Julianne Body Temple: Low FODMAPS Diet for Irritable Bowel Syndrome

FODMAPs are found in the foods we eat and they can cause symptoms of Irritable Bowel Syndrome (IBS) when poorly absorbed by people.

Irritable Bowel Syndrome (IBS) is the most common digestive complaint, suffered by one in seven adults. It can occur at any age, but most likely between the ages of 20-60, with women being more susceptible than men. Sufferers report feeling pain in the belly, bloating and wind; and bouts of either diarrhoea or constipation (or both).

A diagnosis of IBS is usually made by exclusion; when nothing else can be found. It was once suggested IBS was "all in the mind", however we now know the causes are very real. People with IBS are very sensitive to bowel distension (stretching) and gut changes. Previously, stress and an attack of ‘gastro' were thought to be triggers, however recent nutrition research has revealed the effects of food on IBS symptoms. This has lead to new dietary approaches and the Low FODMAPs diet.

Possible dietary triggers for IBS

Alcohol, caffeine, fatty or spicy foods, too little or too much fibre
Naturally occurring food chemicals -such as salicylates, amines and glutamates, and
Poorly digested carbohydrates known as FODMAPS

FODMAPS stands for:

F - Fermentable
O - oligo-saccharides (galacto-oligosaccharides [GOS] and fructans)
D -Disaccharides (lactose)
M - Monosaccharides (fructose)
A- and
P - Polyols (sorbitol and mannitol)

FODMAPS are carbohydrates that are not fully digested in our bodies. They pass through our small intestine to the large bowel where they are fermented by naturally occurring bacteria. This results in the production of gas, and additional fluid being drawn into the bowel. It is this gas and fluid which causes pain in IBS sufferers.

So how do you find out if your IBS is triggered by diet, such as FODMAPs? Your GP can refer you for blood and breath tests. Firstly coeliac and other gut disorders must be ruled out. Then breath tests can be done to see if you are poorly absorbing some carbohydrates like lactose, fructose, mannitol and sorbitol.

FODMAP Problem Fruits
High Fructose	High Fructans	High Polyols
Apple	Peach	Apple
Cherries	Rambutan	Apricot
Mango	Watermelon	Blackberries
Pear		Lychee
Watermelon		Nectarine
Honeydew		Nashi fruit
Figs		Pear, plum, prune

Problem vegetables
High Fructose & GOS	Polyols	High fructose
Artichokes	Cauliflower	Sugar snap peas
Beetroot	Mushroom	Asparagus
Brussel sprouts, cabbage	Snow peas
Garlic
Chicory
Onion - brown/white, spring onion, shallot, onion powder, leek
Legumes/lentils - chickpeas, baked beans, 4 bean mix

Other foods containing FODMAPS

Honey
High fructose corn syrup
Coffee substitutes
Dandelion tea
Fruit pastes and sauces
Fruit juice
Sweet wines
Coconut milk/ cream
Sugar substitutes (with names ending in '-ol', eg sorbitol)
Wheat based products - bread/ pasta/ cereals/ noodles/ biscuits
Milk products - milk, yoghurt, icecream, soft cheeses

Suitable low FODMAP fruits and vegetables
Bananas	Lime
Bean shoots	Olives
Blueberries	Rhubarb
Green beans	Potato
Raspberry	Mandarin
Bok choy	Lettuce
Rockmelon	Passionfruit
Capsicum	Pumpkin
Honeydew melon	Paw-paw
Carrot	Spinach
Durian	Pineapple
Celery	Squash
Grapes	Strawberry
Cucumber	Swede
Grapefruit	Tangelo
Endive	Tomato
Kiwi	Alfalfa
Eggplant	Turnip
Lemon	Bamboo shoots
Ginger	Zucchini

If you think certain foods may cause discomfort and aggravate your IBS symptoms, seek advice from an accredited practising dietitian (APD). A dietitian can help you navigate the Low FODMAP diet and pinpoint which foods you can tolerate and in what amounts. Some people react to small amounts of, say, fructose yet others can tolerate larger quantities. The low FODMAP diet restriction period is usually 6-8 weeks, followed by a controlled reintroduction of various FODMAPs to find out which ones affect you. At the end of the process - which can take many months - you will know what foods affect your IBS and be reassured your diet is also balanced and healthy.