Is FODMAP Diet the Solution for Irritable Bowel?

Apr 5, 2024 | Nutrition

The acronym FODMAPs stands for “fermentables, oligosaccharides, disaccharides, monosaccharides, and polyols”.

Why is gluten exclusion considered outdated?

It is one of the most frequent disorders of the gastrointestinal system and affects 10-15% of the population, in a greater number of women. Until now, the “solution” to the bothersome symptoms of irritable bowel patients has been to avoid the foods that trigger the syndrome. So they were able to feed on a very limited range of foods. A new nutritional approach, however, seems to be a very good alternative for people suffering from Irritable Bowel Syndrome. Pathologist Kaiti Constantinou PhD from the University of Heidelberg in Germany is the person we sought to tell us more.

How can someone know that they suffer from Irritable Bowel Syndrome?

Irritable Bowel Syndrome is a chronic functional disease of the intestine. It is due to a motility disorder of the intestine without presenting any organic damage to it. An increased intestinal motility is observed in response to any intestinal distension with an increased sensation of pain. The diagnosis of Irritable Bowel Syndrome is made only by symptoms such as abdominal pain, discomfort, increased gas production, bloating, and changes in bowel movements, and the absence of any organic damage.

Where is it due to?

According to new studies, it occurs due to deregulation of the central nervous-enteric nervous system axis. In other words, more simply, while in a person who does not suffer from irritable bowel, a small distension of the intestine due to gas does not cause any pain, in people with Irritable Bowel Syndrome, the same distension gives a signal to the brain that the intestine is over-inflated and pain is caused. Reasons that can lead to this dysregulation of the intestinal nervous system can be genetic factors, situations of intense stress or other psychological factors following an intestinal infection, such as the changes that can occur in the balance of intestinal bacterial flora. For example, some people can have a larger number of gas-producing bacteria in their intestines than others.

Many patients with irritable bowel syndrome find that the solution is a gluten-free diet.

Due to the fact that the intestine does not present any organic problem but is only a functional syndrome, it does not pose a risk to the patient’s life, but it significantly affects the quality of his life and puts in limitations on his diet and daily life. Many resort to a gluten-free diet which is a highly restrictive diet resulting in improvement of symptoms.

This is of course due to coincidence since the gluten-free diet significantly limits wheat, so that it simultaneously reduces the consumption of fructans contained in it.

So millions of patients follow a gluten-free diet without ever being diagnosed with celiac disease. The number of people who actually have celiac disease and need to follow this diet is much smaller because it is a rare condition.

What they don’t know is that the solution for those who feel better when they don’t eat gluten and don’t have celiac disease may lie in the FODMAP diet.

More about the FODMAP diet and how it can help someone with irritable bowel?

The FODMAP diet is poor in non-absorbable fermentable carbohydrates (fermentable oligo-di- and monosaccharides and polyols). These carbohydrates are very short chains of food sugars that are not broken down during digestion. So they reach the small intestine where they cannot be absorbed and end up in the large intestine where the microorganisms that make up the microbial flora of the intestine begin to “eat” them resulting in the production of gas as well as the absorption of many liquids in the intestine and this is how the intestine feels very swollen and sore.

Several scientific studies have already shown that a diet low in FODMAPs is effective in the management of Irritable Bowel Syndrome since over time and due to the failure of several drugs that have been tested in its treatment, the diet seems to have the main role in regulating the symptoms.

More specifically about FODMAP carbohydrates

FODMAP carbohydrates are found in oligosaccharides such as carbohydrates that include fructans, fructose, and galacto-oligosaccharides eg wheat, barley, garlic, onion, broccoli, legumes, etc. In monosaccharides such as fructose, for example in apples, pears, fruit juices, etc. In disaccharides such as lactose in dairy products and in polyols such as sorbitol, mannitol, xylitol, and other substances.

And these carbohydrates should sufferers avoid?

Initially, patients must limit the consumption of foods with an increased FODMAP content for six weeks, and then when the symptoms subside, there will be a gradual reintroduction of the foods and a review of the symptoms.

Is the diet plan easy for someone to implement on their own?

The implementation of such a diet is best achieved with the help of a specialist who will design an individualized diet in the absence of such foods, but nevertheless a nutritionally balanced diet.