IBS and a low-fodmap diet

A group of poorly digested carbohydrates (FODMAPs) could well be responsible for triggering the symptoms of irritable bowel syndrome. The poorly absorbed large molecules of these foods make their way to the colon, where the action of bacteria cause them to ferment, resulting in bouts of gas, bloating and bowel problems. A number of studies have shown that the majority of patients with IBS who try a low-FODMAP diet experience a significant lessening of symptoms.

Irritable bowel syndrome (IBS) is a chronic and often disabling condition manifested by abdominal pain, a change in bowel habits (diarrhea and constipation), abdominal distention and intestinal gas. IBS affects 10-20 percent of the U.S. population (more women than men) and accounts for about half of all visits to gastroenterologists. IBS is not a disease in which structural or tissue abnormality occurs, but a functional disorder defined by its symptoms. The mechanisms causing them are not fully understood, but we know they include hyper- sensitivity to visceral sensation, altered motility (movement of food through the digestive tract), abnormal colonic fermentation and sugar malabsorption. Most patients with IBS, however, report that their symptoms seem to be related to the foods they eat. In recent years, attention has been focused on diets that reduce the intake of poorly absorbed complex carbohydrates, called FODMAPs. The acronym stands for fermentable oligo-, di-, and mono-saccharides and polyols. Research studies have shown that a low-FODMAP diet helps the majority of patients with IBS.

FODMAPS have a cumulative effect on GI symptoms, so people with IBS may be able to tolerate small amounts of them and experience symptoms only when they’ve consumed enough to surpass their FODMAP threshold. To keep to a low-FODMAP diet requires careful reading of the labels on prepared foods. Gluten- free products, though often low in FODMAPs, are not uniformly safe— many contain honey, pear juice, onions or garlic for flavoring. remember that ingredients are listed with the most predominant ones first. So, for example, if a FODMAP ingredient is listed last, the amount is likely to be quite small. Generally, try to avoid products in which multiple FODMAPs are present.