Introducing the FODMAP diet


Low-FODMAP foods Amy can eat
Low-FODMAP foods can eat (Photo credit: gumption)

I have been living with a problem for the last 12 years or longer. I have Irritable Bowel syndrome. I got the diagnosis in 2004 after my first colonoscopy (and in my first year as a nurse). The best treatment at the time was fiber. I either had to eat a high fiber diet or take additional supplements. Matters improved somewhat, but I still had episodes of the constipation and diarrhea cycle. I was getting worse in January of 2013 so I saw a gastroenterologist for another scope. Had a polyp removed that time, but nothing new. Most physicians who have been around a while assume that I know as much as they do (granted we have to shoot them down frequently as residents because at that point we do), but I don’t always keep up on the latest with specialties that don’t usually see the ICU. My family practice doc just usually spouts off the current screening recommendations for me and lets me decide what gets ordered or ignored. So food intolerance that does not progress to anaphylaxis is usually off my radar.

For some reason, I started searching for information on IBS treatment last week. I was wondering if I had lactose intolerance. Then I discovered fructose malabsorption. This sounded more like when I would have my IBS flair ups.

I came across some information out of Australia for IBS treatment with diet adjustments. It is called the low FODMAP diet. It was developed at Monash University in Melbourne, Australia in 2005. FODMAP stands for Fermentable Oligo-Di-Monosaccharides and Polyols. Now I have a Bachelor’s degree in chemistry and I barely can pronounce the name. Not only that but I currently work in a teaching hospital with a medical school attached and I cannot find any patient education sheets on this diet.

Fermentable = the process which gut bacteria degrade undigested carbohydrate to produce gases (hydrogen, methane & carbon dioxide)
Oligo-saccharides = Fructo-oligosaccharides of wheat, rye, garlic and onions. Galacto-oligosaccharides of beans and legumes.
Di-saccharides = Lactose found in milk, soft cheese and yogurt
Mono-saccharides = Fructose (in excess of glucose) found in honey, apples and high fructose corn syrup
Polyols = Sugar polyols (e.g. Sorbitol, mannitol) found in some fruit and vegetables and used as artificial sweeteners

When I was in New Hampshire this winter, a coworker had gluten intolerance so I decided to try reducing my gluten intake. It sort of worked. But I moved and did not keep it up. I had also done better in Vermont. What I think happened there was I was eating a lot of fresh farm produce and fewer high fructose foods. I thought Vermont should have “Peace, Love & eat local organic food” for their motto. I think I was getting pieces of the FODMAP diet without realizing it, but the lack of full knowledge prevented me from putting things together.

So now that I have discovered the diet, I might cover a bit of the challenge of adjusting my diet and discovering what I can and cannot tolerate.

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