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FODMAPs: What They Are and How They Make You Sick

What does an artichoke, a garlic clove, a slice of bread, and a cup of yogurt have in common?

Not, that’s not a joke. I wish the answer’s funny!

All four have a type of carbohydrate, or sugar, that makes your stomach upset. Gas, boating, distended stomach, abdominal pain, diarrhea, lose stool, and constipation.

An embarrassing topic it may be, but hey, I’m a dietitian. These stuff matter. We talk digestive system, with all what it encompasses.

They’re called FODMAPs

In my last post, I shared a tofu stir-fry recipe with FODMAPs modification. Let me make an introduction.

The types of sugars that cause these symptoms are called FODMAPs, which stands for Fermentable Oligo-, Di- and Mono-saccharides And Polyols. They’re found in certain grains, fruits, vegetables, dried peas and beans, milk products, honey, agave, high fructose corn syrup, certain sugar-free products, and certain prepared foods and beverages including high-fiber products.

If these sugar don’t get absorbed in the small intestine, they travel to the large intestine where the meet the healthy bacteria in your gut. The bacteria then rapidly eat, or ferment, them, producing gas that makes your large intestine swell.

That’s when you become bloated and in pain.

These FODMAPs also pull fluids out of your cells and into your large intestine, causing pain and watery, urgent diarrhea. Sometimes, the changes in  fluid balance and gas production in your gut are associated with constipation.

What’s IBS?

IBS, irritable bowel syndrome, is a common functional gastrointestinal disorder with the symptoms I just described; gas, bloating, distention, abdominal pain, diarrhea, lose stool, and/or constipation. It’s fairly common: 1 in 7 people have IBS, and it’s more common in women than in men.

What’s even more interesting is that there are more undiagnosed IBS cases than diagnosed. A 2005 phone survey found that 14% of participants had IBS, but only one fifth of them were medically diagnosed cases. Those who had IBS took more days off, spent more days in bed, and were less active than those who didn’t have any symptoms.

I believe it. Would you go for a walk, a bike ride, or even run errands when there’s a big chance you’ll have an urgent need to go and no place to do so? Can you sit in a professional meeting for an hour when your stomach hurts and you can barely hold the gas in? I didn’t think so.

People with IBS also take more meds, visit doctors more often, and are hospitalized more frequently that people without it.

Do NOT self diagnose IBS–that could hurt you!

It’s very important to not self diagnose IBS. That’s because it has similar symptoms to more serious conditions, such as celiac disease, certain cancers, small intestinal bacterial growth (SIBO), liver disease, malnutrition, or inflammation in your gut. Please see a doctor who can rule out a serious condition.

FODMAPs and IBS

All FODMAPs cause the same IBS symptoms, and their effect is cumulative. The more FODMAPs you eat in a meal or a day, the worse your symptoms can be.

A low FODMAPs diet is based on the concept that if you take these sugars out of the diet, the person will not suffer from symptoms. It’s based on research from the Monash University in Australia. I give my IBS clients a somewhat limited diet (I don’t usually limit diets but that’s a special case) for two weeks, and track symptoms. Once gone, we start introducing one type of sugars at a time to figure our exactly which one is the culprit. Why should you avoid onions if milk is what makes you sick? The goal is finding the most liberal diet you can tolerate without pain.

Symptoms Still There!

If you follow a low FODMAPs diet and still get sick, then something else is causing the problem.

If you don’t feel better on low FODMAPs,

your immune system is most likely acting out

Your immune system is thinking that something you eat is a foreign substance, or toxin, and triggering it to fire up. In this case, you need a completely different approach, food sensitivity testing and special program. Take it seriously, you don’t want your body to be at a chronic state of war. That causes inflammation.

Want more?

If you google ‘FODMAPs’ you will find many, many websites and people talking about them. Make sure you get your info from a reliable source. All this research is new and continuously changing. The best place is The Monash University, which released a low FODMAP diet App just 3 days ago. The app is useful, but it doesn’t you should bypass seeing a FODMAP Nutritionist to get you started on the right track. My other go-to website is a colleague who’s been a leader in FODMAPs diet in the US, Kate Scarlata. Her blog if full of low FODMAP recipes. I will be incorporating those modifications in my recipes too.

Remember… don’t self diagnose.

 

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Comments on this entry are closed.

  • Dixya @ Food, Pleasure and Health December 20, 2012, 4:49 pm

    very informational post because people normally people are so embarrassed to discuss their GI issues. I saw Kate’s blog few months ago and loved it.