: The simplest carbohydrates containing glucose and fructose are monosaccharides. Fructose is a fermentable monosaccharide. You can find  Fructose in honey, apples, high fructose corn syrups, watermelon, peaches, plums, and many other fruits.

Polyols:  Carbohydrate alcohols like sorbitol or mannitol are polls. They are naturally found in some fruits and vegetables and artificially present in sweeteners or chewing gums.

How does the FODMAP diet works?

It works by eliminating or reducing the FODMAP food items from the daily diet. Switching to a low

FODMAP diet reduces the IBS symptoms in almost 80% of people. If you are among that 20% of people who don’t enjoy IBS free life after adopting a low FODMAP diet, then you should switch to medications.

It’s not a random diet to be followed in a haphazard manner. FODMAP diet works in three 4 Phases:

 

 

1. Restriction                                     2. Reintroduction                              3. Personalization

1.       Restriction Phase:

This is the first phase of a classical FODMAP diet. In this phase, all the high FODMAP foods are strictly restricted. This is not a lifetime restriction. This stage should only last for 3-8 weeks.

If you restrict FODMAP foods forever, you will deprive your body of essential nutrients, making yourself vulnerable to many other diseases and general mineral deficiencies. You may end up being malnourished with bone and joints degeneration. FODMAP foods are rich in probiotics that are needed for a healthy gut.

Most of the people report that they had reduced or no symptoms at the ending of the restriction phase.

2.   Reintroduction Phase:

The next step is to introduce some high FODMAP foods in the diet slowly. It is advisable to have a food journal or diary and note down daily food intake on that diary.

Begin with one food at a time with only one fermentable group for three days with that food included in each meal. Notice any symptoms or discomfort after eating that particular food. Also, mention the amount of food. Portion size also plays a role in quantifying the food that triggers symptoms.

You can take the help of an app like the Monash University FODMAP app that helps you record all your food and uses a traffic signal system (red light, green light) for foods to be avoided or eaten on the FODMAP diet.

You must note in your diary about high FODMAP food tolerated by you and food that aggravates your symptoms along with the quantity of food. You may take this diary with you to your next appointment with your doctor.

3.   Personalization:

This step is also known as an adapted or modified FODMAP diet. Once you have identified the main culprits responsible for your IBS symptoms in the reintroduction phase, you can formulate a personalized diet plan for yourself. You can take help from our table mentioned below about foods to eat and avoid.

High FODMAP food items vs. Low FODMAP food items:

Now is the time we must discuss certain food rich in FODMAP or low in FODMAP. Once you have learned how your FODMAP diet works, you are ready to dive into classifying your food according to FODMAP carbohydrates content.

Following is a simple table for you to identify what to eat and what to avoid on a LOW FODMAP diet:

Food Items	High FODMAP	LOW FODMAP
Vegetables	Garlic, cauliflower, onion, artichokes, peas, spring onions, mushrooms	Eggplant, beans, carrot, cucumber, tomato, potato, zucchini, capsicum, cabbage, lettuce, broccoli, beansprouts, baby spinach, red or green chilies, beetroot, kale, olives, ginger, radish, turnip, yam, water chestnuts, pumpkin, celery, sweet potato,
Fruits	Apple, pear, plum, watermelon, apricot, mango, peach, nectarines, cherries, grapefruit, plum, blueberries, dried fruit.	Orange, pineapple, grapes, coconut, unripe banana, raspberries, strawberry, mandarins, honeydew melon, kiwi fruit, rock-melon, passion fruit
Milk & Dairy	Cow’s milk, soft cheese ( cream cheese, mozzarella cheese, cheddar cheese, parmesan cheese), custard, evaporated milk powder, condensed milk, soy milk, yogurt, buttermilk, butter, deli ghee.	Almond milk, coconut milk, hard cheeses, feta cheese, lactose-free milk.
Bread & cereals	Wheat/multi-grain/barley-based bread, pasta, tortillas, biscuits, doughs, snacks, cookies or, cereals.	Corn flakes, oats, sourdough bread, wheat/rye/barley free bread, quinoa, rice, rice cakes, rice/corn-based pasta
Protein	Legumes, pulses, some marinated meat/ poultry/seafood, processed meats, chickpeas.	Eggs, firm Tofu, plain cooked meat/poultry/seafood.
Sweeteners and Confectionery	High fructose corn syrup, fructose, sugar-free sweets, honey	Maple syrup, Rice malt syrup, table sugar
Nuts and Seeds	Cashew, pistachio	Peanuts, chia seeds, flax seeds, pumpkin seeds, macadamia nuts, walnuts.

Is Gluten a FODMAP?

Technically No! Gluten is a protein found in wheat, but it’s not a FODMAP. FODMAPS are carbohydrates. Gluten usually coexists with high FODMAP ingredients like wheat in pasta and bread so, It must be avoided to save yourself from abdominal distress.

How to formulate a low FODMAP diet plan for yourself?

Take a look at the table above. You will get an idea about what to eat and what not to. Prepare a grocery list accordingly and buy things beforehand. Download FODMAP diet app five on your smartphone or get a soft copy of the Monash University FODMAP directory booklet.

Clear your fridge and pantry from high FODMAP foods to curb your temptations. Familiarize yourself with ingredients that used in low FODMAP cooking. Find alternatives for yourself when dining out in a restaurant. Here are some useful guidelines apart from the food lists:

– Beware of your sauce when cooking! Garlic and onion 6 are a staple of every sauce, from ketchup to pizza sauce to teriyaki sauce. Dried garlic has more fermentable carbs as compared to fresh garlic. It could be a hidden ingredient in your food. Use ginger in place of garlic. It’s FODMAP friendly and gives a nice aroma and taste to your favorite foods.

• Chose your sweetener wisely: Fructose is a high FODMAP sweetener found in some fruits naturally, while glucose is low FODMAP. Use maple syrup, glucose, table sugar, Stevia, Aspartame, Saccharin as your Avoid xylitol, erythritol and, honey at all costs.

• Pre-soak your legumes and chickpeas for seven to eight hours and don’t exceed 1/4 cup at a

• Read food labels Check for hidden, notorious food items like fructose syrup, sorbitol in chewing gums or, wheat/ rye in certain foods, milk chocolates.

• If you are a vegetarian, it can be hard for you to make choices for a protein source. Try Tofu, hard cheeses, eggs, canned lentils, or the pre-soak method for

Does the Low FODMAP diet actually work?

A study published in 2016 7 showed 70% of individuals getting relief from a low FODMAP diet. Another study 8, consisting of six randomized controlled trials comparing low FODMAP diet with placebo approaches, indicated high efficacy in patients with IBS. It supported the notion to make low FODMAP diet first-line therapy for IBS patients.

Low FODMAP diet has been proven for:

• Lowering the IBS symptoms like bloating, flatulence, diarrhea as well as abdominal Study

9 shows improvement in stomach pain and blasting by 81% and 75%, respectively.

• Improving life quality and energy levels in IBS 10

Make sure to do this before starting a low FODMAP diet:

Get yourself diagnosed by a registered practitioner doctor. There are no specific lab tests for IBS but ruling out differential diagnosis is very important.

IBS can be mistaken for Celiac disease, Inflammatory bowel disease, Crohn’s disease, colon cancer. 11 Once you rule out these diseases, IBS diagnosis is made following official IBS diagnosis criteria- you must fulfill all three to get diagnosed with IBS.

Low FODMAP Oils and Condiments:

Here’s what you can get for your pantry in a supermarket to make for alternative meals:

Condiments: Turmeric, ginger, mustard, basil, lemongrass, saffron, all peppers, fenugreek, chives, soy sauce.

Oils: coconut oil, olive oil.

Beverages: black tea, coffee, green tea, peppermint chai

Low FODMAP food swaps:

• Mashed bananas, pineapples, pureed grapes in place of Make a banana pie instead of apple pie for your next dessert craving!
• Brown sugar in place of
• Rice milk, Soy milk, Hemp milk, Almond milk, Coconut milk for regular
• Sourdough bread instead of normal wheat Sourdough bread is richer in flavor and nutrients than ordinary bread.
• Garlic infused oil in place of Fry garlic in medium heated oil, remove it before adding other ingredients.
• Spring onion tips or Chives in place of onions

The Bottom Line:

A Low FODMAP diet is the best non-pharmaceutical treatment with surprising results for IBS. Before starting this diet, make sure you are clinically diagnosed with IBS.

If you start this diet without being an IBS patient, you can do more harm to your body than good. FODMAP foods are packed with nutrients and probiotics for a healthy gut.

This diet consists of three phases over a time of at least six months. FODMAP diet requires patience and consistency for good results. We advise you to have a food journal or an app on your smartphones like “Monash university FODMAP diet app” to record your food intake.

Look for hidden ingredients, sauces and, condiments with high FODMAD culprit foods. Once you begin this diet, 70% chances are that you will get relief from your abdominal distress symptoms.

References and Citations:

2. https://www.health.harvard.edu/a_to_z/irritable-bowel-syndrome-ibs-a-to- z#:~:text=Irritable%20bowel%20syndrome%20(IBS)%20is,gassiness

3. Anamaria Cozma-Petruţ, Felicia Loghin, Doina Miere, and Dan Lucian Dumitraşcu World J 2017 Jun 7; 23(21): 3771–3783.Published online 2017 Jun 7PMCID: PMC546706 PMID: 28638217

3. https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you- need-to-know

4. https://www.monashfodmap.com/blog/3-phases-low-fodmap-diet/
5. https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/

6. Iacovou M, Tan V, Muir JG, Gibson The Low FODMAP Diet and Its Application in East and Southeast Asia. J Neurogastroenterol Motil. 2015 Oct 1;21(4):459-70. DOI: 10.5056/jnm15111. PMID: 26350937; PMCID: PMC4622128.

7. Wathsala S Nanayakkara,1 Paula ML Skidmore Wathsala Clin Exp 2016; 9: 131– 142.

Published online 2016 Jun 17. doi: 10.2147/CEG.S86798 PMCID: PMC4918736

PMID: 27382323

8. Gibson The evidence base for the efficacy of the low FODMAP diet in irritable bowel syndrome: is it ready for prime time as first-line therapy? J Gastroenterol Hepatol. 2017 Mar;32 Suppl 1:32-35. DOI: 10.1111/jgh.13693. PMID: 28244668.

9. Marsh A, Eslick EM, Eslick Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016 Apr;55(3):897-906. DOI: 10.1007/s00394-015-0922-1. Epub 2015 May 17. PMID: 25982757.

10. Staudacher HM, Lomer MC, Anderson JL, Barrett JS, Muir JG, Irving PM, Whelan Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr. 2012 Aug;142(8):1510-8. DOI: 10.3945/jn.112.159285. Epub 2012 Jun 27. PMID: 22739368.

11. Diagnosis and management of irritable bowel syndrome in adults in primary care: summary of NICE BMJ. 2015 Mar 3;350:h1216. DOI: 10.1136/BMJ.h1216. Erratum for: BMJ. 2008 Mar 8;336(7643):556-8. PMID: 25736443.