FODMAP: Winning the Battle Against IBS.

June 6, 2024

Irritable Bowel Syndrome (IBS) is a common digestive disorder that affects mostly the large intestine in about 11% of the global population.⁶

These symptoms can be life altering and embarrassing.

How do you Identify Signs of IBS?

Abdominal bloating.
Intestinal pain or cramping. Typically, in the lower abdomen.
Aggravated by eating or emotional stress.
Relieved by defecation.
Changes in stool frequency or consistency.
Altered bowel habits.
Alternating from diarrhea to constipation.
Intestinal gas.
Feeling of incomplete defecation.
Rectal urgency.
Passage of clear or white mucus during defecation.
Anxiety and depression.
Fatigue.

So, what can be done about it?

Pinpoint Food Triggers.

Diet can be a common trigger for IBS symptoms, as certain foods like fatty foods, spicy foods, alcohol, caffeine, and artificial sweeteners can worsen symptoms in individuals with IBS. However, it is important to note that specific food triggers can vary from person to person, so it is necessary to identify individual dietary triggers.²

Dietary Interventions

Following the FODMAP diet has proven to bring about significant improvements in IBS symptoms for some people. These foods need to be eliminated for 2-6 weeks or until symptoms have ceased.

“FODMAP” is the acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, a group of short-chain carbohydrates and sugar alcohols.

FODMAP diet are elimination or drastic reduction of all:

High lactose foods (e.g. milk, yoghurt).
High oligosaccharide foods (e.g. chickpeas, lentils).
High fructose foods (e.g. certain fruits and honey).
High fructan foods (e.g. wheat, onion).
High polyol and polyol-sweetened foods (e.g. certain fruits and confectionery).

The below list gives a more detailed breakdown.³

FOODS TO AVOID

Avoid for at least 2 weeks or until there has been a significant reduction in symptoms.

Fructose

Fruits: apples, boysenberries, cherries (>3), figs, pears, nashi pears, peaches, mango, watermelon, tamarillo, tinned fruit, dried fruit, large serves of fruit.

Vegetables: asparagus, artichokes, sugar snap peas.

Sweeteners: honey, fructose (>5.0g daily*), high fructose corn syrup, agave. Drinks: fruit juice, soft drinks sweetened with fructose, sparkling wine, dessert wine, ciders, rum.

Fructans

Fruits: custard apples, nectarines, peaches, persimmon, rambutan, tamarillo, watermelon.

Vegetables: artichokes, asparagus (>3), beetroot (>4 slices), brussel sprouts (>½ cup), broccoli (>½ cup), cabbage - savoy (>1 cup), chicory root, corn (>½ cob), fennel (>½ cup), garlic, leeks, okra, onions, peas (>1∕3 cup), radicchio lettuce, snow peas (>10), spring onion (white part).

Cereals: wheat, rye, barley products (bread, pasta, couscous, crackers, biscuits), inulin.

Nuts: cashews, pistachios, almonds (>10)

Galactans

Legumes: all (chickpeas, lentils, dried/canned beans, baked beans, whole soy beans).

Drinks: soy milk.

Lactose

Milk: cow, goat and sheep.

Cheese: fresh (cottage, ricotta, cream cheese, mascarpone).

Other dairy products: yoghurt, ice cream, custard.

Polyols

Fruits: apples, apricots, avocado (>¼), blackberries, cherries (>3), longan (>10), lychees (>5), nashi pears, nectarines, pears, peaches, plums, prunes, watermelon.

Vegetables: cauliflower, celery (>1 stick), mushrooms, snow peas, sweet potato (>½ cup).

Sweeteners: sorbitol (420), mannitol (421), xylitol (967), maltitol (965), isomalt (953).

FOODS TO ENJOY

Fruit: Banana, blueberries, grapefruit, grapes, honeydew melon, kiwifruit, lemons, limes, mandarins, oranges, passionfruit, paw paw, pineapple, raspberries, rock melon, tomatoes.

Vegetables: Alfalfa, bamboo shoots, bean sprouts, bok choy, carrot, cabbage (common), capsicum, choko, choy sum, eggplant, green beans, lettuce, chives, parsnip, potato, pumpkin, radish, silver beet, spring onion (green only), squash, zucchini.

Cereals: Gluten-free products, spelt, corn, oats, polenta, quinoa, rice (note: gluten is not a FODMAP but commonly occurs with fructans).

Nuts: (<1 handful daily) macadamias, peanuts, pecans, pine nuts, pumpkin seeds, sesame seeds, sunflower seeds, walnuts.

Dairy/dairy alternatives Milk and cheeses: lactose-free cows’ milk, rice milk, almond milk (inulin free), most cheeses (e.g. brie, camembert, cheddar, fetta). Other dairy products: butter, yoghurt (lactose-free coconut), dairy free gelati, sorbet.

Sweeteners: Sugar (sucrose), glucose, maple syrup, golden syrup, stevia, sucralose.

Meat: Beef, lamb, kangaroo, poultry, eggs, tofu, tempeh (up to 160 g per day).

Top Tips to Help you Complete FODMAP Reintroduction:

After the elimination process, the goal is to systematically reintroduce small amounts of each FODMAP-rich food to determine the level of consumption that an individual can comfortably tolerate.

At approximately the same time each day, one at a time reintroduce a new food from the FODMAP list. It is important to leave a 3-day gap between introducing each new food.

If symptoms return for that food, then you must avoid this food again for a minimum of 2 to 6 weeks before re-introducing it again.

It is very important not to reintroduce the next food until your symptoms have ceased.⁵

Support Stress Levels

While the exact mechanism by which stress affects IBS is not fully understood, it is believed to be related to the interaction between the brain and the gut.²

Stress and emotional factors also play a role in IBS, as many people with the condition experience worsening symptoms during times of high stress or anxiety.

Ensure adequate sleep, achieving approximately eight hours of sleep each night.

Reduce physical symptoms of stress through regular relaxation and exercise, including activities that involve progressive muscle relaxation and breathing control (yoga, pilates, meditation), and cardio exercise. Aim for thirty-minute sessions, three times per week.

Test for Infections Via Stool and Blood Tests

Infections, specifically gastroenteritis, which involves an infection or inflammation of the digestive tract, can contribute to the development of IBS in some individuals.²

If you’re looking for support in helping manage your IBS symptoms, consider a targeted probiotic supplement with specific strains of bacteria to combat the symptoms of IBS.

Inner Health IBS Control

Inner Health IBS Control is a shelf stable probiotic formulated to reduce IBS symptoms in 4 weeks. Taking 1 capsule daily helps to:

Relieve & reduce the occurrence of medically diagnosed irritable bowel syndrome symptoms.
Reduce & relieve gut pain, discomfort, intestinal gas & bloating.
Support healthy bowel function.

Inner Health IBS Support

Inner Health IBS Support is a fridge probiotic that helps to reduce the symptoms of medically diagnosed IBS. Taking 1 to 2 capsules daily also helps to:

Maintain normal bowel functions.
Reduce gas & pain.
Promote healthy digestion.
Support intestinal bacteria in healthy adults.

References

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FODMAP: Winning the Battle Against IBS.