FODMAP’s: an individualized diet approach for gut relief

Digestive diseases are prevalent in the U.S. population. Of these diseases, Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder estimated to affect approximately 15 percent of Americans. The common symptoms of Irritable Bowel Syndrome are chronic lower abdominal pain, constipation, diarrhea and bloating. While several treatments are available to manage symptoms of IBS, a growing number of research studies show that specific modifications to the types of carbohydrates in the diet can assist in managing these symptoms.

Sue Shepherd, a registered dietitian, and her colleagues from Monash University researched the impact of eliminating specific short chain carbohydrates (FODMAPs) to manage symptoms related to IBS. Their research showed that significant relief from IBS related symptoms was achieved when individuals reduced the number of FODMAPs in the diet.

FODMAPS (Fermentable, Oligo, Di- and Mono- Saccharides and Polyols) are found naturally in foods such as, but not limited to: milk; fruit; honey, high-fructose corn syrup, wheat, onions, garlic inulin, beans and oolong tea. When these types of carbohydrates are consumed in excess they are not well absorbed and remain in the gut. As a result, water is then pulled into the intestinal tract and contributes to bloating and cramping. The gut bacteria increase in activity in an effort to breakdown these carbohydrates. The increase in gut bacteria activity results in gas production.

Since FODMAP’s are widely found in the typical diet, it is important to work with a specialist trained in identifying the foods containing these carbohydrates and their effect on the gut. The dietitian is specially trained to methodically guide the client in properly applying the FODMAP elimination and challenge diet. Under the supervision of the dietitian, an eight-week trial reducing the intake of moderate to high FODMAP foods is initiated. The dietitian will work with the clients to ensure nutritional adequacy is maintained during this phase. After the eight-week elimination, the client returns to the dietitian to review symptom improvement. The dietitian will then determine the type and amount of FODMAP foods to add back into the diet.

For more information on FODMAP diets and the related research, go online to http://www.med.monash.edu/cecs/gastro/fodmap/.

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Jennifer Dalton is the director of didactic program in dietetics at the University of Dayton. She teaches courses on nutrition and health and is an expert on functional nutrition, celiac disease and digestive health.

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