Do you suffer from chronic gastrointestinal pain and discomfort? If so, a low-FODMAP diet may be just what you need.
Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal (GI) disorder characterized by
abdominal pain or discomfort, and changes in bowel movement patterns and defecation (1, 2).
There are four IBS subtypes, including IBS + diarrhea, IBS + constipation, mixed IBS and unsubtyped IBS, with IBS + diarrhea being the most common. The physiological mechanism differs depending on subtype. IBS can be attributed to visceral hypersensitivity, altered brain-gut signaling, immune dysregulation, microbiota, and psychosocial factors (1).
IBS-related symptom relief can often be found through modifying dietary fiber intake and restricting potential triggers such as caffeine, alcohol, and fat. However, a new dietary approach, known as the low-FODMAP diet, has been proven to relieve pain and discomfort in patients with IBS (1).
With annual IBS-related healthcare costs up to $1.66 billion, the low-FODMAP diet may prove to be an affordable and symptom-relieving solution (1). This diet “produces gastrointestinal symptom relief by reducing the fermentable load on the colon, in order to reduce gas production and luminal distension” (2).
FODMAP stands for Fermentable Oligosaccharide, Disaccharide, Monosaccharide, And Polyol. These short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production, which induces GI symptoms in those with IBS (1).
In addition to a low-FODMAP diet, patients with IBS have found yoga to be helpful in symptom relief. A 2018 randomized controlled trial investigated the effect of a yoga-based intervention versus a low-FODMAP diet on 59 patients with IBS. Although there was no statistically significant difference between groups, there was a statistically significant difference within each group. In other words, both yoga and a low-FODMAP diet were equally beneficial in reducing GI symptoms (2).
Research has also compared a high- and low-FODMAP diet in athletes with a history of nonclinical exercise-associated GI symptoms. Compared to the athletes on the high-FODMAP diet, athletes on the low-FODMAP diet had significantly lower GI symptoms including flatulence, urge to defecate, loose stool, and diarrhea (3).
Similar randomized controlled trials examined the effects of a low-FODMAP diet on patients with IBS and found significant reductions in symptom relief (4, 5, 6), In addition to symptom relief, two additional studies found an improved quality of life in participants assigned to a low-FODMAP diet (7, 8).
Although the low-FODMAP diet brings symptomatic relief to those with IBS, starting this diet can be daunting. Similar to most diets, a low-FODMAP diet is restrictive in nature. You can say goodbye to lactose-containing products, a range of fruit high in fructose, wheat-based products, onions and garlic, and fruits with pits (3).
To guide you through this process, a registered dietitian can help you 1) eliminate FODMAPs from your diet and 2) monitor your symptoms while gradually adding FODMAPs back into your diet.
To learn more about the low-FODMAP diet, visit Harvard Health Publishing.
References
(1) Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017; 66(8): 1517-1527.
(2) Schumann D, Langhorst J, Dobos G, Cramer H. Randomised clinical trial: yoga vs a low-FODMAP diet in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2018; 47(2): 203-211.
(3) Lis DM, Stellingwerff T, Kitic CM, Fell JW, Ahuja KD. Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes. Med Sci Sports Exerc. 2018; 50(1): 116-123.
(4) Staudacher HM, Lomer MCE, Farquharson FM, Louis P, Fava F, Franciosi E, Scholz M, Tuohy KM, Lindsay JO, Irving PM, Whelan K. A Diet Low in FODMAPs Reduces Symptoms in Patients With Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled Trial. Gastroenterology. 2017; 153(4): 936-947.
(5) McIntosh K, Reed DE, Schneider T, Dang F, Keshteli AH, De Palma G, Madsen K, Bercik P, Vanner S. FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial. Gut. 2017; 66(7): 1241-1251.
(6) Böhn L, Störsrud S, Liljebo T, Collin L, Lindfors P, Törnblom H, Simrén M. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015; 149(6): 1399-1407.
(7) Harvie RM, Chisholm AW, Bisanz JE, Burton JP, Herbison P, Schultz K, Schultz M. Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs. World J Gastroenterol. 2017; 23(25): 4632-4643.
(8) Pedersen N, Ankersen DV, Felding M, Wachmann H, Végh Z, Molzen L, Burisch J, Andersen JR, Munkholm P. Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease. World J Gastroenterol. 2017; 23(18): 3356-3366.
Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University