What is IBS?
Irritable bowel syndrome (IBS) is a chronic disorder that affects the lower GI tract, including the small intestine and large intestine (colon). It is characterized by symptoms after eating certain foods such as abdominal pain, cramping, bloating, gas, constipation, and diarrhea, or alternating between both.
The exact cause of IBS is not well understood, but there are several factors that can contribute to its development. These include changes in gut motility, hypersensitivity to certain foods or stress, and an imbalance in the gut microbiome. There are some factors that increase risk of IBS, such as being a woman, and history of gastroenteritis and antibiotic usage.
IBS can be a challenging but not impossible condition to manage, and treatment is not one-size-fits-all. Treatment can involve a combination of dietary changes, stress management, and medication. The first two, dietary changes and stress management, are huge for management. But right now I will provide education on the low FODMAP diet, as that is what I provide for patients.
What is a low FODMAP diet?
I find there are a LOT of misconceptions about what a low FODMAP diet is. First, let’s explain what FODMAPS are.
FODMAPs are types of carbohydrate found in certain foods. The acronym stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. It is not intuitive what foods contain certain FODMAPS- they are seemingly random. For example, an example of a FODMAP is mannitol. This is found in portobello mushrooms and cauliflower, two unrelated foods. Another example of a FODMAP is lactose. This is found in milk and yogurt, but not cottage and ricotta cheeses. You can see how trialing a low FODMAP diet difficult if not under the care of a qualified healthcare professional.
The low FODMAP diet is not a forever diet. This is perhaps the biggest misconception I hear. The low FODMAP diet is a temporary, restrictive, systematic way of eating to figure out what foods may be bothering you. The way a low FODMAP diet works is essentially this: you go 2-6 weeks eating only low FODMAP foods. This gives you body a chance to get rid of FODMAPS in your digestive system, and for symptoms to reside. If symptoms do not reside in this time, the low FODMAP diet is discontinued. This is because it is a restrictive way of eating, which puts you at risk for nutrient deficiencies; and likely you will not respond to the rest of the diet anyways. You would be referred back to your GI doctor for further testing to rule out other health conditions. If symptoms reside, then you progressively work back in FODMAPS in a structured, systematic way in increasing doses to determine if a FODMAP bothers you, but also in what quantity you may be able to tolerate it. Sometimes too, a FODMAP in isolation may not bother you- but in addition to another FODMAP, you may have symptoms. So it can be kind of complicated to interpret, and should be done under supervision of an experienced professional like an IBS Registered Dietitian. Once you are done trialing all the FODMAPS, you will have a log of information that you can use to inform your food choices moving forward. You will go back to eating regularly, except for how you choose to move forward with FODMAPS you have identified that bother you.
For some FODMAPS, you do have options to include them in your diet still even if they bother you. There are over the counter enzymes you can take that will help you eat them more comfortably. For example, lactase enzymes. However it's important to note that while IBS can be disruptive and uncomfortable, it is not a life-threatening or harmful condition, and does not increase the risk of other serious digestive conditions.
If you think you may have IBS, it's important to speak with your healthcare provider to rule out other potential conditions and develop a treatment plan that is tailored to your specific needs. Need help with a low FODMAP diet? You can book an appointment with me to get started!
