When to try the low FODMAP diet for Irritable Bowel Syndrome

If you have irritable bowel syndrome (IBS) and have done a quick internet search for dietary strategies, I’m going to bet that you’ve come across a number of different dietary approaches including the low FODMAP diet that claim to give relief to your digestive woes. By far, the most studied, and agreed upon approach, is the Low FODMAP elimination diet.

The low FODMAP diet came about through research at Monash University in Australia. They discovered that certain short chain carbohydrates can trigger symptoms in those with sensitive bowels.

FODMAP is an acronym for Fermentable Oligosaccharide, Disaccharide, Monosaccharide and Polyols (aren’t you glad they shortened it to FODMAP?).

Essentially, the O, D, M and P in FODMAP are types of carbohydrates naturally found in food that get fermented by the bacteria in our gut, causing symptoms such as gas, bloating, abdominal distention and pain, constipation and/or diarrhea. These FODMAPs aren’t the cause of IBS, nor do they cause any physical damage, but when you have a sensitive gut they can elicit symptoms.

The low FODMAP diet consists of three separate stages – an elimination phase where major sources of FODMAPs are avoided for 2-6 weeks, a challenge phase where each FODMAP group is tested to see if it triggers symptoms, and finally a personalization phase where you reintroduce FODMAPs that were tolerated well, along with small portions of those that you tolerate in limited amounts.

While this elimination diet can reduce troublesome IBS symptoms in about 70% of people, it doesn’t need to be the first thing you try. Actually, as a digestive health dietitian, I’d much rather you try a few other strategies first.

One reason that this diet shouldn’t be the first line of attack is that this diet is complicated. The elimination portion of the low FODMAP diet excludes a large number of foods including garlic, onions, wheat, legumes, apples, pears, cauliflower, mushrooms, honey, and lactose-containing dairy, just to name a few. For many, embarking on this diet means a complete dietary overhaul. It takes learning, planning and lots of patience. Additionally, if your social life involves a restaurants, that’ll take a hit, too. Navigating the low FODMAP diet in restaurants definitely takes some extra effort. That’s not to say that it’s an impossible diet to follow, because it certainly is doable for many people, it’s just that it’s a lot of effort to undertake, especially if there are simpler approaches that may settle symptoms just as well.

Also for those with limited cooking skills, or who travel frequently, have a family member (or several) with differing dietary needs to cook for, or have a history of an eating disorder, this diet may not be appropriate or feasible at this time.

So, if I don’t recommend starting off right away with the low FODMAP diet elimination, then what?

The following are some simple strategies to try before you attempt the low FODMAP diet.

Eat regularly.
I can’t tell you the number of times I’ve seen erratic eating patterns settle when clients start eating regularly. It seems simple but your bowels really do like regular and consistent meals. Eating regularly also means that you’re less likely to overeat at one time which, for some, aggravates IBS symptoms. Aim to eat every 3-5 hours, whether it’s a snack or a full meal.

Get adequate fiber.
Fiber is important for bowel health. With IBS it’s important to get adequate fiber, and not just enough fiber, the right type of fiber for your specific needs. Depending on whether you predominantly struggle with diarrhea or constipation, the type of fiber that will benefit you, either soluble or insoluble, the most will differ.

For those with diarrhea, getting more foods with soluble fiber will be beneficial, such as oats, chia seeds, carrots, oranges and squash. For those who struggle more with constipation, a mix of soluble and insoluble fiber is actually beneficial. Good sources of insoluble fiber include brown rice, quinoa, nuts and seeds, and fruits and veggies (with peel on, preferably).

Just for a reference, women need 25 grams of fiber per day while men need about 38 grams. If you’re wondering where you stand on your fiber intake, you could check in with a registered dietitian.

Get rid of gut irritants.
Certain foods, such as caffeine, alcohol, energy drinks, and spicy foods, are known to irritate the gut. If you consume these, then perhaps experiment with cutting down on them for a while to see if these foods play a role in manifesting your symptoms.

If you can’t live without your morning coffee, try limiting it to a single cup. Alternatively, you could try switching to a lower caffeine product like green tea.

Avoid large high fat meals.
If you have the tendency to eat large, high fat meals this may be triggering your IBS. Perhaps it’s fried foods, cheesy meals, or cream-based sauces that are unknowingly causing you to experience unpleasant digestive symptoms. Try backing off of those high fat meals for a bit to see if you notice a difference in the symptoms you experience.

It’s important to note that even in you find that high fat meals trigger your IBS, it’s generally the amount of fat at once and not the presence of any fat. You can have higher fat food items because we all need some fat in our diet, it’s just wise to have them in smaller amounts.

Check what’s sweetening your food and drinks.
If you tend to gravitate towards sweet items, it’s a good idea to take a look to see if this is what is contributing to your digestive symptoms. Sweeteners such as sugar alcohols (i.e. sortbitol, xylitol, mannitol), high fructose corn syrup (or just fructose), honey and agave nectar can all cause unpleasant symptoms in sensitive individuals.

If you can’t go without some sweetness in your life, some non-symptom inducing sweeteners include table sugar and maple syrup.

Manage stress.
While this isn’t a “food strategy”, managing your stress level is a very important aspect of IBS management. For many people there is a direct connection between their stress and anxiety and IBS symptoms. Since everyone’s stressors are different, how you management your stress is very individualized.

A first step in managing stress is identifying the cause of your stress. Once identified, you’ll be in a better position to find possible solutions.

As you can see, there are a few different strategies that can be attempted before committing to the low FODMAP diet. If you need some help with sorting out whether or not what you are eating is impacting your IBS symptoms, or to assess whether the low FODMAP diet is something you are ready for, contact us as we can help.

For more information on dietitian nutrition counseling for digestion issues such as IBS (irritable bowel syndrome), the low FODMAP diet, constipation, diarrhea, celiac disease, crohn’s disease, colitis and other digestive health concerns CONTACT US and book an appointment with Calgary dietitian Kate Chury. Kate can see you in our local Calgary nutritionist office or by phone or video conferencing for virtual dietitian nutrition counseling.

Read more about our Dietitian Calgary and Online Nutritionist nutrition counseling programs here: NUTRITION COUNSELING