Gavin Guard, Medical Director
A Proven Diet for Your Gut Issues
Updated: Jan 23, 2022
IBS is a condition characterized by bloating, gas, abdominal pain, diarrhea and/or constipation. It effects 10-20% of the American population.
FODMAPS are fermentable carbohydrates found in “healthy” food such as broccoli, onions, apples, wheat, garlic, etc.
A diet low in FODMAPs has been shown to improve symptoms in those with IBS.
70% of those with IBS will respond favorably to a low FODMAP diet.
A low FODMAP diet may be an important first step to improving your gut health.
What is IBS?
IBS stands for irritable bowel syndrome. It affects 10-20% of the population, especially younger women. It’s characterized by bloating, abdominal distention and pain, diarrhea and/or constipation, and gas. As more light is being shed on this condition, clinicians and researchers are finding out how much of a quality of life issue this is for those who are suffering from it. Just imagine trying to work at your 9-5 job and having to excuse yourself to go to the bathroom every 30 minutes? It’s going to be hard to get a promotion at that job, let alone enjoy your work.
If you were to do a colonoscopy on someone with IBS, you wouldn’t find anything since there are no visual pathologic changes found in this disease. However, research is finding a couple different processes involved in IBS such as changes in the bacteria that live in your gut, alterations in how fast your gut pushes food through it, how sensitive your gut is to different stimuli, low grade inflammation, and a deranged gut-brain connection.
What are FODMAPs?
FODMAPs stand for fermentable oligo-, di-, mono-saccharides, and polyols. Can you see why they abbreviated it? These are carbohydrates found in foods that are readily fermented by our gut bacteria.
FODMAPs are found in so called “healthy” foods such as certain vegetables (broccoli, asparagus, onions), fruit (honey, dates, oranges, cherries), grains (wheat, barley), and dairy (milk, yogurt) just to name a few.
These are foods that health experts are telling us on T.V to eat more of. You could imagine how frustrating it is to be having these gut issues, eat more of these foods in attempt to alleviate your symptoms, only to have more issues.
It is thought that FODMAPs may worsen IBS symptoms via a few different mechanisms. These include pulling water into the inside of the gut that leads to changes in how fast the gut moves. Also, these foods may be rapidly fermented (digested) by the bacteria that live in our gut. On top of that, if you have a condition called small intestinal bacterial overgrowth (SIBO) where you have too much or the wrong kind of bacteria living in your small intestine, FODMAPs may pose an even greater problem. Your clinician can assess if you have SIBO by ordering a breath test.
Can a low FODMAP diet improve IBS symptoms?
You are probably wondering by now if a diet low in FODMAPs may be a good tool for someone with IBS. Fortunately, we have two large studies that point to the answer. In fact, these two studies are called meta-analysis which are a study that looks at multiple other studies.
One meta-analysis pulled together 10 studies examining the effect of the low FODMAP diet in those with IBS. The diet duration was anywhere from 1-3 months. Compared to the control diets, the low FODMAP diet showed superiority in symptoms improvement.
In the author’s words they state, “Our meta-analysis is the first to provide unambiguous, high-level evidence for the superiority of a low-FODAMAP diet to a standard dietary approach in the improvement of general symptoms and well-being among patients with IBS.” That’s a strong endorsement!
In yet another meta-analysis, this time examining 12 studies, a low FODMAP diet showed improvement in abdominal pain, bloating, and stool frequency compared to a control diet.
The Bottom Line
If you recognize some of these gut issues discussed as your own, then a low FODMAP diet may be a good idea as it has been proven to be both practical and effective in the literature.
My take is that someone who may be eating a poorer-quality diet may benefit more by focusing first on the quality of their food with something like a Paleo style diet. If this doesn’t improve their gut issues, then a low FODMAP diet would be a good next step. If you are someone that already eats “healthy”, then you could potentially start with a low FODMAP diet.
This diet requires a certain level of oversight and monitoring so having someone to guide you is important. I don’t believe a low FODMAP diet should be an indefinite tactic. This is because addressing other factors such as chronic infections, food sensitivities, autoimmunity, dysfunctional gut-brain connection could be the underlying cause of your gut symptoms. Identifying and fixing these underlying issues is a must for anyone who wants lasting change in their gut health.
I hope you found this information useful and helpful in your journey back to a healthier and happier life.
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· Altobelli, Emma et al. “Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis.” Nutrients vol. 9,9 940. 26 Aug. 2017, doi:10.3390/nu9090940
· Varjú, Péter et al. “Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies.” PloS one vol. 12,8 e0182942. 14 Aug. 2017, doi:10.1371/journal.pone.0182942