Many with IBS just have fodmap senstivity. Largely to fruit and veg. Fodmaps are little fermentable carbohydrates that people with IBS cant digest well, they irritate the gut and cause irritable bowel syndrome like bloating, gas, abdominal pain and diarrhoea. A FodMap is a term that has been highlighted in the new emerging world of good gut health in the last few years. FodMap is an acronym for Fermentable, Olligo, Di, Monosaccharides and Phenols. FodMaps are mostly not bad for you, in fact most of them are really good for you but for people with digestive distress the Fodmap content in a food item may cause digestive difficulties. It does sound complicated but to explain it simply it really just refers to a group of foods that cause IBS. My symptoms at their worst felt like balloons were being blown up inside my stomach pushing my organs out. I also felt I couldn’t digest normally that the food was stuck like “logs in my stomach”. At night i would have to rub and massage my stomach to alleviate it. At night I often felt like my food was sitting there undigested. I had undiagnosed SIBO. I had IBS because i couldnt tell what food were effecting me.
What foods contain fodmaps?
Fructose: High corn fructose syrup, agave, honey, certain fresh fruits such as apples, unripe pears, unripe peaches, mangoes, watermelon, coconut, dried fruits, fruit juices.
Fructans: Wheat, Rye, inulin and fructoligosaccharides are added to food products and vitamin supplements and fibre supplements. Some vitamin supplements contain inulin and chicory root as their filling ingredients and this particularly is a reason why individuals with SIBO cannot tolerate over the counter probiotic supplements.
Vegetables such as artichokes, asparagus, bean shoot, broccoli, brussels sprouts, cabbage, chicory, garlic, leaks, onions, lettuce, and shallots, snow peas.
Galactans: Chickpeas, lentils, kidney beans, soy products, and in some vegetables such as broccoli. The stalks of broccoli, spinach and kale are particularly full of fibre so they are particularly difficult to digest for people with SIBO so it is advised cut off the stocks of broccoli prior to cooking them or prior to eating them, if you suffer from digestive distress. Do not eat raw broccoli!
Polyols– sweeteners such as xylitol, sorbitol, mannitol, ingredients found in sugar free gums, mints and sweets and certain fruits such as apples, apricots, blackberries, cherries, nectarines, peaches, pears, plums, prunes , watermelon, vegetables such as cauliflower, white button mushrooms, and snow peas.
Then biggest fodmap culprits for many people are lentils, kidney beans, chickpeas, onions and garlic, apples and unripe pears, broccoli, kale and spinach, peanuts, currants an sultanas. All the healthy high fibre veg! A plant based diet does not get rid of your IBS.
Gluten and Dairy have fodmaps but so do fruit and veg and sweet things and alcohol. Obviously whole foods and wholegrains are prevalent in the diet and for good reason. When your gut is working fine, eating vegetables, and whole grains provides your friendly flora with valuable nutrients that they then ferment into beneficial substances, short chain fatty acids called butyrate, which do a great job to fill any holes in your leaky gut and therefore strengthen you gut barrier and prevent inflammation of bits of proteins and undigested food particles going into your blood stream alerting your immune system something is not quite right.
The food sensitivity process is different for everybody. You might tolerate one or two of these items together or on their own but if you mix spinach with broccoli with cooked onions and cooked garlic you may have bloat and pain. Gluten and Dairy causes issues for some people but mostly for healthy people a plant based diet can cause huge issues because the fibre in the veg is too much for their system. They are sensitive to fodmaps. If they have SIBO especially. Once the gut lining heals you should be able to eat beans and high fibre veg.
However when your microflora are imbalanced, (I mean too many bad microbes versus the good guys), or if you have low stomach acid from anxiety or stress, bits of food may get stuck in your small intestines, and your gut microbes feast on these fodmaps too aggressively and this out of control microbial feeding causes exceeds your tolerable threshold for the amount of fodmaps your gut can handle and gas, bloating, and cramping are common in people that are sensitive to these foods. This is a condition known as SIBO that is not well know by GPs here. Dairy products are also fodmaps. Cows milk is particularly troubling for a lot of patients, but remember icecream, chocolate and yogurts are also dairy as well as cheese. Goats cheese and sheeps feta cheese are usually much better tolerated than cow cheese like cheddar. High fibre fruits and veg also are difficult for those to digest.
So the question on everyone mind is what the hell do I eat if I can’t eat all these Fodmaps?
The point is not too eliminate Fodmaps but try to figure out which exact ones are causing you digestive issues and reduce them for a time, take a few weeks to do your own version of the “The Low Fodmap Diet” until you figure out what your food sensitivities are and what is triggering your problem. Or do a gluten free diary free diet for 2 weeks and if thats not working then eliminate high fibre beans and veg for the following 2 weeks. You will know what foods are causing you a particular problem a few hours after eating them. As it takes a few hours to digest, fodmap sensitivities may not show up until 4 plus hours after eating.
For the most part people will know if they are gluten or dairy intolerant they will have figured it out years ago but for those that have ongoing digestive distress and by and large these people are eating a really healthy diet full of fiber and full of fruit and veg because after all The GP has told them “oh you have IBS so increase your fruit and veg and increase the fiber in your diet” but what he doesn’t know is that for those with digestive distress bloating and pain that increasing fruit and vegetables at this stage of your treatment protocol may be the worst thing to do! You need to reduce your fruit and veg for a while until you figure out what fodmaps are causing the pain and the bloating.
For example put one onion and two cloves of garlic in a Curry is usually ok. Be careful with adding broccoli or other members of the brassica family when you are eating onions and garlic because these are the biggest trigger foods for people with fodmap sensitivities. Loading broccoli on top of garlic and onions in a curry was one of my biggest triggers.
TOTAL FODMAP LOAD per MEAL: Watch your total fodmap load or how many fodmaps you stack together. Eating a fodmap heavy meal or a few plates in a restaurant may induce symptoms. Be sure not to overdo the amount of fodmaps you consume at one time. The bacteria produce hydrogen and methane gas in the small intestine because they are fermenting the carbohydrates that are stuck there as part of the digestive process and it is this gas that causes the bloating and the uncomfortable feeling.
The total amount of fodmaps one person can handle in a meal is very individualized to another. You have to follow your gut, you have to tailor your consumption based on your experience with them and how they make your gut feel. You might tolerate a banana but not be able to tolerate an orange with a banana.
Also if you are under chronic life stress you may not be able to hear what your body is saying. So you have to remove the stress first to hear what your gut is telling you either by going on medication or changing your life.
For more tips on gut health see Blog Blog – Go With Your Gut (polished.ie)