Martha Gonzalez RD, LD, CLC
Dietitian, Blanchard Valley Health System
Irritable Bowel Syndrome, or IBS, affects 10-15 percent of the population in the United States, primarily women. It is multiple digestive symptoms that together form a syndrome. The symptoms linked to IBS include abdominal pain or discomfort, altered stool form or frequency, bloating, gas, etc. It is also the most common reason for being referred to a specialist. There are typically four types of IBS: IBS-C, which is IBS with constipation, IBS-D, which is IBS with diarrhea, IBS-M which stands for “mixed,” meaning IBS with both diarrhea and constipation, and IBS-U (unsubtyped). People who are suffering from IBS can tell you that this syndrome is nothing to joke about. So the question is, how do we treat it?
The treatment for someone suffering from IBS has typically been putting them on a high fiber diet with lots of fluids. This diet may work for some, however there is new evidence suggesting that FODMAPs can play a significant role in the symptoms of IBS. What is a FODMAP? FODMAP is an acronym that stands for: Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (Monash Universty, 2015). Basically, FODMAPs is an umbrella term that includes simple sugars that are poorly absorbed and rapidly fermented by the gut. What this means is that when you consume foods that are high in FODMAPs, once they get to the intestines, they draw in water, increasing gas production. This leads to the classic symptoms of IBS: bloating, pain, distension, constipation and/or diarrhea.
Using this information, experts have put together a “FODMAP elimination diet” that can be followed for a temporary time period. The diet is simple: avoid foods that are high in FODMAPs for a period of 2-12 weeks while focusing on foods that are low in FODMAPs. After this, one can slowly reintroduce high FODMAP foods back into their diet. It would not be good to avoid high FODMAP foods for longer than 12 weeks, as this can cause permanent damage or changes to your gut. Of course, this diet is easier said than done, as a lot of the foods that we are surrounded by on a daily basis are high FODMAP foods. Some examples include: wheat products, apples, onions and garlic. Some examples of low FODMAP foods are: gluten free breads, corn tortillas, peanut butter, oatmeal and citrus fruits like oranges.
Monash University in Australia has done a substantial amount of research on this topic. They have actually come out with an app you can purchase which has an extensive database of foods that are high and low in FODMAPs including the difference between brands. There is also a lot of information online about high vs. low FODMAP foods. If you or anyone you know is suffering from IBS and feels like they have tried everything to relieve their symptoms with no success, it may be time to try the FODMAP elimination diet!